Influence of acute alcohol intoxication on certain immune reactions

Abstract

Background Long-term alcohol abuse is a potent immunomodulator, and alcohol abusers have increased risk of bacterial infections after surgery. In experiments, acute alcohol intoxication suppresses certain immune reactions and may co-act with trauma to increase risk of post-trauma infectious complications. The aim was to evaluate immune reactions during, an evening of social drinking.

Methods We studied 13 healthy, non-smoking volunteers having red wine (1 g of ethanol/kg body weight) with a three course dinner. Delayed type hypersensitivity (DTH) skin test, plasma plasminogen activator inhibitor-1 (PAI-1), plasma myeloperoxidase (MPO) and plasma histamine, representing parts of the immune response with specific relation to the host defence against bacterial antigens, were tested two weeks before the dinner, immediately prior to the dinner, when the blood alcohol level peaked, and one week after the dinner. The volunteers abstained from alcohol in the two weeks leading up to the dinner and one week afterwards.

Results The median peak blood alcohol level reached 92 (51-124) mg/dl, equivalent to 20 (11-27) mmol/l. No change in the DTH response was found, p = 0.76. PAI-1 concentration in plasma increased significantly from 3 (1-13) ng/ml just before dinner to 20 (5-75) ng/ml at the time of alcohol peak level, p < 0.01. Similarly, plasma histamine increased from 5.8 (4.7-10) nmol/l to 7.1 (5.6-10) nmol/l, p < 0.01 and plasma MPO decreased from 96 (42-158) to 91 (41-125) ng/ml, p < 0.05. After one week of abstinence, PAI-1, histamine and MPO returned to pre-dinner level.

Conclusion The study showed significant changes in various parts of the host’s defence to bacteria following acute alcohol intoxication. Potentially, this may be detrimental for patients, who have been traumatised at injury or surgery during alcohol intoxication, by contributing to enhanced susceptibility to post-trauma bacterial infectious complications.