[Frontiers in Bioscience 8, e202-217, January 1, 2003]

FATTY ACID ETHYL ESTERS: TOXIC NON-OXIDATIVE METABOLITES OF ETHANOL AND MARKERS OF ETHANOL INTAKE

Catherine A. Best and Michael Laposata

Division of Laboratory Medicine, Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts USA 02114

TABLE OF CONTENTS

1. Abstract
2. Introduction
3. Alcoholism
4. Alcohol pharmacokinetics and metabolism
4.1. Gender differences in pharmacokinetics
4.2. Rate of metabolism
4.3. Oxidative and non-oxidative ethanol metabolism
5. FAEE synthesis and degradation
5.1. Enzymes associated with FAEE synthesis
5.1.1. FAEE synthase
5.1.2. Acyl-CoA:ethanol o-acyltransferase (AEAT)
5.1.3. Non-FAEE specific enzymes with FAEE synthetic capabilities
5.1.4. FAEE synthesis in the blood
5.2.FAEE hydrolysis
6. Intracellular FAEE transport
7. Extracellular FAEE transport
8. Studies indicative of FAEE-mediated cytotoxicity
9. Diagnostic implications and clinical utility of FAEE
9.1. FAEE: short-term and long-term markers of ethanol intake
9.2. Gender differences in serum FAEE levels
9.3. Postmortem FAEE detection and assessment of premortem ethanol intake
9.4. FAEE speciation: Potential use in differentiating chronic and social drinking patterns
9.5. FAEE: A biomarker for prenatal ethanol exposure
9.6. FAEE analysis in treatment programs
10. FAEE methodology
10.1. FAEE isolation and quantitation
10.2. Solid phase extraction (SPE)
10.3. GC-MS FAEE identification and quantification
10.3.1. Identification of FAEE by single ion monitoring (SIM)
10.4.Recent technique modifications
11. Natural occurrence of FAEE
12. FAEE in drinks, foods and cosmetics
12.1. FAEE utilization in fatty acid supplements
13. Perspectives: Emerging biological and clinical significance of FAEE
14. References
1. ABSTRACT

This report describes the biochemistry of fatty acid ethyl esters (FAEE), non-oxidative metabolites of ethanol, and their clinical significance. We review information regarding the enzymes responsible for FAEE synthesis and degradation, and the mechanisms involved with the intracellular and extracellular transport of FAEE and FAEE-mediated cytotoxicity. Also a summary of reports on the emerging clinical significance and diagnostic utility of FAEE as short and long-term markers of alcohol consumption, and the methodological aspects of FAEE assessment is included.