Alcohol Use Disorders and the Lung: A Clinical and Pathophysiological Approach (Respiratory Medicine)

__Alcohol Use Disorders and the Lung: A Clinical and Pathophysiological Approach__ is an excellent resource for clinicians who care for individuals affected by alcohol use disorders in diverse settings. Although alcohol abuse alone does not cause acute lung injury, it renders the lung susceptible to dysfunction in response to the inflammatory stresses of sepsis, trauma, and other clinical conditions recognized to cause acute lung injury. In parallel, these same pathophysiological effects of alcohol abuse significantly increase the risk of a wide range of serious lung infections. Many clinicians involved in the primary treatment of alcohol use disorders, such as addiction psychiatrists, will find this text of interest as it will expand their understanding of the health consequences of alcohol use disorders. In parallel, clinicians who specialize in pulmonary and/or critical care medicine will have a unique resource that provides a comprehensive review of the pathophysiology of alcohol-related lung disorders and insights into evolving therapeutic options in these vulnerable individuals. __Alcohol Use Disorders and the Lung: A Clinical and Pathophysiological Approach__ fills a gap in the literature and presents the evolving clinical research that may soon lead to novel therapies that can improve lung health in individuals with alcohol use disorders and co-existing conditions such as HIV infection. Preface 6 Contents 8 Contributors 10 Part I: The Epidemiology of Alcohol Useand Lung Health 12 Chapter 1: A Brief History of Alcohol Use and Abuse in Human History 13 Chapter Body 14 Summary 16 References 16 Chapter 2: Overview of the Evolving Recognition of the Health Effects of Excessive Alcohol Use Over the Past Two Centuries Including the Classic Citations 17 Chapter Body 18 Summary 20 References 20 Chapter 3: Current Definitions of Alcohol Use Disorders and the Use of Validated Questionnaires in Clinical Practice and Research 21 Introduction 21 Low- and High-Risk Alcohol Use 24 Screening and Diagnostic Instruments 24 Summary 26 References 27 Chapter 4: The Epidemiology of Alcohol Abuse and Pneumonia 28 A Historical Perspective on Alcohol Abuse and Pneumonia 29 Alcohol Abuse: A Persistent Risk Factor for Pneumonia in the Age of Antibiotics 30 The Pneumococcus 31 Anaerobic Pathogens 32 Haemophilus influenzae 33 Klebsiella pneumoniae 33 Pseudomonas aeruginosa and Acinetobacter Species 34 Mycobacterium tuberculosis 34 Alcohol and Pneumonia: The Current Socioeconomic Burden 35 Summary 36 References 37 Chapter 5: The Epidemiology of Alcohol and Acute Respiratory Distress Syndrome 44 Introduction 44 Defining Alcohol Misuse, Alcohol Abuse, and Alcohol Dependence 45 Association of Alcohol Misuse with ARDS Risk Factors 46 Alcohol Use and ARDS Risk 47 Alcohol Misuse and ARDS Outcomes 48 Pathophysiology of Alcohol Misuse and ARDS Development 50 Alcohol’s Effects on Innate Immunity 50 Alcohol’s Effects on Oxidative Stress and Alveolar-Epithelial Permeability 51 Conclusion 53 References 53 Part II: The Pathophysiology of the “AlcoholicLung” 56 Chapter 6: Alcohol, the Upper Airway, and Mucociliary Dysfunction in the Conducting Airways 57 Introduction 58 Cilia Action 58 Alcohol in the Airways 59 Alcohol-Induced Ciliary Dysfunction (AICD) 60 Alcohol and Respiratory Syncytial Virus 60 The Combination of Smoke and Alcohol 61 Bidirectional Control Hypothesis 62 Alcohol and Mucus 63 Lung Function and Airway Hyperresponsiveness 63 Barrier Function 64 Wound Repair 64 Pro-inflammatory Cytokine Release 65 Summary 66 References 67 Chapter 7: Alcohol and the Alveolar Macrophage 71 Epidemiology and Statistics 72 Models of Chronic Alcohol Consumption and Pulmonary Injury 73 Alveolar Macrophage Lineage and Differentiation 75 Macrophage Function in Immunity 76 Phenotypic States of Macrophage Activation 77 Chronic Alcohol and Alveolar Macrophage Activation 79 Alcohol-Induced Alveolar Macrophage Oxidative Stress Leads to Phagocytic Dysfunction 80 Summary 83 References 84 Chapter 8: Alcohol and the Alveolar Epithelium 90 Introduction 90 Effects of Alcohol on Alveolar Glutathione 91 Alveolar Epithelial Barrier Function and Fluid Balance 92 Tight Junctions and