User:Ambabcoc/Alcohol flush reaction

Article
=== Alcohol flush reaction is a condition in which a person develops flushes or blotches associated with on the face, neck, shoulders, and in some cases, the entire body after consuming alcoholic beverages. The reaction is the result of consumption of ethanol, a metabolic byproduct of the catabolic metabolism of alcohol, and is caused by an aldehyde dehydrogenase 2 deficiency. This syndrome has been associated with lower than average rates of alcoholism, possibly due to its association with adverse effects after drinking alcohol. However, it has also been associated with an increased risk of esophageal cancer in those who do drink. The condition may be also highly prevalent in some Southeast Asian and Inuit populations.ndividuals who experience the alcohol flushing reaction may be less prone to alcoholism. The resulting irritating flushing reaction tends to discourage affected individuals from drinking. ===

Contents

 * 1Signs and symptoms
 * 2Genetics
 * 3Pathophysiology
 * 4Diagnosis
 * 4.1Differential diagnosis
 * 5References ===

Symptoms and Treatments
=== Alcohol Flush Syndrome may cause symptoms including facial flushing, nausea, vomiting, angina, headaches and a tachycardia. Some cases may induce to symptoms of alcohol-induced respiratory reactions, which involve rhinitis, angina, wheezing, and worsening of asthma. These symptoms are proven to be temporary as the body metabolizes alcohol. Individuals may also experience anxiety Treatment to subside symptoms include taking antihistamines, hydrating by mouth or intravenous, rest and time. Studies have shown that resting and breathing exercises will alleviate symptoms holistically. Psychological perspective & symbolization of those who suffer with Alcohol Flush Syndrome, specifically those who are derived from Asia, include embarrassment and misconceptions of the "asian glow" in America. In Singapore, alcohol flush syndrome is associated as cultural appropriation instead of a disorder or medical deficiency. Singapore symbolize the alcohol flush symptoms as initiation into "manhood" or adulthood. ===

Genetics
=== Alcohol flush reaction is best known as a condition that is experienced by people of East Asian descent; due to this, the condition is often given names such as "Asian flush" or "Asian glow". ALDH2 is a derived genetic sequence for Alcohol Flush Syndrome, that may be presented in those who are have an Asian background as well as other ethnicities. Around 30–50% of East Asians carry the rs671 (ALDH2*2) allele on chromosome 12, which results in a less functional acetaldehyde dehydrogenase enzyme, responsible for the breakdown of acetaldehyde, and accounts for most incidents of alcohol flush reaction worldwide. The rs671 allele is native to East Asia and most common in southeastern China. Analysis correlates the rise and spread of rice cultivation in South China with the spread of the allele. The reasons for this positive selection are not known, but it has been hypothesized that elevated concentrations of acetaldehyde may have conferred protection against certain parasitic infections, such as Entamoeba histolytica. Additionally, in around 80% of East Asians, the rapid accumulation of acetaldehyde is worsened by another gene variant; in this case the allele ADH1B*2, which results in the alcohol dehydrogenase enzyme converting alcohol to toxic acetaldehyde more quickly than other gene variants common outside of East Asia. ===

Pathophysiology
=== Those with facial flushing due to ALDH2 deficiency may be homozygotes, with two alleles of low activity, or heterozygotes, with one low-activity and one normal allele. Homozygotes for the trait find consumption of large amounts of alcohol to be so unpleasant that they are generally protected from esophageal cancer, but heterozygotes are able to continue drinking. However, an ALDH2-deficient drinker has four to eight times the risk of developing esophageal cancer as a drinker not deficient in the enzyme. Because most East Asians have a variant in the ADH gene, this risk is lowered somewhat because the ADH variant reduces the risk of esophageal cancer four-fold. However, ALDH2-deficient people who do not carry this ADH variant are at the highest risk of cancer as these risk factors act in a multiplicative manner through increasing exposure time to salivary acetaldehyde. The idea that acetaldehyde is the cause of the flush is also shown by the clinical use of disulfiram (Antabuse), which blocks the removal of acetaldehyde from the body via ALDH inhibition. The high acetaldehyde concentrations described share similarity to symptoms of the flush (flushing of the skin, accelerated heart rate, shortness of breath, throbbing headache, mental confusion and blurred vision). ===

Diagnosis
=== For measuring the level of flush reaction to alcohol, the most accurate method is to determine the level of acetaldehyde in the blood stream. This can be measured through a breathalyzer test or blood test. Additionally, measuring the amount of alcohol metabolizing enzymes alcohol dehydrogenases and aldehyde dehydrogenase through genetic testing can predict the amount of reaction that one would have. ===

