PEth: internationale Grenzwerte, neue Ansätze und deren Relevanz in der Praxis

Zusammenfassung

Der Nachweis und die Klassifizierung des Alkoholkonsums spielen eine entscheidende Rolle in verschiedenen gesellschaftlichen Bereichen, sei es im Straßenverkehr, im Gesundheitswesen oder am Arbeitsplatz. Die Verwendung von Alkoholbiomarkern ermöglicht eine objektive Beurteilung der Trinkgewohnheiten sowohl im klinischen als auch im forensischen Bereich. Neben etablierten Biomarkern wie Ethylglukuronid (EtG) oder Carbohydrat-defizientes Transferrin (CDT) gewinnt Phosphatidylethanol (PEth) als direkter Alkoholbiomarker zunehmend an Bedeutung. PEth wird nur gebildet, wenn Alkohol im Körper vorhanden ist und liefert als Bestandteil der zellulären Fraktion des Blutes Informationen über das Konsumverhalten. Für die Interpretation wird derzeit hauptsächlich das in menschlichem Blut am stärksten vertretene PEth 16:0/18:1 verwendet und üblicherweise auf Basis von zwei Grenzwerten interpretiert. Diese Grenzwerte erlauben eine Einteilung in: 1.) Abstinenz/minimalen Alkoholkonsum, 2.) Alkoholkonsum und 3.) exzessiven, chronischen Alkoholkonsum. In diesem Artikel werden die derzeitigen Grenzwerte für die Interpretation von PEth-Konzentrationen diskutiert und weitere Bemühungen zur Überprüfung und Gewährleistung der Vergleichbarkeit zwischen verschiedenen Laboren vorgestellt. Darüber hinaus werden aktuelle und neue Ansätze im Bereich der PEth-Forschung präsentiert. Dazu gehören neue Entwicklungen für die Normalisierung des Hämatokrits bei der Messung von PEth, die Verwendung von Point-of-care-testing (POCT) Geräten zur Messung von PEth am Ort der Blutentnahme, der Nachweis von PEth in Speichel und Wangenabstrichen, die Verwendung von Immunoassays, sowie das Potential des neu entdeckten Biomarkers Lyso-PEth. Es bleibt abzuwarten, wie sich diese neuen Ansätze entwickeln und möglicherweise die Überwachung des Alkoholkonsums und die Diagnose von Alkoholkonsumstörungen in Zukunft verändern oder verbessern können. Grundsätzlich besteht noch großes Potenzial für Fortschritte in Richtung höherer Sensitivität, Spezifität und der Anwendbarkeit in verschiedenen klinischen Kontexten.

Abstract

The detection of alcohol consumption and its classification plays a crucial role in various societal domains, whether in road traffic, healthcare, or the workplace. The use of alcohol biomarkers allows for an objective assessment of drinking habits in both clinical and forensic settings. In addition to established markers such as ethylglucuronide (EtG) or carbohydrate-deficient transferrin (CDT), phosphatidylethanol (PEth) is gaining increasing significance as an alcohol biomarker. PEth is only formed when alcohol is present in the body. As a component of the cellular fraction of the blood, PEth provides information on consumption behavior in relation with alcohol. PEth 16:0/18:1, the predominant species in human blood, is currently used for the interpretation of consumption behaviors based on two cut-off concentrations. These cut-offs allow the categorization into: 1.) abstinence/minimal alcohol consumption, 2.) alcohol consumption, and 3.) excessive, chronic alcohol consumption. This article discusses the currently used cut-off concentrations for the interpretation of PEth levels and presents ongoing efforts to verify and ensure comparability between different laboratories. Furthermore, current and new approaches in PEth research are addressed. These include new developments for normalizing hematocrit in PEth measurements, the use of point-of-care-testing (POCT) devices for on-site measurement of PEth, the detection of PEth concentrations in saliva and buccal swab, the use of immunoassays, and the potential of the newly discovered potential biomarker lyso-PEth. It remains to be seen how these new approaches will evolve and potentially change or enhance the monitoring of alcohol consumption and the diagnosis of alcohol use disorders in the future. In essence, there is still great potential for progress towards higher sensitivity, specificity, and applicability in various clinical contexts.

Schlüsselwörter

Phosphatidylethanol - Alkoholmarker - Biomarker - Abstinenzmonitoring

Keywords

Phosphatidylethanol - alcohol markers - biomarkers - abstinence monitoring

Publikationsverlauf

Artikel online veröffentlicht:
12. August 2024

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