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INTRODUCTION

It marvels a lot as the beverage individuals enjoy and relax with has a serious impact on their body defense system (immune system), thereby making them susceptible to bacterial and viral infection, and other diseases. It has been reported that every year three million people die as a result of harmful use of alcohol, having about 13.26 disability-adjusted life years (DALYs). The mortality rate among men was at 2.3 million deaths and about 0.7 million deaths among women (Calina et al., 2021; WHO, 2016). The abuse of alcohol is a major risk factor for the development of other diseases, such as liver disease (Cirrhosis and alcoholic liver disease (ALD)) (Calina et al., 2021; Li et al., 2019)). Several studies have reported an association between chronic alcoholic drinkers and serious organ damage, respiratory diseases, cardiovascular diseases, sepsis, pneumonia, tuberculosis, HIV infection and hepatitis C virus, and even progression of COVID-19 disease (Calina et al., 2021; Sureshchandra et al.,2019; Grewal and Viswanathen, 2012).

To understand the effect of alcohol on the immune system, it is important to understand its mechanism of absorption. The mechanism of alcohol absorption is that when alcohol is taken, it diffuses through the mucosa of the gastrointestinal tract, its main absorption site is at the upper respiratory tract, and the rest find their way to the small intestine (Caslin et al., 2021). Alcohol metabolism occurs in the liver (hepatocytes). The following enzymes act on it which include alcohol dehydrogenase, catalase, or cytochrome p45o which converts ethanol to acetaldehyde, it is then oxidized to acetate by aldehyde dehydrogenase (ALDH). Almost (about 90%) all the alcohol consumed is metabolized through oxidized by alcohol dehydrogenases, whereas microsomal ethanol-oxidizing system takes care of the remaining alcohol (10%). However, the microsomal ethanol oxidizing system is responsible for inducing oxidative stress by producing free oxygen radicals, that are responsible for cellular damage. Apart from the liver, the metabolism of alcohol also occurs in the intestinal mucosa  (Calina et al., 2021; ).

To understand how alcohol affects the immune system, it is vital to have an overview of the immune system. The human immune system is composed of molecules, cells, tissues, and organs that simultaneously in a coordinated manner protect the human body against infectious diseases. This immune system is divided into innate and adaptive immune systems. As for the innate immune system, it is composed of the following cells such as natural killer cells, neutrophils, monocytes, and dendritic cells. The innate immunity responses are not specific to a particular pathogen, however, they express pathogen recognition receptors. When it comes to adaptive immunity, it can be divided into cell-mediated immunity (transported by T-cells) and humoral immunity (B-cells). The T-cells express the CD4, which are T cells co-receptor named helper T-cells. The B-cells undergo maturation into Plasmas cells that produce antibodies called immunoglobulins that eliminate the extracellular microorganisms, thus preventing the spread of infection (Calleja-Conde et al., 2021).

Several types of research have reported that alcohol negatively impacts the immune system and the risk of developing several other diseases, therefore there is no safe limit in alcohol consumption. Calina et al. reported that excessive alcohol consumption weakens the immune system, therefore making the body prone to such SARS-COV-2 virus, several types of cancer, drug addiction, HIV infection, and pneumonia (Calina et al., 2021). The following were the findings of an association between bacterial and viral infections and ethanol dependence; The pathophysiology is that chronic intake of alcohol leads to reduction of the T-cells, increases inflammatory status, reduction in the number of natural killer cells, and alteration of macrophage functions (Calina et al., 2021; Calleja-Conde et al., 2021; Sureshchandra et al., 2019; Barr and Messaoudi, 2016; Sarkar et al., 2015).

AIM

• To determine the effect of alcohol on the Immune system

SPECIFIC OBJECTIVES

• To determine the effect of alcohol on the level of Adaptive immunity (T-cells and B-cells)
• To determine the level of alcohol on the level of macrophages
• To understand the association of chronic alcohol to infectious diseases
• To determine the role of alcohol on alcoholic liver disease (ALD)
• To understand the relationship between alcohol and mortality rate attributed to infectious diseases
• To understand the relationship between alcohol and mortality rate attributed to infectious diseases

RESEARCH PROBLEM

The World Health Organization sounded a serious warning against alcohol usage, with the following statistics: each year 3 million die as a result of harmful use of alcohol, having about 13.26 disability-adjusted life years (DALYs). The mortality rate among men was at 2.3 million deaths and about 0.7 million deaths among women (Calina et al., 2021; WHO, 2016). The impact of alcohol on the human body especially is a serious problem. Chronic intake of alcohol leads to reduction of the T-cells, increases inflammatory status, reduction in the number of natural killer cells, and alteration of macrophage functions (Calina et al., 2021; Calleja-Conde et al., 2021; Sureshchandra et al., 2019; Barr and Messaoudi, 2016; Sarkar et al., 2015). Therefore, it is important to determine the effect of alcohol on the immune system.

