Der Internist pp 317-322 | Cite as

Der Alkoholstoffwechsel

Bedeutung und metabolische Auswirkungen
  • H. K. Seitz
  • U. A. Simanowski


Aufgezeigt wird einmal der extrahepatische Stoffwechsel von Äthanol, der vor allem durch die Alkoholoxidation in der gastrointestinalen Mukosa und durch Darmbakterien gekennzeichnet ist, zum anderen der hepatische Stoffwechsel, der bei chronischer Alkoholzufuhr Adaptationsvorgängen unterliegt. Die Alkoholoxidation hat Auswirkungen auf den intermediären Stoffwechsel, so auf den Laktat-, Harnsäure-, Lipid-, Kohlenhydrat-, Steroid- und Porphyrinstoffwechsel, die bei chronischer Alkoholzufuhr nicht selten pathologischen Charakter annehmen.


Alkohol Alkoholdehydrogenase MEOS Leber-Stoffwechsel 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Baraona E (1985) Ethanol and lipid metabolism. In: Kommereil B, Seitz HK (Hrsg) Alcohol related diseases in gastroenterology. Springer, Berlin Heidelberg New York, pp 65–96CrossRefGoogle Scholar
  2. 2.
    Baraona E, Julkunen R, Tannabaum J, Lieber CS (1986) Role of intestinal bacterial overgrowth in ethanol production and metabolism in rats. Gastroenterol 90:103–110Google Scholar
  3. 3.
    Bode JC, Rust S, Bode C (1984) The effect of Cimetidine treatment on ethanol formation in the human stomach. Scand J Gastroenterol 19:853–856PubMedGoogle Scholar
  4. 4.
    Borowsky SA, Lieber CS (1978) Interaction of methadone and ethanol metabolism. J Pharmacol Exp Ther 207:123–129PubMedGoogle Scholar
  5. 5.
    Caballeria J, Baraona E, Lieber CS (1987) Cimetidine inhibits gastric alcohol dehydrogenase (ADH) and increases blood levels of ethanol after drinking. Gastroenterology 92:1722 (abstract)Google Scholar
  6. 6.
    DiPadova C, Worner TM, Julkunen RJK, Lieber CS (1987) Effect of fasting and chronic alcohol consumption on the first-pass metabolism of ethanol. Gastroenterology 92:1169–1173PubMedGoogle Scholar
  7. 7.
    Doss MO (1985) Alcohol and porphyrin metabolism. In: Kommereil B, Seitz HK (Hrsg) Alcohol related diseases in gastroenterology. Springer, Berlin Heidelberg New York, pp 232–252CrossRefGoogle Scholar
  8. 8.
    Faller J, Fox IH (1982) Ethanol-in-duced hyperuricemia: evidence for increased urate production by activation of adenine nucleotide turnover. N Engl J Med 307:1598–1602PubMedCrossRefGoogle Scholar
  9. 9.
    Frezza M, Pozzato G, DiPadova C (1987) Reduced first pass metabolism of ethanol and alcohol dehydrogenase activity as potential risk factors for increased alcohol related liver toxicity in women. Hepatology 31:1107 (abstract)Google Scholar
  10. 10.
    Garro AJ, Seitz HK, Lieber CS (1981) Enhancement of dimethylnitrosamine metabolism and activation to a mutagen following chronic ethanol consumption. Cancer Res 41:120–124PubMedGoogle Scholar
  11. 11.
    Haskell WL, Camargo C, Williams PT (1984) The effect of cessation and resumption of moderate alcohol intake on serum high density lipoprotein sub-fractions: a controlled study. N Engl J Med 310:805–810PubMedCrossRefGoogle Scholar
  12. 12.
    Hasumura Y, Teschek R, Lieber CS (1974) Increased carbon tetrachloride hepatoxicity and its mechanism after chronic ethanol consumption. Gastroenterology 66:415–422PubMedGoogle Scholar
  13. 13.
    Hoyumpa AM, Schenker S (1982) Major drug interactions: effects of liver disease, alcohol and malnutrition. Annu Rev Med 33:113–149PubMedCrossRefGoogle Scholar