Alveolar Barrier Function 93 Ion Channels and Alveolar Fluid Clearance 96 Intercellular Communication 97 Gap Junctions 97 Paracrine Signaling 99 Pulmonary Surfactant 100 Alveolar Wound Repair and Extracellular Matrix 101 Summary 101 References 102 Chapter 9: Alcohol-Mediated Oxidative Stress in the Airway: The Unique Role of Thiol Depletion 109 Introduction 110 Sources of Alcohol-Induced Oxidative Stress 111 Consequences of Alcohol-Induced Oxidative Stress 112 Treatments to Attenuate Alcohol-Induced Oxidative Stress 115 Summary 117 References 118 Chapter 10: Alcohol and the Adaptive Immune Response in the Airway: Dendritic Cell and Lymphocyte Impairments 121 Effects of Chronic EtOH Consumption on the Human Immune System 122 Effects of Alcohol Consumption on the Immune System in Experimental Rodent Models 122 Alcohol Consumption and Pulmonary Immunity 123 Chronic Alcohol Consumption and T Cell Immunity 124 Chronic Alcohol Consumption and Dendritic Cells (DC) 124 Pulmonary Adaptive Immunity to Pathogens 125 DC Antigen Acquisition, Antigen Presentation, and Activation of Naïve T Cells 125 Dendritic Cell Subsets 126 Respiratory DC Subsets 127 Alcohol-Induced Increases in Pathogen-Associated Morbidity and Mortality 128 Viruses 128 Bacterial Infections 129 Alcohol-Induced Inhibition in Pulmonary DC Numbers and Alteration of Migration 129 Alcohol-Induced Inhibition of Pathogen-Specific CD8 T Cells 132 Dysregulation of the Influenza-Specific CD8 T Cell Response 133 Summary 133 References 134 Chapter 11: Alcohol Impairment of Granulocyte Function During Lung Infection 139 Introduction: Granulocytes and Lung Host Defense 140 Granulocyte Recruitment 140 Acute Alcohol Suppresses Neutrophil Recruitment 141 Cytokine and Chemokine Response 142 Early Response Cytokines 142 Alcohol and Early Response Cytokines 143 Chemokines 144 Chemokines and Alcohol 145 Alcohol Impairs Neutrophil Cytokine and Chemokine Responsiveness 146 Granulocyte Pathogen Killing 146 Alcohol and Neutrophil Pathogen Destruction 147 Granulocyte Production 148 Granulocyte Production During Pneumonia 148 Alcohol Suppresses Neutrophil Production 150 Augmenting Alcohol-Induced Suppression of Granulocyte Recruitment 151 Summary 153 References 154 Chapter 12: Disruption in the Dynamic Balance Between Transforming Growth Factor-β and Granulocyte/Macrophage Colony-Stimulating Factor Signaling Within the Alveolar Space of the Alcoholic Lung: Impact on Epithelial and Macrophage Function 160 Introduction 161 Transforming Growth Factor-β and the Lung 163 Granulocyte/Macrophage Colony-Stimulating Factor and the Lung 166 Alcohol Perturbs the Normal Dynamic Balance Between TGFβ and GM-CSF in the Lung 169 Summary 174 References 174 Chapter 13: Alcohol-Mediated Zinc Deficiency Within the Alveolar Space: A Potential Fundamental Mechanism Underlying Oxidative Stress and Cellular Dysfunction in the Alcoholic Lung 177 Basics of Zinc Homeostasis 178 Regulation of Zinc Transport and Storage 178 The Role of Zinc in the Immune Response 179 Determination of Zinc Status 180 Zinc Metabolism in the Respiratory System 181 The Effect of Alcohol Exposure on Overall Zinc Homeostasis 181 The Effect of Alcohol Exposure on Zinc Homeostasis in the Lung 182 Effect of Zinc Deficiency on Alveolar Epithelial Barrier Function 183 Effect of Zinc Deficiency on Alveolar Macrophage Function 184 Role of Oxidative Stress 185 References 186 Part III: Special Circumstances 189 Chapter 14: The Impact of Alcohol Abuse on Multiple Organ Dysfunction in the Surgical Patient 190 Relevance of Alcohol Abuse in the Surgical Patient 191 Alcohol Withdrawal Syndrome 193 Pathophysiology of the Alcohol Withdrawal Syndrome 194 Prevention and Treatment of the Alcohol Withdrawal Syndrome 194 Cardiovascular Complications of Alcohol Abuse 197 Alcohol and Rhythm Disorders 198 Alcohol and Coronary Artery Disease 198 Alcoholic Cardiomyopathy 199 Alcohol and Bleeding Complications 201 Hepatic Insufficiency and Coagulopathy 202 Impaired Immune Function and Increased Risk of Peri 203 The Preoperative Period 203 The Intraoperative Period 205 The Postoperative Period 205 Interventions to Improve Perioperative Immune Function 206 Therapy and Prevention of AUD-Related Co-morbidities 206 Summary 209 References 209 Chapter 15: Alcohol and HIV: