Alcohol consumption, especially when it is chronic and heavy, has far-reaching effects on the immune system, which can result in an increased susceptibility to multiple infectious diseases. Alcohol impacts both the innate and adaptive immune systems, disrupting their balance and impairing their function. This brief review will outline the impacts of alcohol on the immune system, focusing on various components and the overall immune response.

Ethanol, the active component of alcoholic beverages, is metabolized in the body primarily by the liver. During this process, reactive oxygen species (ROS) are generated, which can lead to oxidative stress. This imbalance between the production of ROS and the body’s ability to detoxify them or repair the resulting damage can lead to cellular injury and contribute to immune dysregulation (Szabo & Saha, 2015).

The innate immune system, which includes physical barriers, phagocytic cells, and pattern recognition receptors, is significantly affected by alcohol. One of the immediate barriers against pathogens is the epithelium lining the respiratory and gastrointestinal tracts. Alcohol can disrupt these physical barriers, making it easier for pathogens to invade the body (Simet & Sisson, 2015). Alcohol also inhibits the function of phagocytes, such as neutrophils and macrophages, impairing their ability to destroy pathogens (Bhatty et al., 2011).

Natural killer (NK) cells, a component of the innate immune system critical for the control of viral infections and tumor surveillance, also have their function compromised by alcohol. Studies have demonstrated decreased NK cell cytotoxicity following alcohol consumption, which may contribute to increased susceptibility to viral infections and cancer (Zhang et al., 2008).

The adaptive immune system, composed of T cells and B cells, is not spared from the detrimental effects of alcohol. T cells have been shown to be particularly susceptible to alcohol-induced dysfunction. Chronic alcohol consumption impairs T-cell activation, proliferation, and cytokine production, affecting both the CD4+ helper T cells and CD8+ cytotoxic T cells. This dysfunction can lead to a decreased immune response to pathogens and a decreased ability to control the proliferation of infected cells (Cook et al., 2007).

B cells, responsible for producing antibodies, also exhibit functional impairment in the presence of alcohol. Alcohol decreases B cell activation and differentiation, which leads to decreased antibody production. This reduction in antibody production limits the immune system’s ability to neutralize pathogens and prevent re-infection (Laso et al., 2010).

Chronic alcohol use can also disrupt the balance between pro-inflammatory and anti-inflammatory immune responses. Alcohol has been found to promote a pro-inflammatory state, which can contribute to chronic inflammation and tissue damage. This pro-inflammatory state has been associated with numerous health problems, including alcoholic liver disease (Szabo, 2015).

Lastly, alcohol consumption impacts the gut microbiota, a vital component of the immune system. It causes dysbiosis, an imbalance in the gut microbial community, which can lead to increased gut permeability, endotoxemia, and systemic inflammation. This dysbiosis can further compromise the immune system, making the individual more susceptible to gastrointestinal and systemic infections (Bull-Otterson et al., 2013).

In conclusion, alcohol has a profound effect on the immune system, leading to impaired function of both the innate and adaptive immune responses, disruption of immune balance, chronic inflammation, and gut microbiota dysbiosis. These effects collectively increase the individual’s susceptibility to various infections and diseases.

References:

Szabo, G., & Saha, B. (2015). Alcohol’s effect on host defense. Alcohol Research: Current Reviews, 37(2), 159.
Simet, S. M., & Sisson, J. H. (2015). Alcohol’s effects on lung health and immunity. Alcohol Research: Current Reviews, 37(2), 199.
Bhatty, M., Pruett, S. B., Swiatlo, E., & Nanduri, B. (2011). Alcohol abuse and Streptococcus pneumoniae infections: consideration of virulence factors and impaired immune responses. Alcohol, 45(6), 523-539.
Zhang, H., Meadows, G. G. (2008). Chronic alcohol consumption in mice increases the proportion of peripheral memory T cells by homeostatic proliferation. J Leukoc Biol, 84(2), 289-299.
Cook, R. T. (2007). Alcohol abuse, alcoholism, and damage to the immune system–a review. Alcoholism: Clinical and Experimental Research, 22(9), 1927-1942.
Laso, F. J., Vaquero, J. M., Almeida, J., Marcos, M., & Orfao, A. (2010). Chronic alcohol consumption is associated with changes in the distribution, immunophenotype, and the inflammatory cytokine secretion profile of circulating dendritic cells. Alcoholism: Clinical and Experimental Research, 31(5), 846-854.
Szabo, G. (2015). Gut–liver axis in alcoholic liver disease. Gastroenterology, 148(1), 30-36.
Bull-Otterson, L., Feng, W., Kirpich, I., Wang, Y., Qin, X., Liu, Y., … & Barve, S. (2013). Metagenomic analyses of alcohol induced pathogenic alterations in the intestinal microbiome and the effect of Lactobacillus rhamnosus GG treatment. PloS one, 8(1), e53028.

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