  14. 14.
    Hulley SB, Gordon S (1981) Alcohol and high density lipoprotein cholesterol. Causal inference from diverse study design. Circulation 64:57–63Google Scholar
  15. 15.
    Iseri OA, Lieber CS, Gottlieb LS (1966) The ultrastructure of fatty liver induced by prolonged ethanol ingestion. Am J Pathol 48:535–555PubMedGoogle Scholar
  16. 16.
    Ishii H, Takagi T, Okuno F, Ebihara Y, Taschiro M, Tsuchiya M (1983) Ha-lothane-induced hepatic necrosis in ethanol preteated rats. In: Lieber CS (Hrsg) Biological approach to alcoholism. Res. Monograph, vol 11. Dept. of Health and Human Services, NIAAA, Maryland, pp 152–159Google Scholar
  17. 17.
    Julkunen RJK, DiPadova C, Lieber CS (1985) First pass metabolism of ethanol — a gastrointestinal barrier against the systemic toxicity of ethanol. Life Sci 37:567–573PubMedCrossRefGoogle Scholar
  18. 18.
    Kater RMH, Carulli M, Iber FL (1969) Differences in the rate of ethanol metabolism in recently drinking alcoholic and non-alcoholic subjects. Am J Clin Nutr 22:1608–1617PubMedGoogle Scholar
  19. 19.
    Koop DR, Morgan ET, Tarr GE, Coon MJ (1982) Purification and characterisation of an unique isoenzyme of cytochrome P-450 from liver microsomes of ethanol treated rabbits. J Biol Chem 257:8472–8480PubMedGoogle Scholar
  20. 20.
    Krebs HA, Perkins IR (1970) The physiological role of alcohol dehydrogenase. Biochem J 118:635–644PubMedGoogle Scholar
  21. 21.
    Leo MA, Arai M, Sato M, Lieber CS (1982) Hepatotoxicity of vitamin A and ethanol in the rat. Gastroenterology 82:194–205PubMedGoogle Scholar
  22. 22.
    Leo MA, Lieber CS (1982) Hepatic vitamin. A depletion in alcoholic liver injury in man. N Engl J Med 37:597–601CrossRefGoogle Scholar
  23. 23.
    Levin ML, Moodie AS (1974) Isoniazid prophylaxix and deaths in Baltimore, Maryland. A State Med J 23:64–74Google Scholar
  24. 24.
    Lieber CS, DeCarli LM (1970) Hepatic microsomal ethanol oxidizing system: in vitro characteristics and adaptive properties in vivo. J Biol Chem 245:2505–2512PubMedGoogle Scholar
  25. 25.
    Lieber CS (1984) To drink (moderately) or not to drink? N Engl J Med 310:846–848PubMedCrossRefGoogle Scholar
  26. 26.
    Lieber CS (1985) Ethanol metabolism and pathophysiology of alcoholic liver disease. In: Seitz HK, Kommerell B (Hrsg) alcohol related diseases in gastroenterology. Springer, Berlin Heidelberg New York, pp 19–47CrossRefGoogle Scholar
  27. 27.
    Mezey E (1976) Ethanol metabolism and ethanol-drug interactiona. Biochem Pharmacol 25:869–875PubMedCrossRefGoogle Scholar
  28. 28.
    Ohnishi K, Lieber CS (1977) Reconstitution of the microsomal ethanol oxidizing system (MEOS): qualitative and quantitative changes of cytochrome P-450 after chronic ethanol consumption. J Biol Chem 252:7124–7131PubMedGoogle Scholar
  29. 29.
    Pestalozzi DM, Bühler R, Von Wartburg JP, Hess M (1983) Immunohisto-chemical localization of alcohol dehydrogenase in the human gastrointestinal tract. Gastroenterology 85:1011–1016PubMedGoogle Scholar
  30. 30.
    Pikkarainen P, Baraona E, Jauhonen P, Seitz HK, Lieber CS (1981) Contribution of oropharnyx microflora and of lung microsomes to acetaldehyde in expired air after ethanol ingestion. J Lab Clin Med 97:631–636PubMedGoogle Scholar
  31. 31.
