Sialic acid: new potential marker of alcohol abuse

Biomarkers of moderate alcohol intake and alcoholic beverages: a systematic literature review

The predominant source of alcohol in the diet is alcoholic beverages, including beer, wine, spirits and liquors, sweet wine, and ciders. Self-reported alcohol intakes are likely to be influenced by measurement error, thus affecting the accuracy and precision of currently established epidemiological associations between alcohol itself, alcoholic beverage consumption, and health or disease. Therefore, a more objective assessment of alcohol intake would be very valuable, which may be established through biomarkers of food intake (BFIs). Several direct and indirect alcohol intake biomarkers have been proposed in forensic and clinical contexts to assess recent or longer-term intakes. Protocols for performing systematic reviews in this field, as well as for assessing the validity of candidate BFIs, have been developed within the Food Biomarker Alliance (FoodBAll) project. The aim of this systematic review is to list and validate biomarkers of ethanol intake per se excluding markers of abuse, but including biomarkers related to common categories of alcoholic beverages. Validation of the proposed candidate biomarker(s) for alcohol itself and for each alcoholic beverage was done according to the published guideline for biomarker reviews. In conclusion, common biomarkers of alcohol intake, e.g., as ethyl glucuronide, ethyl sulfate, fatty acid ethyl esters, and phosphatidyl ethanol, show considerable inter-individual response, especially at low to moderate intakes, and need further development and improved validation, while BFIs for beer and wine are highly promising and may help in more accurate intake assessments for these specific beverages.

Total and free serum sialic acid concentration in liver diseases

Background. The objective of this study was to compare the levels of total (TSA) and free (FSA) sialic acid in acute and chronic liver diseases. Materials and Methods. The serum TSA and FSA levels were determined in 278 patients suffering from acute and chronic liver diseases of different etiologies. TSA was estimated by enzymatic method and FSA by the thiobarbituric method modified by Skoza and Mohos. Results. There were no significant differences in the serum TSA concentration between liver diseases of different etiologies, although in most of the liver diseases the mean TSA level was significantly lower than that in the control group. In contrast to TSA, the concentration of FSA appears to differ between liver diseases. In toxic hepatitis it was higher than that in nonalcoholic cirrhosis. However, neither of them differs between alcoholic and nonalcoholic cirrhosis or between liver tumors and tumors with cirrhosis. Conclusions. We conclude that the changes in concentrations of TSA and FSA during the same liver diseases indicate significant disturbances in sialylation of serum glycoproteins.

Platelets support extracellular sialylation by supplying the sugar donor substrate

Sizable pools of freely circulating glycosyltransferases are in blood, but understanding their physiologic contributions has been hampered because functional sources of sugar donor substrates needed to drive extracellular glycosylation have not been identified. The blood-borne ST6Gal-1 produced and secreted by the liver is the most noted among the circulatory glycosyltransferases, and decorates marrow hematopoietic progenitor cells with α2,6-linked sialic acids and restricts blood cell production. Platelets, upon activation, secrete a plethora of bioactive molecules including pro- and anti-inflammatory mediators. Cargos of sugar donor substrates for glycosyltransferase activity have also been reported in platelets. Here, we implemented a cell-based system to interrogate platelets for their ability to deliver effectively the sugar donor substrate for extracellular ST6Gal-1 to function. We report that thrombin-activated platelets, at physiologic concentration and pH, can efficiently and effectively substitute for CMP-sialic acid in extracellular ST6Gal-1-mediated sialylation of target cell surfaces. Activated platelets can also supply the sialic acid donor to sialylate the synthetic acceptor, Gal(β1,4)GlcNAcα-o-benzyl, with the product Sia(α2,6)Gal(β1,4)GlcNAcα-o-benzyl structurally confirmed by LC/MS. Platelet-secreted donor substrate was recovered in the 100,000 × g sediment, strongly suggesting the association of this otherwise soluble substrate, putatively CMP-sialic acid, within platelet microparticles. Sequestration within microparticles may facilitate delivery of glycosylation substrate at effective dosages to sites of extracellular glycosylation while minimizing excessive dilution.

