The ethanol metabolism and the formation of alcoholism

It should be clear that most of the pathological changes in alcoholism is based on two factors: factor of addiction to ethanol and factor toxic action of ethanol. To understand one last look at the ethanol metabolism.
Chronic alcohol consumption forces me to work all systems, oxidizing alcohol in the body, excessive load. It is recognized that in alcoholism is a redistribution of specific weight and relevance of different ways of oxidation of alcohol. The role of physiological alcoholdehydrogenase path is reduced, the role of ways to make the alcohol, not associated with the action of alcohol dehydrogenase. Microsomal atalakitasa system (MEOS) and catalase way take up to 50% of ethanol oxidation.
Ways of participation of catalase in ethanol metabolism has not been determined yet. Inside the cell catalase is located in peroksisomakh responsible for the oxidation of a significant number of biologically active substances. Chronic alcohol intoxication role catalase way oxidation increases due to a number of reasons. One of them is that the main alcoholdehydrogenase the path of ethanol oxidation is insufficient, because it requires the presence of oxidized OVER+the concentration of which decreases with repetitive or massive alcohol intoxication. In the study of the experimental model of alcoholism found that the cells of the liver increased the number of peroxisome and increases their perechisleniya activity. It is also established the existence peroksisomakh standalone system complete oxidation of the alcohol to acetate (Panchenko and others, 1984). According to A. P. Rumyantsev with co-authors (1981), in alcoholism is observed non-synchronous change of activity alcohol and ferment aldehyddehydrogenase as a part (mainly in connection with increasing deficit of OVER+). Earlier and more sharply decreases in the liver, the activity of ferment aldehyddehydrogenase as a part. In turn, this causes an increase in the concentration of acetaldehyde (in blood of patients with alcoholism it increased by 80%). The excess of acetaldehyde leads to changes in functions and structure of mitochondria in the cells of the liver to reduce the activity of enzymes in the most important for the body Krebs cycle and pentose-phosphate shunt. This is tragic for the body of the situation "vicious circle" - acetaldehyde, accumulate in the conditions of alcohol abuse, affects the processing of his system, leading to ever-greater accumulation of acetaldehyde and consequently to more and defeat processing systems (Fig. 6).

levels of acetaldehyde in the blood Fig. 6. The kinetics of changes in the content of acetaldehyde in the blood of the sick with alcoholism

1 - in the patient's blood alcohol;
2 - in the blood in the control group

Thus, improving in the course of the disease opportunities of the organism against ethanol processing dissociate with its capabilities in terms of processing metabolite of ethanol acetaldehyde. This is an example of how compensatory in fact processes promote further the progress and severity of disease. Under the influence of highly toxic acetaldehyde liver cells (hepatocytes) are destroyed in the liver dystrophic process.
Y. M. Ostrovsky with co-authors (1986) is a supporter of the so-called metabolic concept of development of physical dependence from alcohol. According to this concept, in the development mechanisms (pathogenesis) of alcoholism, the role of endogenous (produced in the body) ethanol and acetaldehyde. The authors metabolic concept believe that the value of endogenous ethanol and acetaldehyde in metabolism is very high. At deficiency of these compounds, the body becomes dependent on additional intake of alcohol. In other words, it is assumed that long-term heavy drinking (voluntary or due to some external factors) completely replaces that of endogenous ethanol and acetaldehyde, leads to the inhibition of the degradation of endogenous systems synthesis need metabolites. At the same time strengthened and mechanisms responsible for the oxidation and utilization of ethanol and acetaldehyde, i.e. in metabolism is such situation, in which an external source of ethanol in the body becomes necessary.
There are other theories of pathogenesis of alcohol (in total, there are about 100), and "metabolic" concept illustrates the fact that the pathogenesis of alcoholism consists of a number of links. Pathological changes in the principle of "vicious circle" are developing at different stages of the organism and in various functional systems. The longer the experience of the disease, the more affected by pathological rebuilding the body, the more work he will be given a return to the former, doblestnom state.
What other violations exacerbate the effects of alcohol with alcoholism, lead to the inclusion of new links in the pathogenesis of the disease?