Alcohol-Related Disorders Clinical Trial
Official title:
Treatment of Asian Flushing Syndrome With Topical Alpha Agonists
Asian Flushing Syndrome (AFS) is a genetic disease affecting approximately 70% of patients of
East Asian descent characterized by severe flushing with minimal ethanol consumption. This
reaction is cosmetically unattractive and socially limiting. Many Asian patients avoid
drinking alcohol on dates, at weddings, and during business events because of this reaction
and the perception of being drunk or alcoholic.
Ethanol is normally metabolized to acetic acid by two enzymes. The first enzyme, alcohol
dehydrogenase (ADH) converts ethanol to acetaldehyde. The second enzyme, aldehyde
dehydrogenase 2 (ALDH2) converts the toxic acetaldehyde to harmless acetic acid. When ADH
function is increased or ALDH2 function is decreased, the toxic intermediate acetaldehyde
accumulates resulting in cutaneous flushing. Over 70% of East Asians have genetic
polymorphisms in either ADH or ALDH2 leading to intense flushing with ethanol consumption.
There are no effective topical treatments for the Asian Flushing Syndrome. Oral
antihistamines have been used with some success in treating symptoms of Asian Flushing
Syndrome; however these can have sedating effects and may be dangerous in combination with
alcohol.
Brimonidine is a selective α2-adrenoceptor agonist that acts through vasoconstriction and is
commercially available in a topical gel. This topical treatment is FDA approved for the
indication of facial flushing and has a long history of safety in human subjects.
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