Hietala Johanna, Koivisto Heidi, Latvala Jaana, Anttila Petra, Niemelä Onni
Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, Seinäjoki, Finland.
Alcohol Clin Exp Res. 2006 Oct;30(10):1693-8. doi: 10.1111/j.1530-0277.2006.00204.x.
Alcohol abuse has been shown to result in the production of antibodies against acetaldehyde-modified epitopes in proteins. However, as yet, only limited information has been available on the clinical usefulness of such responses as markers of hazardous drinking.
We developed an ELISA to measure specific IgAs against acetaldehyde-protein adducts. This method was evaluated in cross-sectional and follow-up studies on male heavy drinkers with a current ethanol consumption of 40 to 540 g/d (n=40), moderate drinkers consuming 1 to 40 g/d (n=25), and abstainers (n=16). The clinical assessments included detailed interviews on the amounts and patterns of ethanol consumption and various biochemical markers of alcohol abuse and liver function.
The mean antiadduct IgAs (198+/-28 U/L) in the alcohol abusers were significantly higher than those in the moderate drinkers (58+/-11 U/L, p<0.001) or abstainers (28+/-8 U/L, p<0.001). The values of moderate drinkers were also higher than those in abstainers (p<0.05). The amount of ethanol consumed during the period of 1 month preceding blood sampling correlated strongly with antiadduct IgAs (r=0.67, p<0.001). The sensitivity (73%) and specificity (94%) of this marker were found to exceed those of the conventional laboratory markers of alcohol abuse in comparisons contrasting heavy drinkers with abstainers although not in comparisons contrasting heavy drinkers with moderate drinkers. During abstinence, antiadduct IgAs disappeared with a mean rate of 3% per day. In additional analyses of possible marker combinations, antiadduct IgAs, together with CDT, were found to provide the highest sensitivity and specificity.
Measurements of antiadduct IgAs may provide a new clinically useful marker of alcohol abuse, providing a close relationship between marker levels and the actual amounts of recent ethanol ingestion.
酒精滥用已被证明会导致产生针对蛋白质中乙醛修饰表位的抗体。然而，迄今为止，关于此类反应作为有害饮酒标志物的临床实用性的信息仍然有限。
我们开发了一种酶联免疫吸附测定法（ELISA）来测量针对乙醛 - 蛋白质加合物的特异性IgA。该方法在横断面研究和随访研究中对当前乙醇摄入量为40至540克/天的男性重度饮酒者（n = 40）、摄入量为1至40克/天的中度饮酒者（n = 25）和戒酒者（n = 16）进行了评估。临床评估包括关于乙醇摄入量和模式的详细访谈以及酒精滥用和肝功能的各种生化标志物。
酒精滥用者中抗加合物IgA的平均水平（198±28 U/L）显著高于中度饮酒者（58±11 U/L，p<0.001）或戒酒者（28±8 U/L，p<0.001）。中度饮酒者的值也高于戒酒者（p<0.05）。采血前1个月内摄入的乙醇量与抗加合物IgA密切相关（r = 0.67，p<0.001）。在将重度饮酒者与戒酒者进行对比的比较中，发现该标志物的敏感性（73%）和特异性（94%）超过了酒精滥用的传统实验室标志物，但在将重度饮酒者与中度饮酒者进行对比的比较中并非如此。在戒酒期间，抗加合物IgA以每天平均3%的速率消失。在对可能的标志物组合的进一步分析中，发现抗加合物IgA与CDT一起提供了最高的敏感性和特异性。
抗加合物IgA的测量可能提供一种新的酒精滥用临床有用标志物，表明标志物水平与近期乙醇实际摄入量之间存在密切关系。