Protein biomarkers of alcohol abuse

Alcohol abuse can lead to a number of health and social issues. Our current inability to accurately assess long-term drinking behaviors is an important obstacle to its diagnosis and treatment. Biomarkers for chronic alcohol consumption have made a number of important advances but have yet to become highly accurate and as accepted as objective tests for other diseases. Thus, there is a crucial need for the development of more sensitive and specific markers of alcohol abuse. Recent advancements in proteomic technologies have greatly increased the potential for alcohol abuse biomarker discovery. Here, the authors review established and novel protein biomarkers for long-term alcohol consumption and the proteomic technologies that have been used in their study.

Lipid-bound sialic acid in alcoholics participates in increased level of total sialic acid

Serum total sialic acid (TSA) concentration is a sensitive marker of excessive alcohol consumption and is the sum of protein-bound sialic acid, lipid-bound sialic acid (LSA), and free sialic acid. The LSA is the fraction of SA attached to gangliosides that are transported in the blood by the lipoproteins. In this article, the effect of chronic alcohol consumption on the serum levels of LSA was evaluated. The objective of the study was to understand the mechanism of elevated serum TSA concentration during alcohol abuse. Additionally, the association of LSA with serum lipid profile was tested. For this purpose, the levels of LSA, TSA, lipids, lipoproteins, and apolipoproteins (apos) in the sera of 106 alcoholics were measured. The serum level of LSA in alcohol abusers was significantly elevated. This increase was because of the elevated level of LSA in patients drinking alcohol up to 2 days before sampling. The elevated level of LSA positively correlated with TSA, and also with biochemical indices of hepatocellular injury such as aspartate aminotransferase and gamma-glutamyltransferase, but did not correlate with any lipids, apos, and lipoproteins. The increase in LSA level is not related with the status of serum lipid profile but is related to the liver status estimated by the biochemical markers of liver cell damage. On the basis of our results, we conclude that the elevated level of LSA in alcohol abusers contributes to an increase in the serum concentration of TSA, and contrary to TSA, is affected by the status of liver cells.

Erythrocyte glutathione depletion impairs resistance to haemolysis in women consuming alcohol

Alcohol abuse is known to cause an array of ethanol induced abnormalities in men but very few reports are available on the effect of alcohol in women. None of them discuss the effect of ethanol consumption on erythrocyte membrane. In the present study, erythrocytes in women who consume alcohol showed significant decrease in their ability to resist haemolysis with HPLC studies. Erythrocyte membrane indicates decreased phospholipid (p<0.05) levels, which increased the cholesterol/phospholipid ratio significantly (p<0.01) in women who consume alcohol. This can decrease the fluidity of membrane, which appears to be related to the effect of ethanol on erythrocyte membrane. Also the protection against exogenous and endogenous peroxides in the erythrocytes of alcoholic women is considerably affected due to decreased (p<0.05) activity of catalase, glucose-6-phosphate dehydrogenase, protein-SH group and glutathione (GSH). Enhanced free radical generation induced oxidation of oxyHb to metHb in alcoholics. Increased methemoglobin leads to significant reduction in membrane GSH, which may cause protein thiol oxidation. Thus peroxidative damage to membrane lipids and oxidation of membrane protein thiols potentially harmful to membrane fluidity and flexibility is responsible for decreased resistance to haemolysis as demonstrated in women who consume alcohol.

Age Effect on Human Aortic Valvular Glycoproteins

BACKGROUND

The aortic valve has been the subject of many hemodynamic studies but, to our knowledge, posttranslational modification of human valve proteins has not yet been studied. Thus, the aim of this study was to determine whether any age-related changes in the protein composition of normal human aortic valves and their glycosylation pattern could be observed.

METHODS

Aortic valves harvested from male cadaveric donors free of cardiovascular diseases were divided into four age groups: I, mean age 21 years; II, 30 years; III, 41 years; IV, 51 years. Proteins were separated by SDS-PAGE and transferred to PVDF membranes. Identification of monosaccharide moieties or oligosaccharide units was performed with the use of eight lectins of narrow specificity: Galantus nivalis agglutinin, Sambucus nigra agglutinin, Maackia amurensis agglutinin, Datura stramonium agglutinin, Aleuria aurantia agglutinin, Arachis hypogeae agglutinin, Phaseolus vulgaris agglutinin, and Lycopersicon esculentum agglutinin.

