Department of Nutrition and Metabolic Research, Scripps Clinic, La Jolla, CA.
Molecular Environmental Biology, UC Berkeley, Delta Nutrassentials, Carson City, NV.
Am J Ther. 2019 Sep/Oct;26(5):583-588. doi: 10.1097/MJT.0000000000000744.
It is estimated that 1 billion people in the world have a point mutation in the gene encoding the aldehyde dehydrogenase 2 (ALDH2) enzyme, the primary enzyme responsible for the metabolism of acetaldehyde. The presence of this mutation is called ALDH2 deficiency. Because of limited ability to metabolize acetaldehyde, individuals with ALDH2 deficiency experience elevated levels of blood acetaldehyde after exposure to various common sources such as recreational alcohol. Because of higher levels of acetaldehyde, individuals with ALDH2 deficiency are at higher risk for numerous diseases, including liver cirrhosis, esophageal and gastric cancer, osteoporosis, and Alzheimer disease.
The present trial was designed to study the effectiveness, safety, and tolerability of a nutritional supplement (Essential AD2).
The primary outcome was change in acetaldehyde levels in the blood after exposure to alcohol in individuals with ALDH2 deficiency before and after the use of study nutritional supplement.
This was a 28-day open-label trial, comparing initial acetaldehyde levels after alcohol ingestion to levels after 28 days of a nutritional supplement (Essential AD2). The study consisted of 12 subjects genotyped to be heterozygous for the ALDH2 gene mutation.
ALDH2 deficient subjects showed a significant decrease in average blood acetaldehyde level 20 minutes after alcohol consumption (from 0.91 mg/dL to 0.71 mg/dL, P value = 0.02) after receiving 28 days of the nutritional supplement. Acetaldehyde levels taken at 10 minutes and 40 minutes also showed a decrease, although they were not statistically significant. In addition, safety tests looking at liver function tests showed a decrease in aspartate transaminase and alanine transaminase liver proteins from 27.3 to 15.2 and 20.9 to 13.2, respectively, over the 28 days. The treatment was well tolerated and no significant side effects were noted.
据估计，全球有 10 亿人存在编码乙醛脱氢酶 2（ALDH2）酶的基因突变，该基因突变是导致乙醛代谢的主要酶。这种突变的存在被称为 ALDH2 缺乏。由于对乙醛的代谢能力有限，ALDH2 缺乏的个体在接触各种常见的酒精来源（如娱乐性饮酒）后，血液中的乙醛水平会升高。由于较高的乙醛水平，ALDH2 缺乏的个体患多种疾病的风险更高，包括肝硬化、食管癌和胃癌、骨质疏松症和阿尔茨海默病。
本试验旨在研究一种营养补充剂（Essential AD2）的有效性、安全性和耐受性。
主要结果是在使用研究性营养补充剂前后，ALDH2 缺乏个体在接触酒精后血液中乙醛水平的变化。
这是一项为期 28 天的开放性标签试验，比较了 ALDH2 缺乏个体在摄入酒精前后的初始乙醛水平与 28 天营养补充剂（Essential AD2）后的水平。该研究包括 12 名经基因分型为 ALDH2 基因突变杂合子的受试者。
接受 28 天营养补充剂后，ALDH2 缺乏个体在饮酒后 20 分钟时血液乙醛平均水平显著下降（从 0.91mg/dL 降至 0.71mg/dL，P 值=0.02）。10 分钟和 40 分钟时的乙醛水平也有所下降，尽管没有统计学意义。此外，对肝功能测试的安全性测试显示，天冬氨酸转氨酶和丙氨酸转氨酶肝脏蛋白分别从 27.3 降至 15.2 和 20.9 降至 13.2，在 28 天内有所下降。该治疗方法耐受性良好，未观察到明显的副作用。
