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A range of biomarkers for detecting alcohol misuse have Gamma-glutamyl Ethanol in breath, been described transpeptidase ( GGT ). blood or urine.
5-hydroxytryptophol / 5
Ethyl glucuronide
EtG ).
Ethyl sulphate ( EtS ).
(
excessive alcohol intake, but the time window for positivity is short ( breath 4-6 h, blood 10-12 h, urine 18-24 h ).
MCV & GGT require significant alcohol intake over a
prolonged period of time ( > 1000 g over atleast two weeks ) to become abnormal & have poor specificity as both can be rised in chronic disease, nutritional deficiencies & obesity.
acids that have been implicated as mediators of alcohol induced organ damage, & measured in blood & tissues as markers of alcohol intake.
The ratio of 5-HTOL / 5-HIAA in urine was shown to
be a more sensitive & specific marker of alcohol ingestion than urine ethanol or methanol, remaining positive for 6 -15 h after the BAC had returned to baseline values.
marker of alcohol misuse over a 7-14 d period & does not become positive after a single session of heavy drinking.
positive in the gap in the time window, between one day & one week, left by the current biomarkers of alcohol consumption.
ethanol formed by the enzymatic conjugation of ethanol with glucuronic acid in liver.
This phase II reaction is catalysed by mitochondrial
membrane-bound UDP-glucuronosyltransferase.
Ethanol is also conjugated to sulphate by
samples together with tissue samples ( gluteal & abdominal fat, liver & brain ) from intoxicated subjects.
EtG has been shown to be a stable marker. Studies have shown that urine samples stored at 4C
chromatography - mass spectrometry ( LC-MS ) since it is highly sensitive, specific & is able to determine both EtG & EtS simultaneously.
assay (EIA ) method based on a new monoclonal antibody came into the market for the analysis of EtG in urine. specific.
positive samples should always be confirmed by LC-MS with EtS to rule out false positives due to contamination.
World Health Organization / International Society for Biomedical Research on Alcoholism ( WHO / ISBRA ) Study of State & Trait Markers of Alcohol Use & Dependence that recruted 304 subjects from Brazil & Australia of whom 158 were diagnosed as lifetime alcohol abusers.
The study also measured the 5-HTOL / 5-HIAA ratio in urine,
conclusions
EtG has potential as a marker of high sensitivity & specificity for the detection of alcohol misuse in a varity of settings, both in clinical & forensic medicine.
As non invasive marker, EtG in urine or hair could have a role in screening, diagnosis & monitoring treatment.
following heavy alcohol consumption; therefore, providing a marker with an intermediate timeframe between ethanol measurements & GGT / CDT.
This may prove perticularly useful in workplace
monitoring schemes, prior to & following liver transplantation, alcohol detoxification programmes & in the identification of neonates at risk of Fetal alcohol syndrome ( FAS ).
THAN Q