Nonoxidative ethanol metabolism in humans—from biomarkers to bioactive lipids
Open accessAbstract
Ethanol is a widely used psychoactive drug whose chronic abuse is associated with organ dysfunction and disease. Although the prevalent metabolic fate of ethanol in the human body is oxidation a smaller fraction undergoes nonoxidative metabolism yielding ethyl glucuronide, ethyl sulfate, phosphatidylethanol and fatty acid ethyl esters. Nonoxidative ethanol metabolites persist in tissues and body fluids for much longer than ethanol itself and represent biomarkers for the assessment of ethanol intake in clinical and forensic settings. Of note, the nonoxidative reaction of ethanol with phospholipids and fatty acids yields bioactive compounds that affect cellular signaling pathways and organelle function and may contribute to ethanol toxicity. Thus, despite low quantitative contributions of nonoxidative pathways to overall ethanol metabolism the resultant ethanol metabolites have important biological implications. In this review we summarize the current knowledge about the enzymatic formation of nonoxidative ethanol metabolites in humans and discuss the implications of nonoxidative ethanol metabolites as biomarkers of ethanol intake and mediators of ethanol toxicity. © 2016 IUBMB Life, 68(12):916-923, 2016.
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Nonoxidative pathway-derived metabolites, including PEth and FAEE, cause alcohol toxicity, but the mechanisms have not yet been determined.
“Nonoxidative pathway-derived metabolites, including PEth and FAEE, are also known to cause alcohol toxicity, but the mechanisms have not yet been determined [31,43].”
From Pathophysiological Aspects of Alcohol Metabolism in the Liver (2021) · cites this paper as [31]
The Introduction and Conclusions identify PEth and FAEE as nonoxidative metabolites that may contribute to ethanol toxicity, but do not establish that both are known to cause it. The Biological Significance of PEth section describes possible cellular mechanisms, while the Conclusions say the pathways mediating effects in vivo remain insufficiently characterized. Thus, the claim overstates both the certainty of causation and how little is known about the mechanisms. (LLM, conf=0.88)
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Lee, S., Baek, A., Sung, B., Yang, B. W., Yang, S., Kim, S., Yang, J.-U., Ko, I. O., Lee, G. H., Park, J. A., et al. (2026) · Journal of Medicinal Chemistry · doi:10.1021/acs.jmedchem.5c03268
Pálóczi, J., Byerley, L. O., & Primeaux, S. D. (2026) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2026.109038
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- Authors
- Heier, C., Xie, H., & Zimmermann, R.
- Affiliations
- University of Graz (AT)
- Corresponding author
- Heier, Christoph
- Venue
- IUBMB Life
- Publisher
- Wiley
- Published
- 2016-10-06
- Volume
- 68
- Issue
- 12
- Pages
- 916-923
- ISSN
- 1521-6543 (ISSN-L)
- 1521-6551
- PMC
- PMC5324703
- OpenAlex
- W2530104279
- Cited by
- 93
- References
- 110
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 16 · 2023: 9 · 2022: 17 · 2021: 12 · 2020: 6 · 2019: 7 · 2018: 7
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- IUBMB Life (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Keywords
- ethanol metabolites, ethyl glucuronide, ethyl sulfate, phosphatidylethanol, fatty acid ethyl esters, ethanol toxicity, phospholipid metabolism, fatty acid metabolism, bioactive lipids
- MeSH terms
- Alcohol Drinking, Ethanol, Animals, Fatty Acids, Glucuronates, Humans, Inactivation, Metabolic, Oxidation-Reduction, Sulfuric Acid Esters, Tissue Distribution, Biomarkers, Glycerophospholipids
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