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An "Unsystematic" Review of Randomised Controlled Trials Interventions for Preventing Alcohol Hangover
- Gerald J Stefanko (24 December 2005)
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Pharmacogenetics can help towards reducing alcohol-associated morbidity
- David Gurwitz (1 January 2006)
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Gerald J Stefanko, CEO Nutrimark, LLC, P.O. Box 346, Cardiff By The Sea, CA92007
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It was disappointing to read the article on hangover prevention that appeared in the current issue of The British Medical Journal. The title of the article included the words "Systematic Review of Randomised TrialsÓ. However after reading the article, it seemed that the researchers may have been "unsystematic" in their approach to reporting on one of todayÕs very popular, clinically proven, hangover prevention "interventions"-- namely that of a patented extract of derived from the skin of the fruit of the Prickly Pear, called Tex-OE¨ Why? Because the patented prickly pear extract, lumped in with a host of truly ineffective hangover prevention interventions, was found to actually be effective at preventing hangover symptoms in randomized controlled trials at a major medical university. Did the research fellows bother to actually read the medical peer review of the published manuscript of clinical research, performed by a noted alcohol research team, on the role of the patented prickly pear extract, Tex-OE¨ in preventing hangover symptoms? The review was published in the June 28, 2004 issue of the Archives of Internal Medicine, a publication of the American Medical Association and it was footnoted in the British Medical Journal article. So the research fellows must have read it, right? The clinical study on the patented prickly pear extract was performed by the distinguished medical research team, that also published a comprehensive report entitled The Alcohol Hangover, presented in the Annals of Internal Medicine in July, 2000. It was performed among 55 graduate medical students at Tulane University. In the double-blind, randomized placebo study conducted at typical-style college barbecue parties on campus at Tulane, the patented extract, Tex-OE, derived by a special process from the fruit of the prickly pear cactus, was found to be the first product ever deemed to be Òstatistically significantÓ at preventing hangover symptoms when taken before ingesting alcohol. In addition the study found Tex-OE to provide improved cognitive function the morning following drinking. The clinical study reported that the active extract works to prevent typical hangover symptoms such as dry mouth, fatigue and nausea by preventing inflammation caused by alcohol. The manufacturer also has studies that show that the extract has the ability to rapidly accelerate the synthesis of protective and restorative HSPs (heat shock proteins in response to various types of stress). Competing interests: Gerald J. Stefanko has profited substantially from new and repeat sales of the only product clinically proven to reduce hangover symptoms in a double blind placebo study performed by a noted alcohol research team at a major medical university. |
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David Gurwitz, Department of Human Genetics and Molecular Medicine Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
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The authors conclude that "no compelling evidence exists to suggest that any complementary or conventional intervention is effective for treating or preventing the alcohol hangover" (1). While this strong statement might be true with regard to pharmacological interventions, it seems a bit too sweeping. We must recall that diagnostics, if performed prudently, can provide useful protection from adverse reactions to drugs as well as to some food ingredients. In the context of alcohol intoxication, it is noteworthy that individuals carrying the inactive ALDH2*2 allele of alcohol dehydrogenase- 2, the enzyme responsible for detoxification of the alcohol metabolite acetaldehyde, are at higher risk of alcohol intoxication from relatively low alcohol intake (2-4). Cytochrome p4502E1 (CYP2E1) participates in the conversion of alcohol to acetaldehyde, and being homozygous for its high- activity alleles might also be associated with increased susceptibility to alcohol intoxication (5). NHS-funded pharmacogenetic diagnostics for identifying alcohol dehydrogenase-2 deficient individuals, combined with appropriate counseling, could offer a real payback to society by reduced alcohol-related morbidity and mortality. References 1. Pittler MH, Verster JC, Ernst E. Interventions for preventing or treating alcohol hangover: systematic review of randomised controlled trials. BMJ. 2005;331:1515-15158. 2. Yoshida A. Differences in the isozymes involved in alcohol metabolism between caucasians and orientals. Isozymes Curr Top Biol Med Res. 1983;8:245-261. 3. Wall TL, Horn SM, Johnson ML, Smith TL, Carr LG. Hangover symptoms in Asian Americans with variations in the aldehyde dehydrogenase (ALDH2) gene. J Stud Alcohol. 2000;61:13-17. 4. Yokoyama M, Yokoyama A, Yokoyama T, Funazu K, Hamana G, Kondo S, Yamashita T, Nakamura H. Hangover susceptibility in relation to aldehyde dehydrogenase-2 genotype, alcohol flushing, and mean corpuscular volume in Japanese workers. Alcohol Clin Exp Res. 2005;29:1165-1171. 5. Ishikawa H, Miyatsu Y, Kurihara K, Yokoyama K. Gene-environmental interactions between alcohol-drinking behavior and ALDH2 and CYP2E1 polymorphisms and their impact on micronuclei frequency in human lymphocytes. Mutat Res. 2005 Aug 25; [Epub ahead of print] Competing interests: None declared |
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