RESEARCH QUESTIONS

• What is the effect of alcohol on the level of Adaptive immunity (T-cells and B-cells)?
• What is the level of alcohol on the level of macrophages?
• Is there any association between chronic alcohol and infectious diseases?
• What is the role of alcohol on alcoholic liver disease (ALD)?
• Is there any relationship between alcohol and mortality rate attributed to infectious diseases?
• Is there any relationship between alcohol and morbidity rate attributed to infectious diseases?

SIGNIFICANCE OF THE STUDY

It is already evident the destructive effect alcohol has on the human body on several systems. Several studies have reported an association between chronic alcoholic drinkers and serious organ damage, respiratory diseases, cardiovascular diseases, sepsis, pneumonia, tuberculosis, HIV infection and hepatitis C virus, and even progression of COVID-19 disease (Calina et al., 2021; Sureshchandra et al.,2019; Grewal and Viswanathen, 2012). However, only a few studies have reported the effect of Alcohol on the immune system, which this present study is going to discuss.

METHODOLOGY

• Study Design: This study will review current literature to determine the effect of stress on cardiovascular diseases. In the search for this literature, keywords such as “Alcohol”, “Chronic alcohol”, “Immune system”, “Immune suppression”, “Immunity”, and other related terms will be utilized. Databases such as Pubmed/ Medline, Google Scholar, Cochrane library, will also be used to source data Also, Inclusion and exclusion criteria will be used in selecting relevant literature for this study.
• ANALYSIS

The following will be used for analysis in this review, they are; cluster analysis (CA) and/or factor analysis (FA), and/or principal component analysis (PCA). The results will be presented as odds ratios (OR).

RISK ASSESSMENT

The risk assessment conducted for this project is provided in the table below:

Table 1:  Risk assessment

SCHEDULE

    Table 2: Project Plan

REFERENCES

Barr, T. M., & Messaoudi, I. (2016). Impact of Alcohol Abuse on the Adaptive Immune System. https://www.researchgate.net/publication/285619112

Calina, D., Hartung, T., Mardare, I., Mitroi, M., Poulas, K., Tsatsakis, A., Rogoveanu, I., & Docea, A. O. (2021). COVID-19 pandemic and alcohol consumption: Impacts and interconnections. In Toxicology Reports (Vol. 8, pp. 529–535). Elsevier Inc. https://doi.org/10.1016/j.toxrep.2021.03.005

Calleja-Conde, J., Echeverry-Alzate, V., Bühler, K. M., Durán-González, P., Morales-García, J. Á., Segovia-Rodríguez, L., Rodríguez de Fonseca, F., Giné, E., & López-Moreno, J. A. (2021). The immune system through the lens of alcohol intake and gut microbiota. In International Journal of Molecular Sciences (Vol. 22, Issue 14). MDPI AG.

Caslin, B., Mohler, K., Thiagarajan, S. and Melamed E. (2021) Alcohol as friend or foe in        autoimmune diseases: a role for gut microbiome?, Gut Microbes, 13:1, 1916278, DOI: 10.1080/19490976.2021.1916278

Grewal, P. & Viswanathan, V. A.   (2012) Liver cancer, and alcohol. Clin Liver Dis 16: 839–850         

Li, S., Tan, H. Y., Wang, N., Feng, Y., Wang, X., & Feng, Y. (2019). Recent insights into the role of immune cells in alcoholic liver disease. In Frontiers in Immunology (Vol. 10, Issue JUN). Frontiers Media S.A. https://doi.org/10.3389/fimmu.2019.01328

Sarkar, D., Katherine Jung, M., Joe Wang, H., & Sarkar, D. K. (2015). Alcohol and the Immune System.

Sureshchandra, S., Raus, A., Jankeel, A., Ligh, B. J. K., Walter, N. A. R., Newman, N., Grant, K. A., & Messaoudi, I. (2019). Dose-dependent effects of chronic alcohol drinking on peripheral immune responses. Scientific Reports, 9(1).

WHO. Global Status Report on Alcohol and Health; World Health Organization: Geneva, Switzerland, 2016. Available online:https://www.who.int/publications/i/item/9789241565639

Last updated: Jan 21, 2022 04:55 PM