The Effect of Ethanol on Inflammation Markers and FGF-21 in Healthy Individuals

Introduction: The mechanisms behind the detrimental effects of ethanol on the liver remain uncertain. It has been suggested that the presence of ethanol in the gut lumen promotes a ’leaky gut’ allowing bacterial products to translocate to the bloodstream causing an inflammatory response. Furthermore, the ethanol-induced hormone fibroblast growth factor 21 (FGF-21) has emerged as a potential safeguard from ethanol-induced liver injury. Here, we aimed to investigate how ethanol administered intragastrically and intravenously, respectively, influences circulating markers of inflammation and FGF-21. Materials and Method: In a double-blinded, randomized cross-over design, we subjected 12 fasted healthy men (age 25.3±3.9 years; body mass index (BMI) 22.6±2.6 kg/m2 (mean±SD)) to intragastrically instilled ethanol (0.70 g ethanol per kg body weight in a 20% (v/w) solution infused over 5 minutes) and isoethanolaemic iv ethanol infusion, respectively, on two separate experimental days, and evaluated a range of circulating markers of inflammation and liver function as well as FGF-21. Results: No increment in plasma sCD163, or any other inflammation markers (lipopolysaccharide binding protein, tumor necrosis factor-α, interferon-γ, interleukin-10 (IL), IL-12p70, IL-13, IL-1β, IL-2, IL-4, IL-6, and IL-8), was observed. Plasma FGF-21 levels increased significantly (nine times baseline level), similarly and throughout both experimental days. Conclusion: Neither ’oral’ nor iv ethanol elicited significant changes in circulating markers of macrophage activation or inflammation, but increased plasma FGF-21 significantly regardless of the administration form suggesting a direct ethanol effect on FGF-21 secretion. Disclosure A.R. Lanng: None. L.S. Gasbjerg: Stock/Shareholder; Self; Antag Therapeutics. N.C. Bergmann: Employee; Self; Zealand Pharma A/S. H. Møller: Other Relationship; Self; IQ-products. M. Gillum: None. H. Gronbaek: Board Member; Self; Ipsen Biopharmaceuticals, Inc., Novartis AG. Research Support; Self; Intercept Pharmaceuticals, Inc., AbbVie Inc., Novo Nordisk A/S. T. Vilsbøll: Advisory Panel; Self; Amgen Inc., Boehringer Ingelheim GmbH, Eli Lilly and Company, AstraZeneca, MSD K.K., Sanofi, Novo Nordisk A/S. Consultant; Self; Amgen Inc., Boehringer Ingelheim GmbH, Eli Lilly and Company, AstraZeneca, MSD K.K., Sanofi, Novo Nordisk A/S. Speaker's Bureau; Self; Amgen Inc., Boehringer Ingelheim GmbH, Eli Lilly and Company, AstraZeneca, MSD K.K., Sanofi, Novo Nordisk A/S. Research Support; Self; Eli Lilly and Company, Novo Nordisk A/S. F.K. Knop: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Advisory Panel; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Amgen Inc.. Speaker's Bureau; Self; Merck Sharp & Dohme Corp.. Advisory Panel; Self; Novo Nordisk A/S. Consultant; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S. Consultant; Self; Amgen Inc.. Advisory Panel; Self; MedImmune, Sanofi. Consultant; Self; Sanofi. Research Support; Self; Sanofi. Speaker's Bureau; Self; Sanofi.