Experimental and Clinical Evidence of Combined Impact on the Lung 214 Overview 215 Part 1: Epidemiology of HIV, Alcohol Abuse, and Lung Health 215 HIV, Alcohol, and Lung Infection: Tuberculosis 215 HIV, Alcohol, and Lung Infection: Streptococcus Pneumoniae ( Pneumoccocus) 217 HIV, Alcohol, and Lung Injury 218 HIV, Alcohol, and Outcomes 219 Part 2: Pathophysiology of How HIV and Alcohol Affect Lung Immunity 220 Oxidative Stress 220 The Alveolar Macrophage 222 Zinc 223 Part 3: HIV and Other Pulmonary Syndromes 223 Chronic Obstructive Pulmonary Disease 223 Pulmonary Hypertension 224 Lung Cancer 224 Summary 224 References 225 Chapter 16: Maternal Alcohol Use and the Neonate 233 Maternal Alcohol Use During Pregnancy 234 Maternal Alcohol Ingestion and the Term Infant 236 Maternal Alcohol Ingestion and the Risk of Premature Delivery 237 Maternal Alcohol Ingestion and the Risk of Infection in the Neonate 237 Maternal Alcohol Ingestion and Lung Immunity 239 Fetal Alcohol Exposure and Oxidative Stress 240 Summary 242 References 242 Index 248 Front Matter....Pages i-x Front Matter....Pages 1-1 A Brief History of Alcohol Use and Abuse in Human History....Pages 3-6 Overview of the Evolving Recognition of the Health Effects of Excessive Alcohol Use Over the Past Two Centuries Including the Classic Citations....Pages 7-10 Current Definitions of Alcohol Use Disorders and the Use of Validated Questionnaires in Clinical Practice and Research....Pages 11-17 The Epidemiology of Alcohol Abuse and Pneumonia....Pages 19-34 The Epidemiology of Alcohol and Acute Respiratory Distress Syndrome....Pages 35-46 Front Matter....Pages 47-47 Alcohol, the Upper Airway, and Mucociliary Dysfunction in the Conducting Airways....Pages 49-62 Alcohol and the Alveolar Macrophage....Pages 63-81 Alcohol and the Alveolar Epithelium....Pages 83-101 Alcohol-Mediated Oxidative Stress in the Airway: The Unique Role of Thiol Depletion....Pages 103-114 Alcohol and the Adaptive Immune Response in the Airway: Dendritic Cell and Lymphocyte Impairments....Pages 115-132 Alcohol Impairment of Granulocyte Function During Lung Infection....Pages 133-153 Disruption in the Dynamic Balance Between Transforming Growth Factor-β and Granulocyte/Macrophage Colony-Stimulating Factor Signaling Within the Alveolar Space of the Alcoholic Lung: Impact on Epithelial and Macrophage Function....Pages 155-171 Alcohol-Mediated Zinc Deficiency Within the Alveolar Space: A Potential Fundamental Mechanism Underlying Oxidative Stress and Cellular Dysfunction in the Alcoholic Lung....Pages 173-184 Front Matter....Pages 185-185 The Impact of Alcohol Abuse on Multiple Organ Dysfunction in the Surgical Patient....Pages 187-210 Alcohol and HIV: Experimental and Clinical Evidence of Combined Impact on the Lung....Pages 211-229 Maternal Alcohol Use and the Neonate....Pages 231-245 Back Matter....Pages 247-252 "Alcohol Use Disorders and the Lung: A Clinical and Pathophysiological Approach is an excellent resource for clinicians who care for individuals affected by alcohol use disorders in diverse settings Although alcohol abuse alone does not cause acute lung injury, it renders the lung susceptible to dysfunction in response to the inflammatory stresses of sepsis, trauma, and other clinical conditions recognized to cause acute lung injury In parallel, these same pathophysiological effects of alcohol abuse significantly increase the risk of a wide range of serious lung infections Many clinicians involved in the primary treatment of alcohol use disorders, such as addiction psychiatrists, will find this text of interest as it will expand their understanding of the health consequences of alcohol use disorders In parallel, clinicians who specialize in pulmonary and/or critical care medicine will have a unique resource that provides a comprehensive review of the pathophysiology of alcohol-related lung disorders and insights into evolving therapeutic options in these vulnerable individuals Alcohol Use Disorders and the Lung: A Clinical and Pathophysiological Approach fills a gap in the literature and presents the evolving clinical research that may soon lead to novel therapies that can improve lung health in individuals with alcohol use disorders and co-existing conditions such as HIV infection - Font no determinada