Alcohol metabolism reframed as a multi-organ network
- This review argues the liver is not the only site of ethanol oxidation and acetaldehyde detoxification; the process runs as a network across several organs.
- It examines liver cell-type heterogeneity and zonation, then the gut, liver-gut axis, brain and other extrahepatic tissues.
- These distributed pathways influence metabolite exchange, drinking behavior and disease progression, and may open new therapeutic options for alcohol-associated disorders.
💡 Points
This review brings no new data, so it works best as a map of untested hypotheses. If gut and brain ADH/ALDH2 genuinely shape exposure, the liver-centric PK models behind ALDH2 activators and disulfiram-type drugs leave something out. Extrahepatic input is probably minor by AUC yet could count for local acetaldehyde, which only tissue-level measurements can settle.
Ethanol metabolism and acetaldehyde clearance: A multi-organ symphony ↗