The Hangover

As I managed to dodge one despite a heavy session on Saturday night, I thought it seemed a good use of my time to write about them. They are an inevitability. I have not met one person yet who drinks and has not been crippled by a hangover at some stage to the point where death would be welcomed just to get rid of the horrors of the morning after. Normally, a hangover has standard symptoms: nausea, dizziness, tiredness, headache, aches and pains, photophobia (sensitivity to light), trembling and the fear. But what causes all of the adverse effects and why do they only kick in the next morning? And most importantly can we cure it?

First things first. Alcohol is a toxin. Defined in chemistry as an organic hydrocarbon compound containing a hydroxyl croup. The type that is present in alcoholic drinks is ethanol which is a byproduct of yeasts metabolic process. It is also produced during germination of many plants. Ethanol is a central nervous system depressant. In small doses it acts as psychoactive drug whereby is causes a sense of euphoria, talkativeness and relaxation. However, as you increase the blood alcohol content, you also increase the risks of alcohol poisoning.  I had always thought that when drinking, you lose a fairly large proportion of alcohol through sweating and urine however in actual fact, only 2-8% is disposed of this way, the rest has to be metabolised. When ethanol is degraded by the enzyme alcohol dehydrogenase in the liver**, it is first broken down into acetaldehyde, which is further broken down to acetic acid radicals. Unfortunately, acetaldehyde is a poison that causes immflamation and is closely related to formaldehyde and is thought to be a major contributor to hangovers. Acetaldehyde is degraded fairly quickly by acetaldehyde dehydrogenase and glutathione and if you only have a couple of drinks, it won’t have time to cause any harm. The issue lies in the limited store of glutathione in the liver which cannot handle larger amounts of alcohol, allowing acetaldehyde to accumulate, leaving the toxin in the body for a prolonged period of time.

Process of ethanol metabolism to acetaldehyde (toxin) and finally to acetic acid.

The reason you become dehydrated after consuming alcohol is due to the inhibition of anti-diuretic hormone. This hormone is responsible for maintaining a fluid balance and hydrated state by making you pee out water in your body. You may notice that drinking makes you urinate more and that is a result of depletions of anti-diuretic hormone. You also lose a lot of key electrolytes (salts) in the process. Dehydration itself causes sickness, headache and dizziness on its own. Combine that with the other side effects of alcohol consumption and there is really no wonder why you feel so dreadful first thing the next morning.

Drinking alcohol also induces what is known as the “glutamine rebound”. Hangovers are suggested to be worse due to lack of sleep and it has been found that after a night of alcohol consumption, a drinker won’t sleep soundly. This because alcohol inhibits glutamine, a natural stimulant (thus the sleepiness associated with drinking). Post-drinking, the body over-produces glutamine to make up the difference and as a result causes a restless sleep as well as tremors, anxiety and increased blood pressure

To summarise there are 3 true causes of hangovers:

1. Acetaldehyde toxicity

2. Dehydration

3. Glutamine rebound

The causes of hangovers makes them so difficult to cure. Because consumption of alcohol inhibits certain hormones as well as relying on the finite reserves of natural chemicals, there is no sure fire way of ridding yourself of the sickness, headaches and chronic fear. However Irn Bru, a fry up and a cuddle is a close as any scientist has come so far.

Possibly the worst symptom of a hangover. This picture could not be more accurate.

**Ethanol is not exclusively broken down by alcohol dehydrogenase, other enzymes do contribute but I could spend a whole other (less interesting) post on alcohol metabolism.

Ebola - Should we be concerned in Scotland?

The short answer is Yes. I had never intended on beginning this blog on such a morbid note but I felt with the current situation regarding Ebola spreading to western countries, I believe it is pretty relevant and hope that I can provide a better understanding of the dynamics of the disease.

