Effect of chronic ethanol consumption on leucine absorption in 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.

Chronic alcohol consumption and intestinal thiamin absorption: effects on physiological and molecular parameters of the uptake process

Thiamin is essential for normal cellular functions, and its deficiency leads to a variety of clinical abnormalities. Humans and other mammals obtain the vitamin via intestinal absorption. The intestine is exposed to two sources of thiamin, a dietary and a bacterial (i.e., normal microflora of the large intestine) source. Chronic alcohol consumption is associated with thiamin deficiency, which is caused (in part) by inhibition in intestinal thiamin absorption. However, little is known about the physiological and molecular aspects of the intestinal thiamin uptake process that are affected by chronic alcohol use. To address these issues, we used rats fed an alcohol-liquid diet and human intestinal epithelial HuTu-80 cells chronically exposed to ethanol as model systems. The results showed that chronic alcohol feeding to rats led to a significant inhibition in carrier-mediated thiamin transport across both the jejunal brush-border membrane and basolateral membrane domains. This was associated with a significant reduction in level of expression of thiamin transporter-1 (THTR-1), but not THTR-2, at the protein and mRNA levels. Level of expression of the heterogenous nuclear RNA of THTR-1 in the intestine of alcohol-fed rats was also decreased compared with their pair-fed controls. Chronic alcohol feeding also caused a significant inhibition in carrier-mediated thiamin uptake in rat colon. Studies with HuTu-80 cells chronically exposed to ethanol also showed a significant inhibition in carrier-mediated thiamin uptake. This inhibition was associated with a reduction in level of expression of human THTR-1 and THTR-2 at the protein, mRNA, and transcriptional (promoter activity) levels. These studies demonstrate that chronic alcohol feeding inhibits intestinal thiamin absorption via inhibition of the individual membrane transport event across the polarized absorptive epithelial cells. Furthermore, the inhibition is, at least in part, mediated via transcriptional mechanism(s).

Effects of maternal ethanol consumption during pregnancy or lactation on intestinal absorption of folic acid in suckling rats

A fostering/crossfostering analysis of the effects of maternal ethanol exposure on jejunal and ileal folate absorption was performed. Male and female rats were randomized into two groups. In the first group, ethanol-treated rats received ad libitum 5, 10 and 15% ethanol in the drinking fluid during three successive weeks. A consumption of 20% was maintained in this group for 5 additional weeks. Ethanol-treated rats were mated. Group 2 served as the control. To study the effect of chronic alcoholism during lactation or gestation separately, at birth (2nd day postpartum) control newborns were cross-fostered to ethanol dams (EG), and the pups issued from the ethanol treated mothers were cross-fostered to control dams (CG). Thus, three experimental groups of pups were formed: (1) control pups receiving no treatment during gestation and lactation (CG); (2) pups exposed to ethanol only during gestation (GG); and (3) pups exposed to ethanol only during lactation (LG). At 21 days postpartum the jejunal and distal ileum folate absorption was determined in the offspring rats by a perfusion technique. Milk folic acid levels were determined by an immunoluminometric assay. The results showed an increase in jejunal folic acid absorption in offsprings exposed to ethanol only during the lactation period (LG). However, in pups exposed to ethanol only during the gestation period (GG), the jejunal folic acid absorption was significantly increased only at concentrations of 0.25, 0.5 and 2.5 microM. No free folic acid absorption occurred in the distal ileum of control pups (CG) at day 21 at all assayed concentrations but in offsprings exposed to ethanol only during the gestation or lactation periods absorption did take place. Pups exposed to ethanol during the gestation period (GG) showed decreased values in ileum folic acid absorption at the lowest assayed concentration (0.25 microM) compared to values obtained for pups exposed to ethanol only during lactation (LG). Milk folic acid levels were significantly decreased in the ethanol-fed dams on day 21 of lactation. These results indicate that exposure of rats to ethanol during the lactation period affects more severely postnatal development of intestinal functions than ethanol exposure only during gestation. In summary, both the exposure to ethanol itself and the decrease in folic acid intake caused alterations in the function of the intestinal mucosa in the offspring, which in turn altered absorption time and development. However, the present results do not explain how ethanol stimulated intestinal absorption of folic acid in pups exposed to ethanol during the gestation or lactation periods. Further studies are needed.

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.

