Acetaldehyde Metabolism in Different Aldehyde Dehydrogenase-2 Genotypes


Reprint requests: Akira Takada, M.D., Division of Gastroenterology, Department of Internal Medicine, Kanazawa Medical University, Uchinada, Ishikawa, 920-02, Japan.


In order to clarify the relationships between acetaldehyde (Ac-CHO) metabolism and low Km (mitochondrial) aldehyde dehydrogenase (ALDHP) genotypes, hepatic ALDHS activity was determined and serial changes of blood Ac-CHO levels after ethanol administration were analyzed in the individuals homorygous for the normal ALDH2 genes, heterozygous for the normal and mutant ALDH2 genes, and homozygous for the mutant ALDH2 genes. Genomic DNA was extracted from white blood cells and genotyping of ALDH2 was performed using the polymerase chain reaction technique and slot blot hybridization with synthesized oligonucleotide probes specific to the normal and mutant ALDH2 genes.

ALDH2 activity was not detectable in the liver in two cases of the mutant homozygote. In four out of eight cases of the heterozygote, hepatic ALDH2 activity was measurable, although the activity was lower compared with that in the normal homozygote. Blood ethanol levels after alcohol administration were not different among the three different ALDH2 genotypes. Blood Ac-CHO levels after drinking of alcohol were significantly higher in the heterorygotes and the mutant homozygotes than in the normal homozygotes. The levels after a moderate amount of ethanol (0.8 g/kg of body weight) in a case of the mutant homozygote were not different from those of the heterozygotes. However, the levels after a small amount of ethanol (0.1 g/ kg of body weight) were significantly higher in the mutant homorygotes than in the heterozygotes.

These results indicate that hepatic ALDH2 activity is lacking completely, and metabolism of Ac-CHO in the liver is severely impaired in the homozygotes of the mutant ALDH2 genes. On the other hand, the lack of hepatic ALDH2 activity is partial, and impairment of hepatic Ac-CHO metabolism is mild, in the heterozygotes of the ALDH2 genes. Clear differences of blood Ac-CHO levels after a small amount of ethanol suggest that blood Ac-CHO levels after a small amount of ethanol are good markers for the evaluation of ALDH2 genotypes.