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Why do some people suddenly become out of breath when they drink alcohol? How does alcohol trigger this reaction?
There is growing concern about respiratory reactions caused by alcohol, known as alcohol-induced wheezing or respiratory symptoms, and is particularly common in people with a history of asthma. These reactions are not simple allergic reactions, but pathological bronchoconstrictive reactions of the body to alcohol and its components.
"These reactions show different mechanisms, often race-related, and are distinct from classical allergy-induced asthma."
Historically, in a 1973 study, scientists found that six of 11 patients with a significant history of asthma after drinking alcohol developed chest tightness and other asthma symptoms after drinking certain alcoholic beverages. These reactions occurred almost immediately after drinking, indicating that they were not simply caused by inhaling the odor released by the drink.
As research continues, experts have discovered that alcohol itself, as well as other ingredients in the drink, may trigger these reactions. In a 1986 study, nine patients showed airway constriction after drinking red wine, and this reaction was positively correlated with the amount of sulfur dioxide contained in the wine, suggesting that certain chemicals rather than alcohol itself may be the cause.
In studies of Asian populations, Japanese people have the most pronounced alcohol-induced asthma effects. These reactions usually appear within one to 30 minutes after drinking alcohol or pure alcohol, and include flushing of the face, rapid heartbeat, dizziness and difficulty breathing. About 50% of people with asthma experience a worsening of their asthma symptoms after drinking alcohol.
"These reactions are usually caused by insufficient metabolism of alcohol, resulting in the accumulation of acetaldehyde."
For many East Asians, the ability to metabolize acetaldehyde is relatively low. In Japan, about 40% of the population carries a genetic mutation that weakens ALDH2 activity, making them unable to effectively metabolize it after drinking alcohol. of alcohol. With the accumulation of acetaldehyde in the body, many adverse reactions will follow. Especially in patients with a history of asthma, alcohol-induced respiratory reactions are strongly displayed.
Research shows that this is not due to classical IgE or T cell-related allergic reactions, but because acetaldehyde stimulates mast cells in tissues and basophils in the blood to release histamine, thereby causing allergy-like symptoms .
"A small number of people may have an allergic reaction to alcohol without a history of asthma."
The frequency of ethanol-induced anaphylaxis is also considerable in non-Asian populations, although these populations generally do not have high frequencies of genetic mutations. In US studies, ethanol-induced respiratory symptoms were highly associated with aspirin allergic reactions, suggesting that some people may rule out alcohol consumption as a potential cause of some allergic reactions.
For the diagnosis of respiratory symptoms caused by alcohol, experts recommend using a questionnaire to confirm the specific type of irritation reaction and further confirm whether the reaction is caused by alcohol and its components. Testing of alcohol and its dilute solutions under medical supervision can also help determine whether a genetic basis exists.
Currently, avoiding alcohol remains the safest and most cost-effective way to deal with these reactions. In addition, for alcohol-induced asthma reactions, early administration of H1 antagonists is expected to effectively prevent the occurrence of these reactions.
As our understanding of alcohol-induced respiratory reactions deepens, we can't help but wonder whether further research on this can help improve the quality of life of more alcohol-allergic patients.
