Lieber C S
Pharmacol Biochem Behav. 1983;18 Suppl 1:181-7. doi: 10.1016/0091-3057(83)90169-7.
Several studies in our unit showed that in men, baboons, rats and deermice, blood ethanol clearance is significantly accelerated at ethanol concentrations higher than the levels needed to effectively saturate the low Km forms of ADH present in animals, thereby incriminating a high Km non-ADH system such as microsomal ethanol oxidizing system (MEOS). Furthermore, kinetics of blood ethanol clearance were consistent with the Km of MEOS. After chronic ethanol consumption, there was an increase in rates of ethanol elimination and in the activity of MEOS. There was an associated rise in microsomal cytochrome P-450, including a form (different from that of a non-ADH pathway of ethanol metabolism and its increase after chronic ethanol consumption was most conclusively shown in ADH-negative deermice. Microsomal induction was also associated with enhanced metabolism of other drugs, resulting in metabolic drug tolerance. In addition, there was increased activation of known hepatotoxic agents (such as CCl4 and acetaminophen) which may explain the enhanced susceptibility of alcoholics to the toxicity of solvents and commonly used drugs. There was enhanced activation of procarcinogens, sometimes at concentrations much lower than those required for other microsomal inducers. Moreover, catabolism of retinoic acid was accelerated possibly contributing to hepatic vitamin A depletion. In conclusion, after chronic ethanol consumption, enhanced MEOS activity and concomitant cytochrome P-450 changes may contribute to accelerated ethanol and drug metabolism and associated activation of hepatotoxic agents and carcinogens.
我们单位的多项研究表明,在男性、狒狒、大鼠和鹿鼠中,当乙醇浓度高于有效饱和动物体内低Km形式乙醇脱氢酶(ADH)所需的水平时,血液乙醇清除率会显著加快,从而表明存在一种高Km非ADH系统,如微粒体乙醇氧化系统(MEOS)。此外,血液乙醇清除动力学与MEOS的Km一致。长期摄入乙醇后,乙醇消除率和MEOS活性增加。微粒体细胞色素P - 450也相应增加,其中一种形式(不同于乙醇代谢的非ADH途径)在长期摄入乙醇后的增加在ADH阴性的鹿鼠中表现最为明显。微粒体诱导还与其他药物的代谢增强有关,导致药物代谢耐受性。此外,已知肝毒性剂(如四氯化碳和对乙酰氨基酚)的激活增加,这可能解释了酗酒者对溶剂和常用药物毒性的易感性增强。致癌物前体的激活增强,有时其浓度远低于其他微粒体诱导剂所需的浓度。此外,视黄酸的分解代谢加快,可能导致肝脏维生素A耗竭。总之,长期摄入乙醇后,MEOS活性增强以及随之而来的细胞色素P - 450变化可能有助于乙醇和药物代谢加快,以及相关的肝毒性剂和致癌物激活。