    Rubin E, Gang H, Misra PS, Lieber CS (1970) Inhibition of drug metabolism by acute ethanol intoxication. A hepatic microsomal mechanism. Am J Med 49:801–806PubMedCrossRefGoogle Scholar
  32. 32.
    Salaspuro M, Lindros KO (1985) Metabolism and toxicity of acetaldehyde. In: Seitz HK, Kommerell B (Hrsg) Alcohol related diseases in gastroenterology. Springer, Berlin Heidelberg New York, pp 106–123CrossRefGoogle Scholar
  33. 33.
    Sanchez-Craig M, Annis HM (1981) Gamma-glutamyltranspeptidase and high density lipoprotein cholesterol in male problem drinkers: Advantages of a composite index for predicting alcohol consumption. Alcoholism Clin Exp Res 5:540–544CrossRefGoogle Scholar
  34. 34.
    Sato C, Matsuda Y, Lieber CS (1981) Increased hepatotoxicity of acetaminophen after chronic ethanol consumption in the rat. Gastroenterology 80:140–148PubMedGoogle Scholar
  35. 35.
    Seitz HK, Garro AJ, Lieber CS (1981) Sex dependent effect of chronic ethanol consumption in rats on hepatic microsome mediated mutagenicity of ben-zo(a)pyrene. Cancer Lett 13:97–102PubMedCrossRefGoogle Scholar
  36. 36.
    Seitz HK, Korsten MA, Lieber CS (1979) Ethanol oxidation by intestinal microsomes: increased activity after chronic ethanol administration. Life Sci 25:1443–1448PubMedCrossRefGoogle Scholar
  37. 37.
    Seitz HK, Meydani M, Simanowski UA, Höpker WW, Blumberg JB, Russell RM (1987) Enhanced acute and chronic toxicity of alcohol with age due to an impairment of ethanol and acetal-dehyde metabolism. Gastroenterology 92:1772 (abstract)Google Scholar
  38. 38.
    Seitz HK, Simanowski UA (1987) Metabolic and nutritional effects of ethanol. In: Hathcock UN (Hrsg) Nutritional toxicology, vol 2. Academic Press, Orlando, pp 63–104CrossRefGoogle Scholar
  39. 39.
    Seitz HK, Simanowski UA (1988) Alcohol and carcinogenesis. Annu Rev Nutr 8: (im Druck)Google Scholar
  40. 40.
    Seitz HK, Veith S, Czygan P, Bösche J, Simon B, Gugler R, Kommerell B (1984) In vivo interactions between H2-receptor antagonists and ethanol metabolism in man and in rats. Hepato-logy 4:1231–1234CrossRefGoogle Scholar
  41. 41.
    Seitz HK (1987) Alkoholische Leberschäden. In: Kommerell B, Stiehl A, Czygan P (Hrsg) Gastroenterologie und Hepatologie, Bd. 5. Kohlhammer, Stuttgart, S. 300–322Google Scholar
  42. 42.
    Smith AC, Freeman RW, Harbison RD (1981) Ethanol enhancement of cocaine-induced hepatotoxicity. Biochem Pharmacol 30:453–458PubMedCrossRefGoogle Scholar
  43. 43.
    Taskinen MR, Välimäki M, Nikkilä EA, Kuusi T, Ehnholm C, Ylikahri R (1982) High density lipoprotein sub-fractions and postheparin plasma lipases in alcoholic men before and after ethanol witgdrawal. Metab Clin Exp 31:1168–1174PubMedCrossRefGoogle Scholar
  44. 44.
    Teschke R, Hasumura Y, Joly JG, Ishii H, Lieber CS (1972) Microsomal ethanol oxidizing system (MEOS): Purification and properties of a rat liver system free of catalase and alcohol dehydrogenase. Biochem Biophys Res Commun 49:1187–1193PubMedCrossRefGoogle Scholar
  45. 45.
    Van Thiel DH, Gavaler JS (1985) Ethanol and the endocrine system. In: Kommerell B, Seitz HK (Hrsg) Alcohol related diseases in gastroenterology. Springer, Berlin Heidelberg New York, pp 324–341CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • H. K. Seitz
    • 1
  • U. A. Simanowski
    • 1
  1. 1.Abteilung Innere MedizinMedizinische UniversitätsklinikHeidelbergDeutschland

Personalised recommendations