Alcohol and airways function in health and disease

被引:144
作者
Sisson, Joseph H. [1 ]
机构
[1] Univ Nebraska, Med Ctr, Dept Internal Med, Pulm Crit Care Sleep & Allergy Sect, Omaha, NE 68198 USA
关键词
cilia; mucociliary clearance; cigarette smoke; alcohol; ethanol; cAMP; PKA; PKG; lung epithelium; COPD; chronic obstructive pulmonary disease; acetaldehyde dehydrogenase 2; ALDH2;
D O I
10.1016/j.alcohol.2007.06.003
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
The volatility of alcohol promotes the movement of alcohol from the bronchial circulation across the airway epithelium and into the conducting airways of the lung. The exposure of the airways through this route likely accounts for many of the biologic effects of alcohol on lung airway functions. The effect of alcohol on lung airway functions is dependent on the concentration, duration, and route of exposure. Brief exposure to mild concentrations of alcohol may enhance mucociliary clearance, stimulates bronchodilation, and probably attenuates the airway inflammation and injury observed in asthma and chronic obstructive pulmonary disease (COPD). Prolonged and heavy exposure to alcohol impairs mucociliary clearance, may complicate asthma management, and likely worsens outcomes including lung function and mortality in COPD patients. Nonalcohol congeners and alcohol metabolites act as triggers for airway disease exacerbations especially in atopic asthmatics and in Asian populations who have a reduced capacity to metabolize alcohol. Research focused on the mechanisms of alcohol-mediated changes in airway functions has identified specific mechanisms that mediate alcohol effects within the lung airways. These include prominent roles for the second messengers calcium and nitric oxide, regulatory kinases including PKG and PKA, alcohol and acetaldehyde-metabolizing enzymes such as aldehyde dehydrogenase 2. The role alcohol may play in the pathobiology of airway mucus, bronchial blood flow, airway smooth muscle regulation, and the interaction with other airway exposure agents, such as cigarette smoke, represents opportunities for future investigation. (C) 2007 Elsevier Inc. All rights reserved.
引用
收藏
页码:293 / 307
页数:15
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