The “Asian flush syndrome”: ALDH2 Deficiency and Long-term Health Consequences
DOI:
https://doi.org/10.47611/jsrhs.v12i1.4048Keywords:
ALDH2, esophageal cancer, cardiovascular disease, Alzheimer's disease, long-term health impactsAbstract
Harmful use of alcohol leads to roughly 3 million deaths worldwide every year, and is linked to the development of roughly 230 different types of disease (World Health Organization, 2016). As alcohol has the ability to diffuse through cell membranes, its toxicity can heavily impact almost all organs within the human body. A large proportion of the East Asian population experiences the “Asian flush syndrome” post-drinking, which induces characteristic facial-flushing symptoms caused by an aldehyde dehydrogenase (ALDH2) enzyme deficiency due to an ALDH2 gene mutation. In the past, investigations on links between ALDH2 deficiencies and long-term health consequences have been conducted with conclusive evidence that confirm that “Asian flushers'' have a predisposed risk for various diseases, including cancer and cardiovascular disease. This literature review systematically compiles research that explains the mechanisms behind ALDH2 deficient communities and increased health risks to esophageal cancer, cardiovascular disease, and Alzhiemer’s disease. Furthermore, it shows that risk levels for disease are compounded when alcohol intake is increased. The preventative measures and social factors are also considered, including recommendations for further interventions to increase awareness and decrease alcohol intake in affected individuals.
Downloads
References or Bibliography
Brooks, P. J., Enoch, M.-A., Goldman, D., Li, T.-K., & Yokoyama, A. (2009, March 24). The alcohol flushing response: An unrecognized risk factor for esophageal cancer from alcohol consumption. PLoS medicine. Retrieved August 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2659709/
Chen, C.-H., Ferreira, J. C. B., & Mochly-Rosen, D. (1970, January 1). ALDH2 and cardiovascular disease. SpringerLink. Retrieved August 26, 2022, from https://link.springer.com/chapter/10.1007/978-981-13-6260-6_3
Chen, C.-H., Kraemer, B. R., & Mochly-Rosen, D. (2022, June 1). ALDH2 variance in disease and populations. Disease models & mechanisms. Retrieved August 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9235878/
Cook, W. K., Tam, C. C., Luczak, S. E., Kerr, W. C., Mulia, N., Lui, C., & Li, L. (2021, February). Alcohol consumption, cardiovascular-related conditions, and ALDH2*2 ethnic group prevalence in Asian Americans. Alcoholism, clinical and experimental research. Retrieved August 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8545194/
Desler, C., Lillenes, M. S., Tønjum, T., & Rasmussen, L. J. (2018). The role of mitochondrial dysfunction in the progression of alzheimer's disease. Current medicinal chemistry. Retrieved August 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446443/
Eng, M. Y., Luczak, S. E., & Wall, T. L. (2007). ALDH2, ADH1B, and ADH1C genotypes in Asians: A literature review. Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism. Retrieved August 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860439/
GD;, L. S. J. S. (n.d.). Alcohol, ALDH2, and esophageal cancer: A meta-analysis which illustrates the potentials and limitations of a Mendelian randomization approach. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. Retrieved August 26, 2022, from https://pubmed.ncbi.nlm.nih.gov/16103445/
Hu, C.-Y., Hung, C.-L., Huang, Y.-C., Huang, P.-H., Tseng, D.-Y., Lin, Y.-H., Sun, F.-J., Kao, F.-J., Yeh, H.-I., & Liu, Y.-Y. (2022, July 3). Alcohol patch test with hue-saturation-value model analysis predicts ALDH2 genetic polymorphism. Computers in Biology and Medicine. Retrieved August 26, 2022, from https://www.sciencedirect.com/science/article/pii/S0010482522005509
Investigation, T. J. of C. (n.d.). Genotypes for aldehyde dehydrogenase deficiency and alcohol sensitivity. the inactive ALDH2(2) allele is dominant. JCI. Retrieved August 26, 2022, from https://www.jci.org/articles/view/113875/pdf
Kamino K;Nagasaka K;Imagawa M;Yamamoto H;Yoneda H;Ueki A;Kitamura S;Namekata K;Miki T;Ohta S; (n.d.). Deficiency in mitochondrial aldehyde dehydrogenase increases the risk for late-onset alzheimer's disease in the Japanese population. Biochemical and biophysical research communications. Retrieved August 26, 2022, from https://pubmed.ncbi.nlm.nih.gov/10873585/
