Ethanol and cell replication in the digestive tract

Ethanol-induced injury of the intestines, liver and pancreas evokes a regenerative response which is characterized by a series of morphological and biochemical adaptive responses in subcellular organelles, and an increase in chromosomal protein and DNA replication. Patterns of cell replication vary with the system involved, the amount of injury and the presence of essential precursors or catalysts needed for cell replication. Maintenance of normal cell replacement patterns in the digestive tract of the alcoholic requires correction of deficits and interruption of alcohol intake. An inadequate or excessive regenerative response is of key importance in perpetuating tissue injury in the alcoholic. Regenerative capacity has been evaluated in man by measurement of circulating levels of CEA and alpha-fetoprotein; unfortunately, there is often no correlation between cell replication and these parameters in the malnourished alcoholic. Studies of mitoses or organelle changes in biopsies of intestines and liver are valuable; however, accurate monitoring of regeneration is possible only by kinetic studies utilizing incorporation of tritiated thymidine into DNA.