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Medical and Nutritional Complications of Alcoholism pp 1–35Cite as

Metabolism of Ethanol

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Abstract

Ethanol is not only produced by yeast but can also be found in mammals in trace amounts (McManus et al., 1966). Bacterial fermentation in the gut is one way in which it is produced (Krebs and Perkins, 1970). How-ever, it is primarily an exogenous compound that is readily absorbed from the gastrointestinal tract. Only 2-10% of ethanol absorbed is eliminated through the kidneys and lungs; the rest is oxidized in the body, principally in the liver. The rate of ethanol removal from the blood is, indeed, remarkably decreased or halted by hepatectomy or procedures damaging the liver (Thompson, 1956). Moreover, the predominant role of liver for ethanol metabolism was shown directly in individuals with portacaval shunts undergoing hepatic vein catheterization (Winkler et al., 1969). Extrahepatic metabolism of ethanol is relatively small (Forsander and Raiha Niels, 1960; Larsen, 1959), except for the stomach (vide infra.) This relative organ specificity probably explains why, despite the existence of intracellular mechanisms to maintain homeostasis, ethanol disposal produces striking metabolic imbalances in the liver. These effects are aggravated by the lack of a feedback mechanism to adjust the rate of ethanol oxidation to the metabolic state of the hepatocyte and the inability of ethanol, unlike other major sources of calories, to be stored in the liver or to be metabolized or stored to a significant degree in peripheral tissues (Table 1.1). The hepatocyte contains three main pathways for ethanol metabolism, each located in a different subcellular compartment: the alcohol dehydrogenase pathway of the cytosol (or soluble frac-tion of the cell), the microsomal ethanol-oxidizing sys-tem located in the endoplasmic reticulum, and catalase located in the peroxisomes (Fig. 1.1).

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Authors
  1. Charles S. Lieber
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© 1992 Springer Science+Business Media New York

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Lieber, C.S. (1992). Metabolism of Ethanol. In: Medical and Nutritional Complications of Alcoholism. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3320-7_1

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  • DOI: https://doi.org/10.1007/978-1-4615-3320-7_1

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