RESULTS

Isolated proteins showed no age-related changes in SDS-PAGE protein profile, contrary to their glycosylation. Protein sialylation, number of tri/tetraantennary complex glycans, proteins having terminal galactose and polylactosaminyl units increased with age, whereas protein fucosylation showed the opposite relationship. Moreover, groups III and IV possessed a larger number of proteins bearing high-mannose and/or hybrid-type glycans, and the quantity of these structures seemed to change, in particular proteins, with the age of donors.

CONCLUSIONS

Our results clearly demonstrate that glycosylation profile in human aortic proteins is associated with the age of the donor.

Relationship between serum sialic acid and sialylated glycoproteins in alcoholics

AIMS

Total sialic acid (TSA) has been suggested as a marker for chronic alcohol abuse. It seems that the elevation of TSA during excessive alcohol consumption reflects the changes in sialylated glycoproteins in the sera. On the other hand, chronic ethanol consumption increases the desialylation rate of many serum glycoproteins. The aim of this study was to evaluate the relationship between the total and free form of sialic acid levels (FSA), and the concentration of sialylated glycoproteins in alcoholics.

METHODS

We determined the serum concentration of many glycoproteins (alpha1-antitrypsin, alpha1-acid glycoprotein, haptoglobin, ceruloplasmin, transferrin, complement C3 protein, fibrinogen and immunoglobulin G) in a sample of 100 alcoholics and 30 healthy controls. Total sialic acid was determined by the enzymatic method and its free form by using a modification of the thiobarbituric acid method.

RESULTS

Among alcoholics, we found increased concentrations of alpha1-antitrypsin and alpha1-acid glycoprotein but decreased levels of transferrin. The concentrations of TSA and FSA were significantly higher in alcoholics than in healthy controls. The tested glycoproteins, except for transferrin and immunoglobulin G, positively correlated with TSA and FSA. The correlations with TSA were higher than that with FSA.

CONCLUSIONS

Chronic alcohol abuse alters the concentrations of some sialylated glycoproteins in the sera. The alpha1-antitrypsin, alpha1-acid glycoprotein, and transferrin are the only affected glycoproteins. The serum level of total and free form of sialic acid in the sera of alcoholics depends on the concentration of the most sialylated glycoproteins.

Serum level of sialic acid (SA) and carbohydrate-deficient transferrin (CDT) in type 2 diabetes mellitus with microvascular complications

Sialic acid (SA) is responsible for the composition of different isoforms of transferrin and is reported to be a marker of microvascular complications in type 2 diabetes mellitus. Therefore, we explored the serum concentration of SA, and the less sialylated isoforms of transferrin, termed carbohydrate-deficient transferrin (CDT), in relation to the presence of microvascular complications in type 2 diabetes mellitus. We studied 21 patients with type 2 diabetes with microangiopathy and 22 patients without complications who were hospitalized at a diabetic clinic. The prevalence of microvascular complications was based on clinical history, fundoscopy, and laboratory tests. Blood samples were taken for measurements of SA, CDT, total transferrin, glucose, HbA1c, fibrinogen, C-reactive protein (CRP), and indicators of renal dysfunction (i.e., creatinine, urea, albumin excretion rate (AER), and glomerular filtration rate (GFR)). A rise in serum SA and a decrease in CDT concentrations were observed in both diabetic groups with and without complications, and there were no differences between the two groups of patients. There was a statistically significant correlation between serum SA and CDT in diabetic subjects with microvascular complications, but not in patients without such complications. This proves that the serum changes in CDT and SA levels in the course of type 2 diabetes mellitus are associated with each other in the presence of microangiopathy.

Serum free sialic acid as a marker of alcohol abuse

BACKGROUND

Previous studies have shown that serum total sialic acid (TSA) concentration significantly increases during alcohol abuse. Chronic ethanol consumption impairs glycosylation of many proteins. The increased desialylation rate of serum glycoproteins is one of the effects of alcohol abuse. The aim of this study was to investigate the diagnostic value of free sialic acid (FSA) as a marker of alcohol abuse.

