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Terracina S, et al. 2025 Alcohol consumption and autoimmune diseases.

Jun 4, 2025

Alcohol Consumption and Autoimmune Diseases

Introduction

  • Alcohol: Second most misused substance after tobacco.
  • Impact: Identified as a causal factor in 200+ diseases, 5.3% of all deaths.
  • Focus: Alcohol's role in autoimmune diseases (ADs) as a risk or protective factor.
  • Diseases Discussed: Autoimmune thyroiditis, multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, diabetes, allergic rhinitis, and primary biliary cholangitis.

Alcohol and Immune System

  • Dose-dependent Effects:
    • Low-to-moderate alcohol intake may have protective effects.
    • High alcohol intake increases risks and has harmful effects.
  • Mechanisms:
    • Alters anti-inflammatory cytokines (IL-4, IL-10, TGF-β).
    • Modulates gut microbiome and its metabolites.
    • Affects immune cells and cytokines through pathways like NF-κB and NLRP3.

Autoimmune Diseases Overview

  • Prevalence: 10% global population; more common in women.
  • Causes: Genetic predispositions, environmental triggers, immune system imbalance.
  • Types: Organ-specific (e.g., thyroid disease) vs systemic (e.g., lupus).
  • Immune System: Composed of innate (nonspecific) and adaptive (specific) immunity.
    • Innate Immunity: First line of defense.
    • Adaptive Immunity: Specific responses, memory.

Alcohol Consumption as a Protective Factor

  • Evidence of Protective Role:
    • Studies show dose-dependent benefits in autoimmune thyroiditis, rheumatoid arthritis, systemic lupus erythematosus.
    • May influence cytokine production, gut microbiome, and fatty acid metabolism positively.
    • Impacts vary by alcohol type, cultural background, and sex.

Alcohol as a Risk Factor

  • Negative Effects:
    • Chronic inflammation, oxidative stress, immune cell alteration.
    • Linked to chronic diseases when consumed excessively.

Specific Autoimmune Diseases

Autoimmune Thyroiditis

  • Types: Hashimoto's thyroiditis (HT) and Graves' disease (GD).
  • Alcohol Impact: Moderate consumption might reduce risk of hypothyroidism and hyperthyroidism.

Multiple Sclerosis (MS)

  • Characteristics: CNS disorder with demyelination and neurodegeneration.
  • Alcohol Impact: Complex; potential protective effects in moderate consumption.

Rheumatoid Arthritis (RA)

  • Symptoms: Joint inflammation, pain, destruction.
  • Alcohol Impact: Potential protective impact; low-to-moderate consumption linked to reduced risks.

Systemic Lupus Erythematosus (SLE)

  • Symptoms: Multisystem autoimmune disease.
  • Alcohol Impact: Some studies suggest moderate consumption is beneficial.

Diabetes (Type 1)

  • Characteristics: Autoimmune destruction of pancreatic beta cells.
  • Alcohol Impact: Moderate consumption linked to reduced risk.

Allergic Rhinitis

  • Characteristics: IgE-mediated inflammatory condition of nasal mucosa.
  • Alcohol Impact: Some association with increased IgE, but no clear link.

Primary Biliary Cholangitis

  • Characteristics: Autoimmune liver disease.
  • Alcohol Impact: Mild-to-moderate consumption may offer protective effects.

Conclusions

  • Moderate Consumption Benefits: Potential beneficial effects, but balance needed due to risk of abuse and associated health issues.
  • Future Research: Needed to identify alcohol's protective pathways without actual alcohol consumption.

Considerations

  • Cultural and Individual Variations: Factors like genetics, lifestyle, and existing health conditions affect alcohol's impact.
  • Public Health: Emphasizes caution due to addiction risks and variable individual responses.