Alcohol consumption can weaken your immune system by destroying the cells or by altering its functions
By DR NURUL HUDA AHMAD
By ASSOC PROF DR TAN TOH LEONG
“A little more exercise, a little less food and a little less tobacco and alcohol” was one of the famous quotes by William Osler, a renowned physician more than a century ago.
He recognised the detrimental consequences of alcohol on health and observed increased risk of pneumonia or lung infection among alcoholics.
In Malaysia, the National Health and Morbidity Survey (NHMS) in 2019 stated 11.8 per cent of the population are alcohol drinkers with almost half binge drinkers.
The most prevalent alcohol-related deaths are road traffic accidents, followed by liver cirrhosis and cancer, based on report by the World Health Organisation (WHO). Alcohol use, especially heavy alcohol use, is associated with various health issues. Most notably, it increases the risk of infection through its indirect but toxic effect on the body system
We are constantly exposed to microorganisms that are present around us. Some microorganisms are possibly harmful while others have beneficial effects such as promoting the healing process in the body. Our body has its own mechanism of protecting itself from pathogens and this is called the immune system.
There are several innate cells and highly specialised cells involved in this intricate network of the immune system. Alcohol consumption weakens this immune system either by destroying the cells or by altering its functions.
While it is true that the effects correlate with the amount and duration of alcohol consumption, there are studies showing significant effects on the immune system even with a single episode of binge drinking. An impaired immune system provides the opportunity for harmful pathogens to thrive and increase the risk of infection. Metabolism of alcohol in the liver releases a by-product called aldehyde, which binds and mutates cell proteins in the body. These mutated cells known as neo-antigens are perceived as abnormal cells and cause development of antibodies that attack these altered normal cells leading to the autoimmune phenomenon.
The effects of this phenomenon can be seen in alcoholic liver disease. Progression of the disease continues despite the absence of alcohol in the body. Over time, less and less exposure to alcohol is needed to cause liver inflammation and the severity worsens with each repeated occurrence.
Long standing inflammation causes the cells to die and lead to a condition called cirrhosis. Patients with liver cirrhosis are highly predisposed to infection with up to 50 per cent of deaths in cirrhotic patients accountable to infection.
Other effects of alcohol
One of the direct effects alcohol has is on the gastrointestinal system where nutrition absorption takes place. Not only does it disrupt the symbiotic relationship between microorganisms in the gut and intestinal immune system, alcohol also impairs the cells in the intestinal lining and cause leakage of microorganisms from the gut into the body circulation leading to infection.
Similarly, alcohol also cause disruption in the lungs. It weakens the lining of both the upper and lower airway as well as interrupt the function of immune cells. All these damages may go undetected until one develops respiratory infection.
For those with chronic alcohol consumption, even a simple respiratory infection may lead to more severe lung diseases owing to the coexisting immune impairment.
Statistics has shown binge drinking is a worrying prospect among Malaysians. The percentage of binge drinkers in Malaysia in 2019 exceeded the proportion seen in other countries such as the United Kingdom and Indonesia.
Adding to this concern is the fact that the majority of binge drinkers are young adults, leading to a much-reduced life expectancy. A more active national movement is necessary to draw attention to the causes and effects of alcoholism.
Awareness on alcoholism needs to be strongly disseminated within our society. — The Health
Dr Nurul Huda Ahmad is a Lecturer and Emergency Physician at Universiti Teknologi MARA (UiTM) and also vice secretary of the Malaysian Sepsis Alliance (MySepsis) while Assoc Prof Dr Tan Toh Leong is Senior Lecturer and Consultant Emergency Physician at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and President and Founder of MySepsis