METHODS

We determined serum FSA concentrations in the group of 156 alcoholic subjects and 35 healthy control subjects by means of a modification of the thiobarbituric acid method. The alcoholic group was divided into subgroups according to their history of abuse.

RESULTS

The FSA concentration was significantly higher in alcoholic subjects than in healthy controls. The subjects who consumed alcohol for longer than a week showed significantly higher FSA level than those who consumed alcohol for a shorter period. The serum FSA concentration was significantly higher in alcoholic subjects with elevated markers of liver dysfunction. The diagnostic accuracy of FSA was high, although it did not differ from TSA, and was limited by its low sensitivity.

CONCLUSIONS

This study shows that FSA concentration in the sera of alcoholic subjects is increased. The low diagnostic sensitivity is accompanied by high specificity, however the accuracy is high and similar to the accuracy of TSA. Free sialic acid does not seem to be a better marker of alcohol abuse than TSA and current markers.

Detection of alcohol consumption during pregnancy—Current and future biomarkers

Alcohol, one of the most frequently reported addictions, is a significant public health problem in the USA. Early identification is important and would aid in intervention for the pregnant woman who continues to drink and for the affected infant. To date, there isn't a definitive test which identifies either alcohol abuse during pregnancy or newborns exposed to alcohol prenatally. The existing biomarkers can detect varying degrees of alcohol exposure but further research is needed to improve sensitivity/specificity and to validate these markers.

The diagnostic accuracy of carbohydrate-deficient transferrin, sialic acid and commonly used markers of alcohol abuse during abstinence

BACKGROUND

The normalization of alcohol abuse markers during the abstinence depends on the time since the last drinking. The aim of this study was to evaluate the diagnostic accuracy (area under the curve-AUC, sensitivity and specificity) of CDT, sialic acid and others biochemical and hematological markers of chronic alcohol abuse during abstinence.

METHODS

We studied 75 patients admitted to the treatment of alcohol dependence. The blood samples were collected upon admission to the hospital. CDT was estimated using an immunoturbidimetric assay after anion-exchange chromatography and sialic acid by enzymatic colorimetric method.

RESULTS

Mean values of all markers were significantly higher. All tests, except SA, negatively correlated with time of abstinence but not with age, duration of dependence and amounts of weekly alcohol consumption. The area under the curve (AUC) for all tested markers decreased progressively during the abstinence. The highest AUC was obtained for CDT (0.98) and the lowest for ALT (0.78) when alcohol was consumed in the last week. AUC for sialic acid was lower than of CDT but higher than of ALT.

CONCLUSIONS

We conclude that the diagnostic accuracy for tested laboratory markers depends on the self-reported time of abstinence being the highest for CDT in the first week of abstinence. The accuracy of sialic acid was observed between GGT and ALT.

Binding affinity of aluminium to human serum transferrin and effects of carbohydrate chain modification as studied by HPLC/high-resolution ICP-MS--speciation of aluminium in human serum

Aluminium (Al) in the blood is bound to transferrin (Tf), a glycoprotein of about 80kDa that is characterized by its need for a synergistic anion. In this focused review, the binding affinity of Al to Tf is surveyed in the context of our recent studies using on-line high-performance liquid chromatography/high-resolution inductively coupled plasma mass spectrometry (HPLC/HR-ICP-MS). Al in human serum without any in vitro Al-spikes was present in a form bound to the N-lobe site of Tf. The influences of sialic acid in the carbohydrate chain of human serum Tf (hTf) were studied using asialo-hTf, obtained by treatment with sialidase. The binding affinity of Fe was similar between asialo-hTf and native-hTf, while that of Al for asialo-hTf was larger than that for native-hTf, especially in the presence of oxalate, a synergistic anion. The above findings are discussed in relation to diseases in which the serum concentrations of carbohydrate-deficient Tf and oxalate are augmented.

