Riggs J E
Department of Neurology, West Virginia University School of Medicine, Morgantown, USA.
Clin Neuropharmacol. 1998 Nov-Dec;21(6):363-4.
An association between alcohol use and episodes of rhabdomyolysis has long been recognized, but never understood. Ethanol is a potent inducer of cytochrome P450. In the presence of cytochrome P450, the metabolism of many drugs includes reactive and toxic intermediates. Accordingly, some alcohol-associated myotoxicity could be related to skeletal muscle cytochrome P450 induction by ethanol leading to the production of toxic metabolites of other compounds that then injure muscle. The recent identification and localization of cytochrome P450 on skeletal muscle sarcoplasmic reticulum provides supportive evidence for this potential role of ethanol in the pathogenesis of alcohol-associated rhabdomyolysis. Case histories of episodes of rhabdomyolysis in individuals with chronic ethanol abuse characteristically do not comment on the concomitant consumption of other substances. This common deficiency is illustrated by two additional case histories of alcohol-associated rhabdomyolysis.
长期以来，人们一直认识到酒精使用与横纹肌溶解发作之间存在关联，但从未完全理解其中的原因。乙醇是细胞色素P450的强效诱导剂。在细胞色素P450存在的情况下，许多药物的代谢会产生反应性和毒性中间体。因此，一些与酒精相关的肌毒性可能与乙醇诱导骨骼肌细胞色素P450有关，进而导致其他化合物产生有毒代谢产物，从而损伤肌肉。最近在骨骼肌肌浆网上鉴定并定位了细胞色素P450，这为乙醇在酒精相关性横纹肌溶解发病机制中的这一潜在作用提供了支持性证据。慢性乙醇滥用个体横纹肌溶解发作的病例记录通常未提及同时使用其他物质的情况。另外两个酒精相关性横纹肌溶解的病例记录也说明了这一常见的疏漏。
