Alcohol and abnormal protein biosynthesis; biochemical and clinical

505 Pages·1975·9.3 MB·English

by  Marcus Adolphus Rothschild

AlcohaonldA bnormal
ProteBiino synthesis
BiochemaincdCa lli nical
editbeyd
MarcuAs. R othschild
DepartomfeN nutc leMaerd icVientee,r Aadnmsi nriasttiHoons pital
anNde wY orUkn iverSscihtooyof l Medicine
NewY orNke,w Y ork
MurraOyr atz
DepartomfeN nutc leMaerd icVientee,r Aadnmsis ntiraHtoisopni tal
anNde wY orUkn iverDseiptayr tomfeB nictoh esmtiry
NewY ork, YNoerwk
SidneSy.S chreiber
DepartomfeN nutc lMeeadri cVientee,r Aadnmsi nriasttiHoons pital
anNde wY orUkn iverSscihtooyofM l e dicine
NewY orNke,w Y ork
PERGAMON PRESSI NC.
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CopyrightP©e r1g9a7mP5or,ne I snsc .
LibraorfCy o ngrCeastsa loignPi unbgl icDaattiao n
RothscMhairlcduA,sd olph1u29s4,-
Alcohaonlda bnorpmraolt beiions ynthesis.
I.A lcoholism--Coamnpdsl eiqcuaetliaoen.s
2.P rotmeeitna bodliissomr dIe.rO sr.a tz, Murray,
joianutt hoIrI..S chreiSbiedrnS,e. yj, o int
author. TiItIl[IeD..N LM:I .A lcohEotlh,y l-­
Pharmacodsy.n2a .mA ilccoholism--Complications.
3.N utridtiisoonr derbso-l-iMse4mt..Pa roteins-­
Biosynth5e.sP irso.t eins--MeQtUa5b5Ao 3l5i4s m.
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RC565.R574 61.68''6071 74-5308
ISBN0 -087-70018-5
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foarlo lft hepiarsa tnp dr esent
undersattatnednaitnnaigdso, tsn ai,ns ce
Preface
oft heet iolodgiys,e aaaslrealesc c ompabnyis eodma el teriant ion
REGARDLESS
cellnuultarri ctoimobni wnietdth h e specifiocft hedeffi escetaPsse reh.a ps the
mostc ontrovceormsbiianla htaisbo ene tnh aotf a lcohaosslo ciawtietdh
malnutrWihtaitro onl.de ost hetsweo p ossibilnyt errsetlerastspeeldsa iynt he
developomfce lnitn diicsaelaI sne ?tp haet ieinnta neo xrp erimaennitmatalhl e,
dissecotfti hoeenff ectss peocfni ufitcr ioern taoslf c oohroi ltm se taboilsi tes
mosdti fficudlutet o tbhoed yh'osm etoastmiecc hsamnisT.h ust,ob egitno
undershtoawn da lcaonhdo/alol rt enruetdr iatffieoccnte llmueltaarlb iosimti, s
necestsaodr eyv elop mseptehcoidfiscm oadnedsl ost haeta cehn timtayyb e
evalusaetpeadr ately.
Int hitse xwte h avceh osperno tein saystn hteeh nedspiosfi onprtr ,o tein
synthiests hiuesl timfautnec toifao lncl e lTlhsem. e thofdosmr e asuring protein
metaboalrieesv ma luaanttdeh dee ff ecotfas l coahnoadll teprreodt ienitnaa kree
examianset dh eayff ectthh ee arlti,v sekre,l meutsaclal nedt, h ber ain.
xi
Acknowledgments
THIS woulndo hta vbee epno ssiwbilteh otuhmteo numenetffaolro tfts h e
TEXT
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We alswoi stho e xpreosusrt hantkost heD epartmoefMn etd icainnde
Surgertyh Veoe ft erAadnmsi nistTrhaetrwieeo rnme.a nyp eopilnev olivne d
helpuisnb go tahtt he ManhattaAnd mVienrtiaestrtiaHononss piatnadal tt he
VeterAadnmsi nistCreanttiOroffiancl e I.na dditwieow no,u lldi kteos inogulte
threweh om ade wtohrek p ossibleA-bDrra.h aDmu ryA,c tiAnsgss tiant
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CoheCnh,i eFfi,s cDailv isMianohna,t Vteatne ranss tArdamHtioinsoipni; a tnadl
MrsJ.e anE .M illSeerc,r e,t DaerpyartmoefnN tusc leMaerd icianned
RadioisSoetrovpiec e.