Folic acid intestinal absorption in newborn rats at 21 day postpartum: effects of maternal ethanol consumption

This study was designed to examine the effects of prenatal and postnatal exposure of ethanol in the in vivo absorption of free folic acid in the small intestine in pups rats at the 21st day after birth. The rats were accustomed to increasing amounts of ethanol (5 to 20%, vol/vol) in tap water for 1 month. During pregnancy and suckling period, ethanol-fed dams were assigned again to ethanol 20% in drinking water. Two sets of experiments were performed. In the first set, jejunal free folic acid absorption in control group and litters nursed by dams receiving ethanol showed a gradual increase along with the increase of perfusion time at all the assayed concentrations. In general, in litters of ethanol-fed dams, jejunal free folic acid absorption expressed as nmol/intestinal surface, nmol/g tissue wet weight and nmol/g tissue dry weight were higher than in control animals. In the second set of experiments, in distal ileum loops, free folic acid absorption did not occur in control pups, but appeared in litters exposed to ethanol. Milk folic acid levels are significantly decreased in ethanol-treated dams. However, only a slight decrease in the serum folic acid levels occurs in litters of ethanol-fed dams. In conclusion, the results obtained in the present work suggested a different pattern of free folic acid absorption in distal ileum for the two groups. The exposure of rats to ethanol during the pregnancy and suckling period, can affect postnatal development of intestinal functions and could play a role in the genesis of malnutrition observed in the infant.

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.

Changes in the fatty acid profile of plasma and adipose tissue in rats after long-term ethanol feeding

The effect of chronic ethanol feeding on the fatty acid composition of plasma and abdominal adipose tissue in rats was studied. Animals were maintained on a 30% ethanol solution in drinking water for 3 and 5 months. Control rats were given water. Caloric intake was similar in control and ethanol-fed rats at the end of the experimental period. However, a decrease in body weight was observed in rats that had consumed ethanol. Palmitoleic (16:1n7) and oleic (18:1n9) acids increased markedly, and linoleic acid (18:2n6) decreased in the plasma and in the adipose tissue of ethanol-fed rats with respect to control rats. After 3 months of ethanol ingestion, long-chain polyunsaturated fatty acids were reduced both in plasma and adipose tissue. When ethanol was administered for 5 months, only plasma long-chain polyunsaturated fatty acids of the n-3 series were decreased. This suggest that changes induced by ethanol ingestion in essential fatty acid metabolism is less pronounced when ethanol feeding is maintained for a long period of time.

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.

Leucine metabolism during chronic ethanol consumption

Chronic ethanol consumption is known to increase plasma concentrations of branched-chain amino acids (BCAA) in rats and man, but the mechanisms of this effect are not known. Chronic ethanol consumption may increase levels of BCAA by altering protein turnover and/or by affecting the oxidation of BCAA. These possibilities were investigated in rats pair-fed liquid diets containing either 0% or 36% of total calories as ethanol for 21 days. In the fed state, ethanol-treated rats had a plasma ethanol level of 20 +/- 5 mmol/L and twofold increases in BCAA concentrations in plasma. There were also significant increases (37% to 63%) in muscle, liver, and jejunal mucosa BCAA concentrations. Chronic ethanol consumption significantly increased whole-body rates (mumol/100 g/h) of leucine turnover (73.8 +/- 7.5 v 104 +/- 5.6, P < .01) and oxidation (12.0 +/- 1.7 v 17.7 +/- 1.1, P < .05). In contrast, it significantly decreased leucine incorporation (nmol/mg protein/240 min) into both muscle (0.61 +/- 0.07 v 0.35 +/- 0.05, P < .01) and liver (13.25 +/- 1.40 v 6.78 +/- 0.98, P < .01) proteins. Incorporation of leucine into the mucosal proteins of jejunum (17.42 +/- 1.42 v 15.85 +/- 1.90, P = NS) was not significantly altered by ethanol. These results suggest that reduced protein synthesis and/or increased protein breakdown may account for the elevated tissue BCAA concentrations in chronic ethanol consumption. The consequences of these increased tissue concentrations are increases in tissue oxidation and plasma concentrations of BCAA.

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.

The effect of ethanol on intestinal L-leucine absorption in rats

The chronic effect of ethanol on leucine absorption by the whole rat intestine (between duodenum and rectum) was studied using an in vivo multiple-pass perfusion technique. Leucine concentrations in the perfusion medium were 5, 10 and 25 mM respectively in successive passes. Ethanol was administered in drinking water during a one month induction period and then for a four week period of ad libitum ingestion of 30% ethanol solution. The results were compared with ad libitum-fed control rats. The total calorie consumption due to the chow diet plus ethanol increased in the rats which had ingested ethanol when compared with that of the controls. The daily protein intake in ethanol-fed rats was less than that of the controls. No significant differences in morphometric tissue parameters were found between the two experimental groups. Chronic ethanol ingestion provoked a slight (but not significant) decrease in net leucine absorption at 5 mM leucine concentration. In contrast, minor increases in the absorption values were found at 10 and 25 mM leucine concentrations. These findings suggest that the diminished active mechanisms of leucine absorption provoked by ethanol ingestion are compensated for by the enhanced diffusive processes, the passage of the nutrients through the whole intestine, and that the low protein consumption of ethanol-fed rats in ad libitum conditions isn't enough to provoke significant decreases in leucine absorption by the whole intestine.

