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Role of Alcohol Oxidative Metabolism in Its Cardiovascular and Autonomic Effects

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Aldehyde Dehydrogenases

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1193))

Abstract

Several review articles have been published on the neurobehavioral actions of acetaldehyde and other ethanol metabolites as well as in major alcohol-related disorders such as cancer and liver and lung disease. However, very few reviews dealt with the role of alcohol metabolism in the adverse cardiac and autonomic effects of alcohol and their potential underlying mechanisms, particularly in vulnerable populations. In this chapter, following a brief overview of the dose-related favorable and adverse cardiovascular effects of alcohol, we discuss the role of ethanol metabolism in its adverse effects in the brainstem and heart. Notably, current knowledge dismisses a major role for acetaldehyde in the adverse autonomic and cardiac effects of alcohol because of its low tissue level in vivo. Contrary to these findings in men and male rodents, women and hypertensive individuals are more sensitive to the adverse cardiac effects of similar amounts of alcohol. To understand this discrepancy, we discuss the autonomic and cardiac effects of alcohol and its metabolite acetaldehyde in a model of hypertension, the spontaneously hypertensive rat (SHR) and female rats. We present evidence that enhanced catalase activity, which contributes to cardioprotection in hypertension (compensatory) and in the presence of estrogen (inherent), becomes detrimental due to catalase catalysis of alcohol metabolism to acetaldehyde. Noteworthy, studies in SHRs and in estrogen deprived or replete normotensive rats implicate acetaldehyde in triggering oxidative stress in autonomic nuclei and the heart via (i) the Akt/extracellular signal-regulated kinases (ERK)/nitric oxide synthase (NOS) cascade and (ii) estrogen receptor-alpha (ERα) mediation of the higher catalase activity, which generates higher ethanol-derived acetaldehyde in female heart. The latter is supported by the ability of ERα blockade or catalase inhibition to attenuate alcohol-evoked myocardial oxidative stress and dysfunction. More mechanistic studies are needed to further understand the mechanisms of this public health problem.

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Acknowledgments

The authors’ reported studies cited in this book chapter were supported by NIH grants 2R01 AA07839 and 2R01 AA14441 (Abdel-Rahman) and by the Science and Technology Development Fund, Egypt, STDF Grant No. 14895 (El-Mas).

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Authors and Affiliations

  1. Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt

    Mahmoud M. El-Mas

  2. Department of Pharmacology and Toxicology, The Brody School of Medicine, East Carolina University, Greenville, NC, USA

    Abdel A. Abdel-Rahman

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  1. Mahmoud M. El-Mas
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  2. Abdel A. Abdel-Rahman
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Correspondence to Abdel A. Abdel-Rahman .

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Editors and Affiliations

  1. Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China

    Jun Ren

  2. Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China

    Yingmei Zhang

  3. Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China

    Junbo Ge

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El-Mas, M.M., Abdel-Rahman, A.A. (2019). Role of Alcohol Oxidative Metabolism in Its Cardiovascular and Autonomic Effects. In: Ren, J., Zhang, Y., Ge, J. (eds) Aldehyde Dehydrogenases. Advances in Experimental Medicine and Biology, vol 1193. Springer, Singapore. https://doi.org/10.1007/978-981-13-6260-6_1

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