Finatlhleeyd itwoirstsho t hatnhkfe o llocwoirnpgo raftotirho enisr soufp port
thiesn deavor:
AbboLtatb aotrorNioerst,Ch h icaIgloli,i sAn;yo erLsatb aotrorNieewsY ,o rk,
NewY or;kB eckmIanns utmrenItnsc,.M ,o untaiNneswiJ deer,s Ceoym;m ercial
AlliaCnopcroer atNieownY ,o rNke,w Y orEka;s tmKaond aCko mpanRyo,c hes­
ter, YNoerwk H;o ffman-La-RoIcnch.eN, u tleNye,w JerseNyu;c lear
AsscoiatIencs,.W, e stbuNreywY, o rMke;a Jdo hnsoEnv,a nsvIinldlieaM,en dai;­
RayT,u ckahNoeewY, o r;kR aythCeoomnp anWya,l th,Ma amssachussS;ee taltre
RadioghriaepIsnc,. D,e sP laiInleolsii,;sEn .R .S qui&b Sbo nIsn,c P.r,i nceton,
NewJ ers;ae nydS tandd BarranSdasl Ceosm panNye,w YoNrekw,Y ork.
xiii
Lisotf C ontributors
AbelmanWna,l teHr.,, M .D. FisheVri,n cenJt.,M, .D.
ProfesosfMo erd icine AssociChaiteeof f Staff
HarvaMredd icSaclh ool VeterAadnmsi tnriastHioosnp ital
ChieCfa,r diovaDsicvuilsairo n AssioactPer ofesosfPo hry siology
BostoMna,s sachu0s21e81t ts NewY orUkn iverSscihtoyoo flM edicine
AsofskRy.,M, . D. NewY orkN,e wY ork
ChieLfa,b oraotfoM riyc roIbmimauln ity GarlicPk.J, . P, h.D.
NatioInnaslt iotfuH teeasl th LondoSnc hoooflH ygieannedT ropical
BethesMdaar,y l2a0n10d4 Medicine
BaligSau,r enB,. ,P h.D. LondoEnn,g land
DepartmoefNn utt riatnido nF Socoide nce GlazkAon,t honJy.,P, h.D.
Massachusettosf T eIcnhsntoiltougtye ParkDea vis Caonmdp any
CambriMdagses,a chu0s21e93t ts AnnA rboMri,c hi4g8a1n0 6
BeckeFrr,e deriFc.k,M, . D. HendersoGn.,,P h.D.
ProfesosfPo art hology InstruicnPt hoarr macology
NewY orUkn iversity Medical CVeanntdeerr Ubniilvte rSscihtoyoo flM edicine
550F irst Avenue NashviTlelnen,.
NewY orkN,e wY or1k0 016
Ho,J .M, .Sc.
BujaM,a ximiliLa.n,M, . D.
SeniToerc hnician
SeniIonrvs etigator
DivisoifGo ans troenterology
NatioHneaalra tn dL ung Institute
ToronGteon eral Hospital
NatioInnaslt iotfuH teeasl th
ToronCtaon,a da
BethesMdaar,y la20n10d4
· HubertC,h ristine
ChangT,s unM, .Sc.
LabaratdoeCr liien ica
SeniRoers recahB iochemist
HormonaMlaete,r nite
ParkDea viasn dC ompany
AcutdeeP orRto yal
AnnA rboMri,c hi4g8a1n0 6
PariFsr,a nce
ConnH,a rol0d,. M, .D.
JeejeebhKo.yN ,. ,M .D.
ChieHfe,p atRiecs earch
DirecDtiovri,s oifGo ans troenterology
VeterAadnmsi nistHroastpiiotna l
Associate oPfrM oefdeiscsionre
WesHta veCno,n nect0i61c56ut
UniverosfTi otryo nto
ProfeossfMo erd icine
ToronCtaon,a dMaS S !Al
YalUen iverSscihtoyoo flM edicine
NewH aveCno,n nect0i61c50ut KavaleFrr,e derMic.,D .
