Genetic deficiency leads to ‘flush’ for drinkers

National research indicates “Asian flush” sufferers may be at increased risk for esophageal cancer.

Often called the âÄúAsian flushâÄù or the âÄúAsian glow,âÄù about a third of Asian American students of Korean, Japanese and Chinese descent are susceptible to an unusual reaction to drinking alcohol that causes their faces to flush red. Researchers at the National Institutes of Health are hoping to educate people who âÄúflush,âÄù as well as their physicians, with the article they published last week in the Public Library of Science Medicine Journal detailing an elevated risk for esophageal cancer. People with the alcohol flushing reaction generally fall into two categories: those who canâÄôt drink very much and those who develop a tolerance, said Philip Brooks , researcher and investigator at the National Institute of Alcohol Abuse and Alcoholism . According to BrooksâÄô article, the latter are at an increased risk for esophageal cancer. Brooks paired with Dr. Akira Yokoyama of Japan , whose past work has shown people with the ALDH2-deficiency, an inherited gene variation that causes the flushing response, and who drink at moderate to high levels are six to 10 times more likely to develop squamos cell esophageal cancer. âÄúSomehow it just isnâÄôt that well known in our country,âÄù he said of the ALDH2-deficiency. One University of Minnesota health official said he had not heard of ALDH2-deficiency. Heavy drinking is a risk factor for esophageal cancer for anyone, Brooks said, but the ALDH2-deficiency multiplies the risk at each relative level of drinking. This information was all news to entrepreneurial management junior Robert Fruhstuck , who is Korean. Fruhstuck said after a couple years of drinking, he had built up a tolerance to the initial flushing reaction he had experienced. âÄúI felt really hot, flushed, it was all over my chest and back,âÄù he said of his first drinking experience. âÄúI wasnâÄôt really sure what was going on.âÄù His friends told him about the âÄúflush,âÄù he said, and over time the reaction diminished. But Wednesday, he learned of the elevated risk for ALDH2-deficient people who have built up a tolerance for higher levels of drinking. âÄúItâÄôs a medical condition thatâÄôs specific to me,âÄù he said. âÄúIt creates a higher sense of urgency and problem that says to me itâÄôs something that I need to take a stronger sense of responsibility for.âÄù Fruhstuck compared his situation to someone who knows about a family history of heart disease or obesity âÄî âÄúyou respond differently,âÄù he said, when you know that the risks of things like drinking and eating unhealthy foods are higher for you. Brooks also pointed out that college students sometimes attempt to treat their flushing by using antacids or antihistamines, which Fruhstuck said he had done. Brooks said the practice, âÄúmay prevent the flushing, but they will not in any way prevent the esophageal cancer risk.âÄù The information is not only important for students who may be experimenting with alcohol for their first time in college, Brooks of the NIH said, but also for the health providers at campus clinics. The issue isnâÄôt on the radar yet at Boynton Health Service, Dave Golden , director of marketing and public health, admitted. âÄúItâÄôs news to me,âÄù he said. âÄúOn the public health side, weâÄôre not aware of this and havenâÄôt addressed it. ItâÄôs certainly worth us looking into.âÄù âÄî Emma L. Carew is a senior staff reporter