Effect of chronic ethanol on D-galactose absorption by the rat whole intestinal surface

The in vivo absorption of D-galactose by rat whole intestinal surface after 4 weeks of 30% ethanol ingestion in drinking water has been studied, and the results were compared with ad lib-fed control rats. The total serosal intestinal area was determined by integration obtaining similar values between control and alcohol-treated groups. In the caecum surface of ethanol-fed rats slight but not significant increases were found, while the jejunum area decreased with respect to control rats. Total galactose absorption during 10 min of perfusion was slightly increased in ethanol-fed rats but these results were not significant with the substrate concentrations tested. When absorption data were referred to serosal surface, the absorption/cm2 values in ethanol-fed rats were increased at the studied galactose concentrations although these results were only statistically significant at 10 mM. In conclusion, the present data indicates a slight increase in D-galactose absorptive capacity by the whole intestine in ethanol-fed rats which suggest that the tissue traditionally not evaluated such as caecum and colon could modify the functional response to the absorption nutrients.

Effect of chronic vanadate ingestion on amino acid and water absorption in rat intestine

Chronic administration of a relatively low concentration of vanadate to rats causes inhibition of water, alpha-aminoisobutyric acid (AIB) and L-alanine absorption. The mechanism responsible for this inhibition was tested by studying the uptake of alanine in isolated rat intestinal cells. The studies suggest that the vanadate inhibition of amino acid transport is primarily caused by a decreased activity of the Na+-K+ pump, an action that is similar to what is observed when the rat intestine is acutely exposed to vanadate. Vanadate appeared to have no direct effect on the entry of amino acids into the intestinal cell. This was evident by the fact that amino acid uptake by enterocytes of control rats was not different from the uptake by cells of vanadate-treated animals that have an inwardly directed Na gradient artificially created across them. Furthermore, 86RB influx and efflux into and out of intestinal tissues of the vanadate-treated animals were, respectively, decreased and increased as compared to normal control tissues and they were similar to what is observed when the intestine is acutely exposed to ouabain, a known specific inhibitor of the Na+-K+ pump.

Enzymatic inhibition of lysine transport across the small intestine in vivo

1. Trypsin, at different concentrations, significantly inhibited lysine absorption (P less than 0.05) in a dose-dependent pattern. 2. Maximum inhibition equivalent to 35% below control value was reached with 10 micrograms/ml (100 BAEE units) trypsin with a non-reversible inhibitory effect. 3. Chymotrypsin at 10 micrograms/ml produced a significant decrease (P less than 0.05) of lysine absorption although it did not exceed 5%. Perfusion of both enzymes did not show an additive inhibitory effect. 4. Lysine absorption showed a 39% decrease with 10 micrograms/ml trypsin and 1 X 10(-4) M ouabain, whereas ouabain alone produced 34% inhibition. 5. Lysine absorption showed a 71% decrease with 10 micrograms/ml trypsin in a sodium-free medium, and 70% inhibition with Na-free medium alone. 6. The inhibition of lysine absorption after trypsin treatment could be due to inhibition of the active component of lysine transport.

Animal models of chronic alcohol ingestion: the liquid diet

A suitable animal model that mimics the effects of chronic alcohol intake in man has long been sought. The ethanol-containing liquid diet, although often finding favour in a variety of experimental studies, has recently been criticised for being nutritionally inadequate. Results of this study indicate liquid diets are capable of maintaining the growth of female, but not male, rats at rates comparable to those of similar animals fed on commercially available rodent pellets or on laboratory-prepared pelleted diets. In addition preliminary data are reported indicating the suitability of this model for inducing tolerance to alcohol.

Failure of a branched chain amino acid-enriched diet to reverse ethanol inhibition of cardiac protein synthesis in the rat

The fractional rate of protein synthesis was determined in the hearts of rats in vivo fed on diets containing 27% of energy as ethanol or on this diet supplemented with 5% of equimolar amounts of branched chain amino acids (BCAA). Administration of ethanol significantly decreased the fractional synthetic rate of mixed cardiac proteins and this depression was not ameliorated by concomitant feeding of BCAA. These data are discussed in relation to the stimulation of cardiac protein synthesis by BCAA observed in vitro.

Ethanol and leucine oxidation--I. Leucine oxidation by the rat in vivo

The effect of ethanol upon the oxidation of leucine by the rat in vivo was determined. The rate of leucine oxidation was not significantly altered by chronic administration of ethanol (20% v/v solution as drinking water for 28 days). Ethanol administered acutely (8 g kg 0.73) significantly decreased leucine oxidation by the rat in vivo. This decrease appeared to be independent of a more general depression of oxidation metabolism. Decrease in leucine oxidation by ethanol is discussed in relation to the regulation of tissue leucine pool sizes in vivo.