FalloHna,r olJd.,M, .D. AssoactPier ofeossfPo hry siology
Professor-Chairman DownstMaetdei cCaeln ter
DepartmoefIn ntt erMneadli cine BrooklNyenwY, o rk12 130
MedicCaoll loefgV ei rginia LeevyC,a rrolMl.,D .
VirgiCnoimam onwealth UniversitPyr ofesosfMo erd icine
RichmoVnidr,g i2n3i2a2 0 DirecotfHo erp atoalnodgN yu trition
FerranVsi,c toJr.,P, h.DM..,D . ColloefgM ee dicainnde DenotfiN s.tJr.y
SeniIonrv iegsattor Jersey NCeiwJt eyr,s 0e7y3 04
SectoifoP na thology LiebeCrh,a rleSs.,,M .D.
NatioHneaalra tn dL unIgn stitute ChieSfe,c toifoLn i veDri seaasned
NatioInnsatli touft esH ealth Nutrition
Bethesda, 2M0a10r4y land VeterAadnmsi sntiratHioosnp ital
xv
xvi Lisotf Contributors
BronNxe,w Y or1k40 68 ReganT,i mothJy.,M, .D.
ProfeosfsM oerd icine ProfeosfsM oerd icainndDe i rector
MounSti nSacih oooflM edicine DivisoifCo anr diovaDsicsuelaasre s
NewY orkN,e wY ork ColloefgM ee dicinDee natnids try
McFarlanAe.,S .,M .D. ofN ewJ ersaety Newark
CliniRecsaela Crecnht er Newar-Nke,w J ers0e7y3 04
NorthwPiacrkHk o spital Roberts, WiCl.lMi,a. mD,.
LondoHnA 31U J ChiePfa,t holSoegcyt ion
England NatioHneaalra tn dL unIgn stitute
MillwarDd.,J . P, h.D. NatioInnaslt iotfuH teeasl th
DepartmoefNn utt rition BethesMdaar,y l2a0n10d4
LondoSnc hoooflH ygieanned
Robertson-BAr.u,Mc e.,D .
TropiMceadli cine
AssociDaetpea,r tmoefMn etd icine
LondoWnC IE7 HT
Toronto GHeonsepriatla l
England
ToronCtaon,a dMa5 1SA 1
MorganH,o wardE,. ,M .D.
RosenoeVri,c toMr.,, M .D.
ProfeasnsdoC rh airman
PhysicLiaahneC,yl inic
DepartmoefP nhty sigoy lo
DepartmoefM netd icine
TheP ennsylSvtaanUtineai versity
HarvaMredd icSaclh ool
HershPeeyn,n syl1v07a3n3i a
BostoMna,s sachu0s21e2t5t s
Munro, HamNi.s,hM ,. D.
RothschiMladr,c uAs. ,M .D.
ProfeosfsP ohry osliogiCchaelm istry
ChieNfu,c leMaerd icDienpea rtment
DepartmofeN nutt rition Sacnide nFcoeo d
VeterAadnmsi nistHroastpiiotna l
MascshauseItntsst iotfTu etceh nology
ProfeosfsM oerd icine
CambriMdagses,a chu0s21e93t ts
NewY orUkn iverSscihtoyoo flM edicine
NobleE,r nesPt.,,P h.DM..,D . NewY orkN,e wY or1k00 10
ProfeosfsP osyrc hiaPtsyrcyh,o logy
and Pharmacology RubinE,m anueMl,. D.
UniverosfCi atlyi fornia ProfeasnsdoC rh airman
IrviCnael,i fo9r2n6i6a4 DepartmoefPn att hology
MounSti nSacih oooflM edicine
OratzM,u rrayP,h .D.
NewY orkN,e wY or1k00 29
AsssitaCnhti eDfe,p artmoefNn utc lear
Medicine SchenkeSr.,,M .D.
