CLN Daily 2024
While the identification of biomarkers for chronic alcohol abuse is advancing rapidly, they are still underused in some clinical laboratories.
That’s also true when working with transplant patients, said Jacob Nielsen, PhD, clinical chemistry fellow at Houston Medical Center. “We should be monitoring their compliance with abstinence from alcohol” and use the best tests possible, he said, which right now isn’t happening in every laboratory.
Nielsen will host a roundtable discussion on these new biomarkers at ADLM 2024, with topics including how to test for them, how they can be better used to help patients who suffer from alcohol abuse disorder, and their role in determining whether someone is a candidate for a transplant or not.
Treating patients with alcohol use disorder requires the expertise of healthcare professionals across disciplines. According to the Substance Abuse and Mental Health Services Administration, 29.5 million Americans ages 12 and older suffered from alcohol use disorder in 2022. Heavy alcohol use is associated with poor pregnancy outcomes, increased risk of injuries, chronic diseases such as liver disease and heart disease, and several cancers. And according to the Centers for Disease Control and Prevention, during 2020 and 2021, excessive alcohol use was responsible for 178,000 deaths and 4 million years of potential life lost per year. The U.S. also saw 30,910 alcoholic liver disease deaths in 2022, which averages to 9.3 per every 100,000 people.
When most healthcare providers think of alcohol detection, they think of ethanol, Nielsen said. “But they don’t think of all the other markers of alcohol consumption that are currently available.” That includes phosphatidylethanol, carbohydrate-deficient transferrin, and ethyl glucuronide, which are all identifiers of chronic alcohol abuse.
The roundtable will discuss the advantages and disadvantages of using each biomarker, and outline detection methods involved in working with patients who are or have been heavy drinkers.
The discussion will also include the clinical guidelines and institution requirements on alcohol abstinence specifically in the transplant population, with a focus on the “six-month rule,” which is a commonly used standard where patients cannot drink alcohol for 6 months in order to be eligible for a liver transplant. Nielsen will also discuss the implications of testing for biomarkers for both liver and kidney transplant patients during the pre- and post-transplant phases.
These newer biomarkers are critical for more accurate detection, as they are “longer-term markers that are better for detecting things like compliance with alcohol abstinence,” he said.
The roundtable will also explore the difference between detecting biomarkers in a serum sample versus whole blood, he added. Since the assessment of many of these alcohol biomarkers uses laboratory developed tests, he will be delving into the critical validation process required to use these biomarkers in routine clinical laboratory use.
Overall, the roundtable will “offer a knowledge base so providers and laboratorians will have more information about what’s available to them so they can make better decisions going forward about how to help their patients,” Nielsen said. This is critical for patients “whether they’re trying to reduce the amount of alcohol they consume, trying to overcome the addiction, or whether it be for better treatment and preparation for their transplant or post-transplant treatment.”
Jen A. Miller is a freelance journalist who lives in Audubon, New Jersey. +X: @byJenAMiller.