Miller N S
J Subst Abuse Treat. 1987;4(2):93-102. doi: 10.1016/0740-5472(87)90020-1.
The treatment of alcoholism may be delayed because of the difficulty in confirming a diagnosis. There are currently no direct blood tests to objectively determine the presence of pharmacodynamic tolerance to alcohol. The state of the membrane fluidity of the peripheral blood erythrocyte may provide a biophysical measurement of the pharmacodynamic tolerance to alcohol. This discussion proposes methods that potentially may be applied to the clinical purpose of diagnosing alcoholism in humans. The methods have been used to successfully measure pharmacodynamic tolerance in animals and humans. The development of the physiologic state of acquired tolerance and dependence is related to alcohol intake. Chronic alcohol consumption that leads to pharmacodynamic tolerance may be assessed by measuring the membrane fluidity of the peripheral blood erythrocyte. Physiologic recovery from tolerance and dependence to alcohol may also be assessed during withdrawal in which the reversal of changes in membrane fluidity is measured in the abstinent state. Relapse to drinking may be detected in the state of the membrane fluidity of the peripheral blood erythrocytes that reflect the return of tolerance and dependence. Tolerance to alcohol may be a manifestation of the inheritability to alcoholism. Alcoholics and high risk individuals appear to have an increased, innate (genetic) tolerance to alcohol. High risk individuals are nonalcoholic, blood relatives of alcoholics. Animal studies suggest that innate (genetic) tolerance and dependence to alcohol may be related to the biophysical state of erythrocyte membrane fluidity. The assessment of these changes in membrane fluidity of the erythrocyte may be performed in the peripheral blood in humans. A trait marker (in the genetically predisposed) for high risk individuals and a state (in the actively drinking) marker for pharmacodynamic tolerance in the erythrocyte might be developed. In this way, a blood test may be used to detect the inheritability for alcoholism and the development of pharmacodynamic tolerance to alcohol. No blood test for pharmacodynamic tolerance is currently available. This article represents an extrapolation from animal and human research data. The proposals contained therein may not be considered readily, clinically applicable.
由于确诊困难，酒精中毒的治疗可能会被延迟。目前尚无直接的血液检测方法来客观确定对酒精的药效学耐受性。外周血红细胞膜流动性状态可能提供对酒精药效学耐受性的生物物理测量。本讨论提出了可能应用于人类酒精中毒临床诊断目的的方法。这些方法已成功用于测量动物和人类的药效学耐受性。获得性耐受性和依赖性生理状态的发展与酒精摄入量有关。导致药效学耐受性的慢性酒精消费可通过测量外周血红细胞的膜流动性来评估。在戒断期间也可评估从酒精耐受性和依赖性中的生理恢复情况，在此期间，在禁欲状态下测量膜流动性变化的逆转情况。外周血红细胞膜流动性状态反映了耐受性和依赖性的恢复，可据此检测复饮情况。对酒精的耐受性可能是酒精中毒遗传性的一种表现。酗酒者和高危个体似乎对酒精具有增强的先天（遗传）耐受性。高危个体是非酗酒者，是酗酒者的血亲。动物研究表明，对酒精的先天（遗传）耐受性和依赖性可能与红细胞膜流动性的生物物理状态有关。红细胞膜流动性这些变化的评估可在人类外周血中进行。可能会开发出高危个体的特质标记（在遗传易感性方面）和红细胞中药效学耐受性的状态标记（在积极饮酒者中）。通过这种方式，血液检测可用于检测酒精中毒的遗传性以及对酒精药效学耐受性的发展。目前尚无用于药效学耐受性的血液检测方法。本文是从动物和人类研究数据推断而来。其中包含的提议可能不被认为在临床上易于应用。