Veterans AdmiHnoissptirtaalt ion ProfeosfsM oerd icainnde
AdjunAcsts ocPiraotfee osfsB oiro chemistrCyh ieGfa,s troenterology
NewY orUkn iverCsoiltlyoe fgD ee ntistry VeterAadnmsi nistHroastpiiotna l
NewY orkN,e wY or1k0 010 Nashville, Tennessee 37203
PeterTsh,e odorJer,.P ,h .D. SchreibSeird,n eSy.,,M .ScM..,D .
AssociinaB tieo chemistry AttendIinntge rDneipsatr,t moefNn utc lear
Coelgleo fP hysicainadSn usr geons Medicine
Columbia University VeterAadnmsi naitsitHorons pital
ResearBciho chemist ProfesofsC olri niMceadli cine
The Mary IBmaosgseHenotest p ital NewY orUkn iverSscihtoyoo flM edicine
CoopersNteowwY no,r k NewY orkN,e wY or1k00 10
RamireAzl,b ertMo.,D . SodtkUe.,
AsstiasnPtr ofeosfsMo erd icine DivisoifGo ans troenterology
HarvaMredd icSaclh ool Toronto GHeonsepriatla l
ThorndMiekmeo rLiaablo ratory ToronCtaon,a dMa5 S 1A1
BostoMna,s sachu0s21e1t8t s TewarSiu,j atPah, .D.
RannelEsu,g eneD,. ,P h.D. AssainsPttr ofesDseopra,r tmofe nt
InstruDcetpoarr,t moefP nhty siology PsychiaatnrdHy u maBne havior
TheP ensnylvaSntiaaUt nei versity CalifoCroneliglaeo fM edicine
HershPeeyn,n snyil1av0 7a33 IrviCnael,i fo9r2n6i64a
LisotfC ontributxoviris
WaterloJw.,C .,C MG,M .D.S,cD F,R CP ColloefgM ee dicainndDe e ntistry
ProfesofsH ourm aNnu trition ofN ewJ ersey
LondoSnc hoooflH ygieanned NewarNke,w J ers0e7y1 03
TropiMceadli cine ZimmonD,a vidM,. D.
UniverosfLi otnyd on ChieGfa,s troentSeercotlioogny
LondoWnC lE 7HT VeterAadnmsi nistHroastpiiotna l
England AssoactPier ofesosfC olri niMcedailc ine
ZettermRaonw,e nK,. ,M .D. NewY orUkn iverSscihtoyoo flM edicine
InstruicnMt eodri cine NewY orkN,e wY or1k0 010
1
MalnutritainodnA lcoholism-OAvne rview*
CarlrMlo. L eevayn Rd oweKn.Z ettaenrm
DIVISIOOFNH EPATOLOGYA NDN UTRITIOCNO,L LEGOE F
MEDICINAEN D DENTISTROYF N EW JERSEYN,E WARK
I.I ntroduction 3
III.n terreolfaM tailuontnrsi taindoE nt hanol 3
III. InocfiN duetnrciDeee nfitc ieinnAc lyc oholism 5
IV.M echanoifsN mu triDeenfitc ieinnAc lyc oholism 7
V.I nflueonfcA el cohoolniI snmt ermeMdeitaarbyo lism 8
VI.Ma lnutrEitthiaonnao,nl dT, i ssDuaem age 11
VIIT.h erapeIumtpilci caotfMi aolnnsu triinAt licoonh olism 12
VIISIu.m mary Caonndc lusions 13
References 14
I.I NTRODUCTION
Ther oloef m alnutriintt ihoepn a theongesoifsc liniacnadll a boratory
abnormailnai ltcioehso hlaibsse met nh e submjueccdhte boafAt lec.o howliitchs
identpiactatle rfnoso adon fda lcoihnotla ke exhibbiito cdhieffmaeinrcdea nlt
morpholloegsiicos nugsg,e stinga ngdce onsnettiitcu tfiaocntaolr osf k aerye
import[alnT]ch.ei tsh esiiss suppotrhtreee dm abryk daibffleyr meentta bolic
effecetnsc ountienir neddi vsiudbujaelfc otlsl o(wait)no gtf aolod de privfaotri on
contorfoo ble s[i2;ta] yn (db l)a rignet aokfee tsh ainnto hlpe r eseonfc neao rmal
di[e3tT ]h.ip sa pperro viadnoe vse rvoifpe owss ibilnet errelaotfni uotnrsiheinpts
deficaintdsm etaboolrti ocx ic eofffee tchtasni ondl e velopomfea nltt ered
intermemdeitaarbyo alnidts ims sduaemg ae ailnc oho(lFiis1gm). .