I have a fascination with diseases. By detaching from the harm and suffering they cause, the way in which they interact to immune systems and pharmaceuticals captivates me. I had always believed that when we feel feverish due to illness, that was the bug causing us to feel unwell, but it is in fact our body raising its own temperature to make it a less hospitable host to the infection. Basically, we make ourselves ill. Now, at some stage I would like to write short entries on other diseases and how they interact with the body but as it is topical I will overview Ebola.

Ebola is a zoonotic virus meaning it reservoirs non-pathogenic within a host before being passed to another susceptible host for the virus to take effect. Ebola, amongst other viruses, are carried by bats however, there has been little evidence as to why they are not affected by the disease itself. Some hypothesis suggest that the rapid and significant body temperature and metabolism increase bats incur during flight is adjuvant to an effective immune response. Frighteningly, humans and primates do not possess the ability to fend off the infection. A study in 2006 revealed that as Ebola spread across central Africa, 90% of Gorilla populations were wiped out. At the time it was also noted that the mortality rate in humans was 80% and unfortunately, that figure has not changed.

The typical symptoms of Ebola after infection. As you can see it takes rapid effect and can be catastrophic.

The disease targets endothelial cells (lining of blood vessels), mononuclear phagocytes and hepatocytes. Upon infection, the Ebola virus glycoprotein is synthesised and replication overwhelms protein synthesis of infected cells and the host immune system. The glycoprotein also interferes with neutrophil signalling further helping it evade the immune system. The result is haemorrhagic fever with subsequent organ damage, leading to organ failure and death.

There is currently no vaccine or treatment available against the virus. This is not reason to panic as there are many labs all over the world currently working to find one. Certain procedures can help patients such as fluid and electrolyte balance to counter dehydration and the administration of anticoagulants early in the infection to control intravascular coagulation although these treatments still do not guarantee survival by any means. The best chance of fighting it is isolation and quarantine. The disease typically spreads via fluid transmission, ie and infected bat’s saliva contacting a hosts blood, introducing the virus (there has been instances of bats dropping part-eaten flats and passing the disease to mammalian hosts that way). At this stage there is very little evidence to suggest it can be transmitted through the air which is in some ways comforting as airborne transmission is a much more effective method of disease progression.

I hope the intent of this post is not misconstrued. I am opposed to media derived scaremongering with little evidence backing up their weekly “civilisation ending” catastrophe, be it war, disease, famine or something more nonsensical. I merely want to provide a bit more insight into the disease itself. I believe that if the disease is controlled properly then we will not face any danger as a civilisation and as individuals in the western wealthy world we should be relatively safe from contracting it (unless you visit central Africa or get particularly cosy with bats). So to go back on my initial answer to the question: in Scotland, we probably shouldn’t worry about Ebola. 

My only concern is failure to properly quarantine the disease. Aid and healthcare workers who have been flown back to america for better treatment could prove problematic if there is a breach in patient isolation. The recent story of 2 American humanitarians who have been released from hospital after receiving treatment with experimental drugs (http://www.theguardian.com/society/2014/aug/21/ebola-americans-released-hopsital-recovery-doctors) is also a bit dodgy. Releasing patients at this stage without knowing the long term effects could result in relapses of the virus.

Next time I plan on writing about more positive and cheery scientific stories however I cannot guarantee the odd disease cropping up that I find interesting.

A Welcome to Scientific Blogging

Welcome to my blog. 

I will be writing a far from from impartial and heavily biased account of recent scientific discoveries and stories of interest. I will do my utmost to make this not sound like bitching and moaning but I entirely intend to voice my opinions on common misconceptions on everyday topics.

A bit about me: I have recently graduated in animal biology and am a few months away from travelling the world. I one day hope to pursue a career in pharmaceuticals due to my interest in diseases and cell biology but for now I just wanted to keep myself stimulated by researching and writing this blog. 

I hope you enjoy it! I welcome comments and if I haven't been clear on some aspects or if I am wrong about something (which will happen, I guarantee that) please let me know and I will do my best to clarify.

Cheers,

Chris

P.S - Below is the only photo that I have appropriate for this blog, typically they would include alcohol or lack of clothing.