Serum sialic acid and γ-glutamyltransferase levels in alcohol-dependent individuals

Alcohol abuse is a very common problem all over the world. Identification of alcoholism is crucial in preventing some adverse health effects, economical and social consequences of excessive alcohol consumption. The aim of this study was to determine sialic acid (SA) and gamma-glutamyltransferase (GGT) levels in serum samples of alcoholics and to compare the diagnostic accuracy of SA with the conventional marker, GGT. The results have shown that serum SA (p<0.01) and GGT levels (p<0.001) were significantly increased in alcohol-dependent individuals as compared with healthy controls. No significant relationship was observed between SA and GGT levels in alcohol-dependent subjects and control group. Interestingly, a positive correlation was found between amount of alcohol consumption and serum SA level (r = 0.381, p<0.05). In order to evaluate the ability of SA and GGT determinations to discriminate between alcohol-dependent subjects and healthy controls, an analysis of receiver operating characteristic (ROC) curve was performed. Data suggest that GGT and SA levels in serum may be used as valuable biological markers for detecting and monitoring alcohol abuse. In view of the findings, introducing serum SA determination can be recommended as a part of diagnostic tests for identifying alcohol abuse.

Incidence of alcohol dependence among drunken drivers

To discriminate 'alcoholics' and 'non-alcoholics', individual Alc-Indices (determined by methanol, acetone, 2-propanol, gamma-GT and CDT-concentrations) were calculated in a collective of 327 alcohol-impaired drivers with regard to the blood alcohol concentration, the time of the event and the age of the drivers. Applying this new defined Alc-Index, 48% of the drivers investigated could be characterised as alcohol dependent. The prevalence of alcoholics among individuals with blood alcohol concentrations (BAC) higher than 1.9per thousand was more than 80%. The diagnostic value of alcohol concentrations for the recognition of 'alcoholics', considering the legal limit in Germany (1.1per thousand) as well as statistically calculated limits, were compared to the Alc-Index.

Achievements and challenges of sialic acid research

Slalic acids are one of the most important molecules of life, since they occupy the terminal position on macromolecules and cell membranes and are involved in many biological and pathological phenomena. The structures of sialic acids, comprising a family of over 40 neuraminic acid derivatives, have been elucidated. However, many aspects of the regulation of their metabolism at the enzyme and gene levels, as well as of their functions remain mysterious. Sialic acids play a dual role, not only are they indispensable for the protection to and adaptation of life, but are also utilised by life-threatening infectious microorganisms. In this article the present state of knowledge in sialobiology, with an emphasis on my personal experience in this research area, is outlined including a discussion of necessary future work in this fascinating field of cell biology.

Occurrence of sialic acids in healthy humans and different disorders

Sialic acid (SA), N-acetylated derivatives of neuraminic acid, play a central role in the biomedical functioning of humans. The normal range of total sialic acid (TSA) level in serum/plasma is 1.58-2.22 mmol L-1, the free form of SA only constituting 0.5-3 mumol L-1 and the lipid-associated (LSA) forms 10-50 mumol L-1. Notably, considerably higher amounts of free SA are found in urine than in serum/plasma (approximately 50% of the total SA). In inherited SA storage diseases such as Salla's disease, SA levels are elevated many times over, and their determination during clinical investigation is well established. Furthermore, a number of reports describe elevated SA levels in various other diseases, tentatively suggesting broader clinical utility for SA markers. Increased SA concentrations have been reported during inflammatory processes, probably resulting from increased levels of richly sialylated acute-phase glycoproteins. A connection between increased SA levels and elevated stroke and cardiovascular mortality risk has also been reported. In addition, SA levels are slightly increased in cancer, positively correlating with the degree of metastasis, as well as in alcohol abuse, diabetes, chronic renal failure and chronic glomerulonephritis. Several different mechanisms are assumed to underlie the elevated SA concentrations in these disorders. The apparent non-specificity of SA to a given disease limits the potential clinical usefulness of SA determination. In addition, some non-pathological factors, such as aging, pregnancy and smoking, may cause changes in SA concentrations. The absolute increases in SA levels are also rather small (save those in inherited SA storage disorders); this further limits the clinical potential of SA as a marker. Tentatively, SA markers might serve as adjuncts, when combined with other markers, in disease screening, disease progression follow-up, and in the monitoring of treatment response. To become clinically useful, however, the existing SA determination assays need to be considerably refined to reduce interferences, to be specific for certain SA forms, and to be more easy to use.