11.I NTERRELATIONSO F MALNUTRITION AND ETHANOL
Mediccaolm plicaotfai locnosh osluicsahms W erniec'eksn cephalopathy,
beribheeradiri ts eaorsm ea,c rocaynteimchi aav e baetetnr itbuodt eefidc oift s
specniufitcr iwehnitdlsee,l irtiruemm egnosuo,tr a, l cohgoalsitcar rifete ilstb et o
*Aidbeyda g rafnrto tmh Nee wJ ersey DSetpaatret moefHn eta lth, Doifv iCshirIoolnnl ince ss
Control.
3
4 CARROLLM .L EEVYA ND ROWENK .Z ETETRMAN
METABOLIC DEPLETION
or OF
TOXIC EFFECTS ESSENTIAL
OF NUTRIENTS
ETHANOL
//
\\
ALTERED INTERMEDIARY
METABOLISM
11
TISSUE
DA MAGE
Fig1. Possirbellea tioofnn suhtirpid eenfitct iodt esv elopomfe natl itnetreerdrm ye dia
metaboalnidts ims sduaem agient hael coholic.
duteo m etaboorlt iocxe iffce cotfes t haOnopli.n iroenmsad iinv iodnec da usative
factionhr esp adtiisco radnedpr asn cre(aTtaibt1li)Ees.ff oratrsne o wu nderway
bym anrye seagrrcohut pors e evaltuhaet ev asruysicnegp ttiolb iivldeiirts ye ase
bya lcoihcossl;i mialpaprr oaschhoeusbl edu sefdo ro thebri ochemoirc al
morpholloegsiiceo nncso untienar lecdo hoTlhisus,em t.h anol-ihnydpuoc­ed
gylcemoinalo yc cuirncs e rtaalicno hosluigcgse,sag t einnegpt riecd isp[o s4ii]tt ;i on
isd uet oi nhibiotfgi lounc oenneeosgriess ulftrionmmge taboelffiecco tfs
etha[n5;o]a ln di tm ayb ep revenbtyce hda ngensu tirnib eanlta nfcolel owing
admirnaitsitoofnl ys[i6n,]ae n drogenic-satnear[bo1oilo]dirs,a c d rensatle r­
oid[s7 ].
Nutritainomdne atla baolltiecr actoimobnitsno e proadd ueccer eiancs eer ebral
oxidamteitvaeb oilniu snmc omplidcealtiertdir uemm eAnns i.n creiants hee
spiflnuailld a ctate-apcyirdu virantat hteaei bo s,e onfc ec hianbn lgoelo adc tiast e,
charactoefr itsshttiiawscth ei cahp peafrosl lowwiitnhgd rfarwoaamll coohro l
lecsosm mondleys pmiatien taiinnteaodkfl e a rqguea ntoifte itehsa[ n]8oD.le ficits
oft hiammiangens,ei uomrp, h osph(aFti2eg)c . o ntridbiurteteco tt hlmeye tabolic
abnoarlmirteys;ap tiorarlyk alosaissso cainahdty epdo xiinade penpdreondtulcye
anerogbliycc oalnydas nia sc cumuloafts ipoinnfl aulil da ct[a9tS]ee.r isatlu dies
indichaatlel ucisn,da etliiornium,n eshaiynpsde,e r lkeivastpeidnfl aulil da ctate
Tabl1e Postulmaetcehda nfiostrmi ssiunej uirnty h ael coholic.
ToxicoirMt eyt abolic Combined
Nutrient DepletiEoffne cotfsE thanol Effects
Werniceknec'hesap lopathy Delirtiruemm ens Fatltiyv er
Beribheeraidr its ease Cardiomyopathy Alcohhoelpiact itis
Periphneeruarlo pathy Gout Cirrhosis
Macrocaynteimci a Alcohgoalsitcr itis Pancreatitis?
Hypoglycemia
Myopathy?