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Group of dehydrogenase enzymes

Alcohol dehydrogenases (ADH) are a group of dehydrogenase enzymes that occur in many organisms and facilitate the interconversion between alcohols and aldehydes or ketones with the reduction of nicotinamide adenine dinucleotide (NAD+) to NADH. In humans and many other animals, they serve to break down alcohols that are otherwise toxic, and they also participate in the generation of useful aldehyde, ketone, or alcohol groups during the biosynthesis of various metabolites. In yeast, plants, and many bacteria, some alcohol dehydrogenases catalyze the opposite reaction as part of fermentation to ensure a constant supply of NAD+.

Genetic evidence from comparisons of multiple organisms showed that a glutathione dependent formaldehyde dehydrogenase, identical to a class III alcohol dehydrogenase (ADH 3/ADH5), is presumed to be the ancestral enzyme for the entire ADH family. Early on in evolution, an effective method for eliminating both endogenous and exogenous formaldehyde was important and this capacity has conserved the ancestral ADH 3 through time. Gene duplication of ADH 3, followed by series of mutations, led to the evolution of other ADHs. In humans, sequencing of the ADH1B gene (responsible for production of an alcohol dehydrogenase polypeptide) shows several functional variants. In one, there is a SNP (single nucleotide polymorphism) that leads to either a Histidine or an Arginine residue at position 47 in the mature polypeptide. In the Histidine variant, the enzyme is much more effective at the aforementioned conversion. The enzyme responsible for the conversion of acetaldehyde to acetate, however, remains unaffected, which leads to differential rates of substrate catalysis and causes a buildup of toxic acetaldehyde, causing cell damage. Various haplotypes arising from this mutation are more concentrated in regions near Eastern China, a region also known for its low alcohol tolerance and dependence. A study was conducted in order to find a correlation between allelic distribution and alcoholism, and the results suggest that the allelic distribution arose along with rice cultivation in the region between 12,000 and 6,000 years ago. In regions where rice was cultivated, rice was also fermented into ethanol. However, the persistence of the Arg variant in other populations argues that the effect could not be strong.

There have been studies showing that variations in ADH that influence ethanol metabolism have an impact on the risk of alcohol dependence. The strongest effect is due to variations in ADH1B that increase the rate at which alcohol is converted to acetaldehyde. One such variant is most common in individuals from East Asia and the Middle East, another is most common in individuals from Africa. Research continues in order to identify the genes and their influence on alcoholism.

Drug dependence is another problem associated with ADH, which researchers think might be linked to alcoholism. One particular study suggests that drug dependence has seven ADH genes associated with it, however, more research is necessary. Alcohol dependence and other drug dependence may share some risk factors, but because alcohol dependence is often comorbid with other drug dependences, the association of ADH with the other drug dependencies may not be causal.

Fomepizole, a drug that competitively inhibits alcohol dehydrogenase, can be used in the setting of acute methanol or ethylene glycol toxicity. This prevents the conversion of the methanol or ethylene glycol to its toxic metabolites (such as formic acid, formaldehyde, or glycolate). The same effect is also sometimes achieved with ethanol, again by competitive inhibition of ADH.

The drug hydroxyzine is broken into its active metabolite cetirizine by alcohol dehydrogenase. Other drugs with alcohol groups may be metabolized in a similar way as long as steric hindrance does not prevent the alcohol from reaching the active site.