Kim, H. K., Lim Si En, R., & Wong Kang Min, D. (2019, May 29). Psychosocial motivators for moderate drinking among young Asian flushers in Singapore. International journal of environmental research and public health. Retrieved August 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603583/
Korea’s drinking culture: When an organizational socialization tool ... (n.d.). Retrieved August 26, 2022, from https://www.researchgate.net/profile/Ulas-Cakar/publication/301665161_Korea's_Drinking_Culture_When_an_Organizational_Socialization_Tool_Threatens_Workplace_Well-being/links/5943ba78a6fdccb93ab58c96/Koreas-Drinking-Culture-When-an-Organizational-Socialization-Tool-Threatens-Workplace-Well-being.pdf
Matsumura, Y., Li, N., Alwaseem, H., Pagovich, O. E., Crystal, R. G., Greenblatt, M. B., & Stiles, K. M. (2020, February). Systemic adeno-associated virus-mediated gene therapy prevents the multiorgan disorders associated with aldehyde dehydrogenase 2 deficiency and chronic ethanol ingestion. Human gene therapy. Retrieved August 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047123/
Matsumura, Y., Stiles, K. M., Reid, J., Frenk, E. Z., Cronin, S., Pagovich, O. E., & Crystal, R. G. (2019, August 26). Gene therapy correction of aldehyde dehydrogenase 2 deficiency. Molecular Therapy - Methods & Clinical Development. Retrieved August 26, 2022, from https://www.sciencedirect.com/science/article/pii/S2329050119300841
Nicolas Bertholet, M. D. (2005, May 9). Reduction of alcohol consumption by brief alcohol intervention in primary care. Archives of Internal Medicine. Retrieved August 26, 2022, from https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1152798
Ohta, S., Ohsawa, I., Kamino, K., Ando, F., & Shimokata, H. (1970, January 1). Mitochondrial ALDH2 deficiency as an oxidative stress. SpringerLink. Retrieved August 26, 2022, from https://link.springer.com/chapter/10.1007/978-3-662-41088-2_4
Peele , S., & Grant , M. (Eds.). (n.d.). Alcohol and pleasure. Google Books. Retrieved August 26, 2022, from https://books.google.com.hk/books?hl=en&lr=&id=MbAE5YG7iPQC&oi=fnd&pg=PA113&dq=Japanese%2Bdrinking%2Bculture&ots=eCb06V6aml&sig=DjGwpFUW2W9LPU0RdBe9ggRfiYw&redir_esc=y#v=onepage&q=Japanese%20drinking%20culture&f=false
Seo, W., Gao, Y., He, Y., Sun, J., Xu, H., Feng, D., Park, S. H., Cho, Y.-E., Guillot, A., Ren, T., Wu, R., Wang, J., Kim, S.-J., Hwang, S., Liangpunsakul, S., Yang, Y., Niu, J., & Gao, B. (2019, July 4). ALDH2 deficiency promotes alcohol-associated liver cancer by activating oncogenic pathways via oxidized DNA-enriched extracellular vesicles. Journal of Hepatology. Retrieved August 26, 2022, from https://www.sciencedirect.com/science/article/abs/pii/S0168827819303903
Wang B;Wang J;Zhou S;Tan S;He X;Yang Z;Xie YC;Li S;Zheng C;Ma X; (n.d.). The association of mitochondrial aldehyde dehydrogenase gene (ALDH2) polymorphism with susceptibility to late-onset alzheimer's disease in Chinese. Journal of the neurological sciences. Retrieved August 26, 2022, from https://pubmed.ncbi.nlm.nih.gov/18201725/
Wang, D., Zou, Y., Yu, S., Lin, S., Li, H., Yin, Y., Qiu, L., Xu, T., & Wu, J. (2020, December 4). The effect of ALDH2 rs671 gene mutation on clustering of cardiovascular risk factors in a big data study of Chinese population: Associations differ between the Sexes. BMC cardiovascular disorders. Retrieved August 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716427/
World Health Organization. (n.d.). Global information system on alcohol and health. World Health Organization. Retrieved August 26, 2022, from https://www.who.int/data/gho/data/themes/global-information-system-on-alcohol-and-health
Xu, F., Chen, Y., Lv, R., Zhang, H., Tian, H., Bian, Y., Feng, J., Sun, Y., Li, R., Wang, R., & Zhang, Y. (2009, October 30). ALDH2 genetic polymorphism and the risk of type II diabetes mellitus in CAD patients. Nature News. Retrieved August 26, 2022, from https://www.nature.com/articles/hr2009178
Published
How to Cite
Issue
Section
Copyright (c) 2023 Hei Yu Zeng; Michael McAloon
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright holder(s) granted JSR a perpetual, non-exclusive license to distriute & display this article.