Alcoholic is a social problem in western countries but not in East Asian countries probably due to an enzyme difference for alcohol metabolism among the people. Aldehyde dehydrogenase (ALDH) is one of the key enzymes that degrade alcohol to acetic acid in the liver. There are two major isoenzymes of ALDH: ALDH1 and ALDH2. ALDH1 locates in cytosol and ALDH2 locates in mitochondria. Most Caucasians have both isoenzymes, but ~50% East Asians have normal ALDH1 and inactive ALDH2. Interestingly, low ALDH2 activity is associated with alcohol intolerance, whereas low ALDH1 activity is associated with alcoholic. A recent paper in Science (Kim et al. (2015)) provides a possible explanation for this phenomena.
In the Science paper, the investigators elucidate an alternative pathway for GABA synthesis in midbrain dopaminergic neurons. The neurotransmission in midbrain dopaminergic neurons is essential to understand the mechanisms of Parkinson disease, a neurodegenerative disorder affecting many people. The investigators are interested in a puzzle that GABA and dopamine are co-released from dopaminergic neurons, but very few dopaminergic neurons express the classic GABA synthesis enzymes—glutamate decarboxylases (GAD65 and GAD67). Learning from another enzyme, ALDH, used by plant, frog, and glia cells to synthesize GABA, they had a hypothesis that ALDH is the enzyme for GABA synthesis in midbrain dopaminergic neurons.
First, they recorded the alterations in inhibitory postsynaptic currents (IPSC) in spiny projection neurons in the striatum of mice, which receive input signal (GABA) from midbrain dopaminergic neurons. By using GAD inhibitor or GAD knockout, they confirmed that the IPSC in spiny projection neurons are independent of GAD activity. In addition, they excluded the possibility that dopamine may activate GABA receptors on spiny projection neurons.
Next, based on previous knowledge that one isoenzyme of ALDH, ALDH1, is cytosolic and highly expressed in the brain, they checked Aldh1a1 expression in midbrain and found it highly abundant in the terminals of midbrain dopaminergic neurons. Then they found the IPSC in spiny projection neurons were reduced with ALDH inhibitors or Aldh1a1 knockout, which supports the hypothesis that ALDH1 mediates the GABA synthesis in midbrain dopaminergic neurons.
At last, due to the association of Aldh1a1 with alcoholic and the involvement of dopaminergic system in alcoholic addiction, they continued to test the connection in a alcohol binge model in mice. They found binge drinking can reduce IPSC in spiny projection neurons, and Aldh1a1 knockout mice consume more alcohol than normal mice. It indicates that alcohol can inhibit GABA synthesis in midbrain dopaminergic neurons, and in people with ALDH1A1 variants, the GABA inhibition is abolished, which causes alcoholic behavior.
Although both ALDH1 and ALDH2 are involved in alcoholic metabolism, ALDH1 is responsible for GABA synthesis in dopaminergic neurons, whereas ALDH2 is responsible for alcohol clearance. without ALDH1, you are more likely to be alcoholic; without ALDH2, you are more likely to be intolerable of alcohol. That said, ALDH2 is also highly expressed in the brain. Will ALDH2 variants affect the GABA synthesis and alcohol addiction? This is the limit of this paper.