Differential Diagnosis

 * Alcohol-induced respiratory reactions including rhinitis and exacerbations of asthma appear, in many cases, due to the direct actions of ethanol.
 * Rosacea, also known as gin blossoms, is a chronic facial skin condition in which capillaries are excessively reactive, leading to redness from flushing or telangiectasia. Rosacea has been mistakenly attributed to alcoholism because of its similar appearance to the temporary flushing of the face that often accompanies the ingestion of alcohol.
 * Degreaser's flush – a flushing condition arising from consuming alcohol shortly before or during inhalation of trichloroethylene (TCE), an organic solvent with suspected carcinogenic properties.
 * Carcinoid syndrome – episodes of severe flushing precipitated by alcohol, stress and certain foods. May also be associated with intense diarrhea, wheezing and weight loss. ===

References[ edit]

 * 1) Brooks PJ, Enoch MA, Goldman D, Li TK, Yokoyama A (March 2009). "The alcohol flushing response: an unrecognized risk factor for esophageal cancer from alcohol consumption". PLOS Medicine. 6 (3): e50. doi:10.1371/journal.pmed.1000050. PMC 2659709. PMID 19320537.  2. Lee H, Kim SS, You KS, Park W, Yang JH, Kim M, Hayman LL (2014). "Asian flushing: genetic and sociocultural factors of alcoholism among East asians". Gastroenterology Nursing. 37 (5): 327–36. doi:10.1097/SGA.0000000000000062. PMID 25271825. S2CID 206059192.  3. J. Yoo, Grace; Odar, Alan Y. (2014). Handbook of Asian American Health. Springer. p. 132. ISBN  978-1493913442 .  4. Brooks PJ, Enoch MA, Goldman D, Li TK, Yokoyama A (March 2009). "The alcohol flushing response: an unrecognized risk factor for esophageal cancer from alcohol consumption". PLOS Medicine. 6 (3): e50. doi:10.1371/journal.pmed.1000050. PMC 2659709. PMID 19320537.  5. Peng Y, Shi H, Qi XB, Xiao CJ, Zhong H, Ma RL, Su B (January 2010). "The ADH1B Arg47His polymorphism in east Asian populations and expansion of rice domestication in history". BMC Evolutionary Biology. 10: 15. doi:10.1186/1471-2148-10-15. PMC 2823730. PMID 20089146.  6. Alcohol Flush Signals Increased Cancer Risk among East Asians Archived 2012-02-16 at the Wayback MachineMarch 23, 2009 News Release – National Institutes of Health(NIH)  7. Lee, Chien-Hung; Lee, Jang-Ming; Wu, Deng-Chyang; Goan, Yih-Gang; Chou, Shah-Hwa; Wu, I.-Chen; Kao, Ein-Long; Chan, Te-Fu; Huang, Meng-Chuan; Chen, Pei-Shih; Lee, Chun-Ying (2008). "Carcinogenetic impact of ADH1B and ALDH2 genes on squamous cell carcinoma risk of the esophagus with regard to the consumption of alcohol, tobacco and betel quid". International Journal of Cancer. 122 (6): 1347–56. doi:10.1002/ijc.23264. ISSN 1097-0215. PMID18033686.  8. "Rs671". Archived from the original on 2018-10-22. Retrieved 2011-12-22.  9. "Disulfiram". MedlinePlus Drug Information. Archivedfrom the original on 1 October 2008. Retrieved 15 November2012.  10. "Dartmouth Undergraduate Journal of Science". Archived from the original on 2016-01-12. Retrieved 2021-10-07.  11. Adams KE, Rans TS (December 2013). "Adverse reactions to alcohol and alcoholic beverages". Annals of Allergy, Asthma & Immunology. 111 (6): 439–45. doi:10.1016/j.anai.2013.09.016. PMID 24267355  12. Oota; et al. (2004). "The evolution and population genetics of the ALDH2 locus: random genetic drift, selection, and low levels of recombination". Annals of Human Genetics. 68 (2): 93–109. doi:10.1046/j.1529-8817.2003.00060.x. PMID15008789. S2CID 31026948.  13. Eng MY, Luczak SE, Wall TL (2007). "ALDH2, ADH1B, and ADH1C genotypes in Asians: a literature review". Alcohol Research & Health. 30 (1): 22–27. PMC 3860439. PMID 17718397.  14. Wright C, Moore RD (June 1990). "Disulfiram treatment of alcoholism". The American Journal of Medicine. 88 (6): 647–55. doi:10.1016/0002-9343(90)90534-K. PMID 2189310.  15. Boulton P, Purdy RA, Bosch EP, Dodick DW (February 2007). "Primary and secondary red ear syndrome: implications for treatment". Cephalalgia. 27 (2): 107–10. doi:10.1111/j.1468-2982.2007.01270.x. PMID 17257229. S2CID 31973969.  ===