The effect of chronic ethanol intake on leucine absorption from the rat small intestine

The Influence of Alcohol Consumption on Intestinal Nutrient Absorption: A Comprehensive Review

Chronic alcohol use has been attributed to the development of malnutrition. This is in part due to the inhibitory effect of ethanol on the absorption of vital nutrients, including glucose, amino acids, lipids, water, vitamins, and minerals within the small intestine. Recent advances in research, along with new cutting-edge technologies, have advanced our understanding of the mechanism of ethanol's effect on intestinal nutrient absorption at the brush border membrane (BBM) of the small intestine. However, further studies are needed to delineate how ethanol consumption could have an impact on altered nutrient absorption under various disease conditions. Current research has elucidated the relationship of alcohol consumption on glucose, glutamine, vitamins B1 (thiamine), B2 (riboflavin), B9 (folate), C (ascorbic acid), selenium, iron, and zinc absorption within the small intestine. We conducted systematic computerized searches in PubMed using the following keywords: (1) "Alcohol effects on nutrient transport"; (2) "Alcohol mediated malabsorption of nutrients"; (3) "Alcohol effects on small intestinal nutrient transport"; and (4) "Alcohol mediated malabsorption of nutrients in small intestine". We included the relevant studies in this review. The main objective of this review is to marshal and analyze previously published research articles and discuss, in-depth, the understanding of ethanol's effect in modulating absorption of vital macro and micronutrients in health and disease conditions. This could ultimately provide great insights in the development of new therapeutic strategies to combat malnutrition associated with alcohol consumption.

Effect of alcohol consumption on the gut

Both acute and chronic alcohol consumption have severe effects on the structure and function of the entire gastrointestinal tract (GIT) which result in a vicious cycle. The healthy person who begins to drink heavily, first experiences the toxic effects of high concentrations of ethanol. Mucosal damage compromises the basic functions of the GIT. Suppression of the gastrointestinal immune system and increased transport of toxins across the mucosa result in increased susceptibility to infections. Inhibition of digestion, absorption and secretion cause diarrhea and reduce the transfer of nutrients to the rest of the body. As the individual becomes more dependent on alcohol, the functional reserve and regenerative capacity of the GIT are overwhelmed and malnutrition increases. The rate of progression of this cycle depends on several factors including nutritional intake. Whilst the clinical effects of alcohol are well recognized, more research is required to fully elucidate the underlying mechanisms.

Effect of alcohol consumption on the gut

Consumption of large quantities of alcoholic beverages leads to disturbances in the intestinal absorption of nutrients including several vitamins. The inhibition of the absorption of sodium and water caused by alcohol contributes to the tendency in alcoholics to develop diarrhoea. Excessive alcohol consumption (even a single episode) can result in duodenal erosions and bleeding and mucosal injury in the upper jejunum. An increased prevalence for bacterial overgrowth in the small intestine may contribute to functional and/or morphological abnormalities of this part of the gut and also to non-specific abdominal complaints in alcoholics. The mucosal damage caused by alcohol increases the permeability of the gut to macromolecules. This facilitates the translocation of endotoxin and other bacterial toxins from the gut lumen to the portal blood, thereby increasing the liver's exposure to these toxins and, consequently, the risk of liver injury. The results of recent experimental studies support the assumption that alcohol significantly modulates the mucosal immune system of the gut.

Dietary protein regimens and chronic ethanol administration effects on sodium- and proton-dependent solute uptake in rat intestine

The effect of feeding ethanol daily for 40 days has been studied on intestinal uptake of glucose, glycine, and leucine in rats fed control, 8% protein (LP), and 30% protein (HP) diets. Na(+)-dependent uptake of glucose and glycine both at pH 7.2 and pH 5.5 was significantly depressed (p < 0.001) in ethanol or LP diet-fed animals and remained unaffected in HP-fed rats compared to the controls. But ethanol administration to protein-malnourished rats enhanced the Na(+)-linked glucose and glycine uptakes. Leucine uptake remained unaffected under these conditions. Glucose uptake remained unaltered whereas glycine uptake was reduced when ethanol was administered to rats given HP diet. In the absence of Na+, uptake of glucose, glycine, and leucine was more at acidic pH compared to that at pH 7.2 under all the experimental conditions investigated. Proton-linked uptake of solutes was unaffected by feeding ethanol, LP, or HP diet in rats. Thus, chronic ethanol feeding specifically depresses the Na(2+)-dependent uptake of glucose and glycine. Dietary protein content modifies ethanol effects on intestinal solute uptake in rats.

Gastrointestinal protein turnover and alcohol misuse

Acute and chronic ethanol ingestion causes a variety of pathological changes in the gastrointestinal tract, including gross morphological lesions and functional changes. We review whether these alterations also include changes in protein turnover, to explain the frequently observed villus atrophy and smooth muscle myopathy. The possibility that different regions of the gastrointestinal tract express diverse sensitivities is explored. Acute ethanol dosage profoundly reduced the synthesis of proteins in proximal regions of the rat gastrointestinal tract, but distal regions were less affected. In response to chronic ethanol exposure, similar regional sensitivities of the intestine were observed. In chronic studies the small intestine effects were characterised by selective losses of RNA, principally from the stomach and jejunum. We speculate whether the effects on protein synthesis were primarily due to ethanol or the consequence of acetaldehyde formation. We also determined whether changes in protein synthesis occurred secondary to alterations in nucleotide composition. The possible mediation by free-radical formation or impaired antioxidant status are also discussed. The overall results indicate that both acetaldehyde and ethanol are potent protein synthetic inhibitors and may contribute to the genesis of intestinal myopathy, possibly contributing towards motility disturbances and secondary malnutrition via malabsorption.

Effect of chronic ethanol administration on the absorptive functions of the rat small intestine

Ethanol feeding to rats for 40 days significantly (p < 0.01) depressed sodium-stimulated glucose and glycine uptakes at pH 5.5 and 7.2 without affecting sodium-independent solute transport in the rat intestine. Leucine uptake was essentially unaltered under these conditions. Absorption of bovine serum albumin and gamma-globulin as detected by enzyme-linked immunosorbent blocking assay (ELISA) was markedly augmented (p < 0.001) in ethanol-fed rats compared to the controls. These observations suggest that chronic ethanol intake differentially affects the uptake of organic solutes and macromolecules in the rat intestine.