The effect of Alcoholic beverages on the Immune System

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The effect of Alcoholic beverages on the Immune
System
Special Study Module
By Lucy Cooper
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Introduction
Making sense of alcohol studies is enough
to drive you to drink!

• Aims
• Six week SSM to review current literature
  investigating the effects of alcohol on the
  immune system and body as a whole
• Problems
• The majority of the research has been carried out
  on chronic alcoholics.
• More recent research has studied the effects of
  moderate quantities of alcohol on the immune
  system.
• Vast subject with hundreds of papers, much
  speculation, many theories and assumptions but
  little proof!
• This project will strive
• to present a balanced account of
• the literature as it exists at present.

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Guidelines
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Recommended alcohol consumption
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The history of alcohol use

• Accidental discovery
• Contradictory aspects to personality
• Aqua vitae middle ages
• Whisky derived from usquebaugh Scots Gaelic for
  'Water of Life
• Medicinal qualities

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The Immune system

• Excessive alcohol ? increased infection
• 20 of hospital inpatients - alcohol related
  diagnosis
• Important risk factor for hospital acquired
  infection
• Future Screening patients for alcohol induced
  immunosuppression

1874 "The Bar of Destruction By Thomas Nast -
famous political cartoonist.
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Systemic effects of alcohol

• Intoxication ? systemic effects
• No cell resistant to alcohol
• Increased stomach acid production
• Cancer of the mouth, oesophagus, stomach, and
  intestine
• Destruction of liver cells, fat accumulation
  around the liver, and cirrhosis

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Systemic effects of alcohol

• Diuretic - causes kidneys to increase urinary
  output ? dehydration, hypoglycaemia and a
  hangover
• Penetrates blood-brain barrier affecting neurons
• Reduced coordination altered perception, memory
  blackouts
• Mood altering
• Chronic alcohol use ? depression

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Systemic effects of alcohol

• Worse case scenario
• Alcohol reaches mid-brain
• Reflexes diminish
• Confusion, stupor ? coma
• Alcohol reaches medulla
• Heart rate drops
• Breathing ceases ? death

1870 King Death giving a prize to Bachus God
of wine Thomas Nast
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Alcohol, stress and the HPA axis

• Any threat to a persons physical and
  psychological well-being
• Regulates glucose levels, BP, muscle breakdown,
  immune system
• Stress hormones e.g. glucocorticoids
• Alcohol-induced
• Pseudo-Cushings syndrome

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Alcohol, stress and the HPA axis

• Alcohol intoxication replicates stress response
• Ironically, elevated levels of these stress
  hormones contribute to alcohols pleasurable
  effects
• Three-way interaction exists among alcohol
  consumption, HPA axis activity and the ageing
  process
• High reactors, low reactors and
• CD8 cell division

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Alcohol, stress and the HPA axis

• Relationship between stress and alcohol in
  different studies inconsistent
• Stress response dampening effect (SRD)
• Counter chronic psychological stress
• Alcohols effects on stress are complex. More
  research required to determine conditions where
  drinking will reduce stress

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Alcohol and AIDS

• Alcohols immunosuppressive effect increases
  susceptibility to contracting HIV
• Intensified HIV-induced immunosuppression
  influencing severity or duration of opportunistic
  infections, which characterize AIDS
• Speeds multiplication of HIV in human blood

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Alcohol, the liver and the immune system

• Free radical production ? destroys healthy liver
  tissue
• Persistent activation" of T-cells
• Inhibition of antioxidants
• Increased cytokine levels imitating hepatitis
• TNF
• Distorted scarring process ? Cirrhosis

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Alcohol, diet and the immune system

• Food with non-nutritional calories that quickly
  add up
• Thiamine (B1) and Folate deficiencies
• Wernicke-Korsakoff syndrome
• Vit B12 deficiency - excess homocysteine -
  increased risk of heart disease, stroke,
  Alzheimers disease and osteoporosis
• B6 deficiency through poor diet increased
  clearance
• Malnutrition

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Thrombocytopenia in alcoholics

• Reduction in the number of platelets in the blood
• Immune thrombocytopenia caused by alcohol
• Clinical presentation
• bleeding into the skin, spontaneous bruising and
  prolonged bleeding after injury

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Alcohol, sleep disturbance and the immune system

• Alcohol suppresses REM
• Latency to sleep reduced
• Wake time during latter half of sleep increased
• Self medication of insomniacs seems to improve
  their sleep and health
• Therefore
• Detrimental effect to sleep of otherwise healthy
  individuals
• Improved sleep of people with insomnia outweighs
  immunosuppressive effects and confers a small
  advantage to immune system

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Health factors

• Heavy drinkers and teetotallers report higher
  rates of ill health than moderate drinkers
• Link between health and alcohol consumption - not
  age specific
• Problem study unable to comment on sensible
  drinking limits

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Age

• gt2 drinks/week promotes ageing
• Earlier onset of age related reduced immunity -
  reduced phagocytosis
• Opposition
• Report in Lancet - better psychological
  well-being from moderate drinking after age 33yrs
• Cardiovascular health benefactor

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Alcohol and allergies

• Increased IgE
• Link with atopy

• Current research association with variable rate
  of sensitization to distinct aeroallergens

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The beneficial effects of red wine

• In science's good books for some time
• Antioxidants

• Cabernet sauvignon vs. Muscadine wine
• Differences in how liver processes the two wines

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Prenatal effects

• Fetal Alcohol Syndrome
• Decreased immune response of offspring
• Stillbirth

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What quantity of alcohol detrimental to your
health?

• Health problems and infectious diseases
• Reduce antibody production
• URTI, Pneumonia, Tuberculosis
• Increased likelihood of post-surgical sepsis
• Increased incidence of common cancers
• Influence of genes involved in alcohol metabolism

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Alcohol in moderation is beneficial to your
health?

• 3 drinks/day ? No or decreased risk of URTI
• Moderate intake ? Reduced CV and Alzheimer's
  disease
• Reduced risk of food poisoning
• No benefit of wine over beer, both in moderation
  ? reduced reports of ill health

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To drink or not to drink

• 1998 reanalysis of previous research,
• Balance between and effects on immune system
• Myriad of effects on immune system depending on
  individual differences ranging from genetic
  make-up to current health status

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Useful contacts
If you or anyone else you know is affected by any
of the issues mentioned today then these
organisations may be helpful!
Any Questions?
info_at_acad.org.uk
http//www.alcoholconcern.org.uk
http//www.alcoholics-anonymous.org