Bench to bedside: Mechanisms and consequences of alcohol-altered host defenses

Joseph H. Sisson, Todd A. Wyatt, David M. Guidot, Gregory J. Bagby, Anders Helander, Hanne Tønnesen, Claudia D. Spies

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


This article presents the proceedings of a symposium presented at the 2004 ISBRA meeting in Mannheim, Germany, October 1, 2004. The organizers and chairpersons were Joseph H. Sisson, MD, and Claudia Spies, MD. The presentations were as follows: "Alcohol: Impact on Mucociliary Clearance"; "Alcohol and Alveolar Epithelial Dysfunction"; "The Reluctant Neutrophil in Lung Bacterial Host Defense During Alcohol Abuse"; "Prevalence, Diagnosis, and Relevance of Alcohol Use Disorders in Surgical Patients"; and "Intervention in Alcohol-Use Disorders: How Can We Meet the Challenge to Reduce Postoperative Complications?" Alcohol is known to alter pulmonary host defenses, thus putting the lung at risk for severe infection. Alcohol is also recognized as a major risk factor for developing acute respiratory distress syndrome. These dreaded pulmonary complications pose especially difficult management challenges to the clinician during surgery and after trauma, because the prevalence of alcohol abuse is very high in these settings. Particularly common in this perioperative context is pneumonia, which, despite advances in antimicrobial therapy, remains a major cause of morbidity and mortality in the alcoholic. In this symposium, we explored recent advances in our knowledge of both the mechanisms by which alcohol puts the lung at risk in these settings and the consequences that these impairments cause. We approached this important topic from a "bench-to-bedside" perspective by linking the mechanisms by which alcohol impairs lung defenses to the perioperative consequences of lung impairment. Using this approach, the speakers in this symposium highlighted recent advances from the "bench" in our understanding of the mechanisms of alcohol-mediated lung impairment and from the "bedside," where understanding the consequences of these impairments impact patient outcomes. We also examined ways to detect and monitor patients at risk for alcohol-related complications and how clinical systems are being developed to minimize risk. Better clinical outcomes in these alcohol-consuming patients depend on a heightened awareness of patients at risk, understanding of the mechanisms that put them at risk, and applying appropriate prevention and treatment strategies.

Original languageEnglish (US)
Pages (from-to)1090-1097
Number of pages8
JournalAlcoholism: Clinical and Experimental Research
Issue number6
StatePublished - Jun 2005


  • Alcohol intake biomarkers
  • Alveolar macrophage dysfunction
  • Mucociliary clearance
  • Neutrophil and host defenses
  • Oxidative stress
  • Perioperative risk management

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Toxicology
  • Psychiatry and Mental health


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