Detoxification

Last updated

Detoxification or detoxication (detox for short) [1] is the physiological or medicinal removal of toxic substances from a living organism, including the human body, which is mainly carried out by the liver. Additionally, it can refer to the period of drug withdrawal during which an organism returns to homeostasis after long-term use of an addictive substance. [2] [3] In medicine, detoxification can be achieved by decontamination of poison ingestion and the use of antidotes as well as techniques such as dialysis and (in a limited number of cases) chelation therapy. [4]

Contents

Many alternative medicine practitioners promote various types of detoxification such as detoxification diets. Sense about Science, a UK-based charitable trust, determined that most such dietary "detox" claims lack any supporting evidence. [5] [6]

The liver and kidney are naturally capable of detox, as are intracellular (specifically, inner membrane of mitochondria or in the endoplasmic reticulum of cells) proteins such as CYP enzymes. In cases of kidney failure, the action of the kidneys is mimicked by dialysis; kidney and liver transplants are also used for kidney and liver failure, respectively.

Types

Alcohol detoxification

Alcohol detoxification is a process by which a heavy drinker's system is brought back to normal after being habituated to having alcohol in the body continuously for an extended period of substance abuse. Serious alcohol addiction results in a downregulation of GABA neurotransmitter receptors. Precipitous withdrawal from long-term alcohol addiction without medical management can cause severe health problems and can be fatal. Alcohol detox is not a treatment for alcoholism. After detoxification, other treatments must be undertaken to deal with the underlying addiction that caused alcohol use.

Drug detoxification

Clinicians use drug detoxification to reduce or relieve withdrawal symptoms while helping an addicted person adjust to living without drug use. Drug detoxification does not aim to treat addiction but rather represents an early step within long-term treatment. Detoxification may be achieved drug-free or may use medications as an aspect of treatment. Often drug detoxification and treatment will occur in a community program that lasts several months and takes place in a residential setting rather than in a medical center.

Drug detoxification varies depending on the location of treatment, but most detox centers provide treatment to avoid the symptoms of physical withdrawal from alcohol and from other drugs. Most also incorporate counseling and therapy during detox to help with the consequences of withdrawal.

Metabolic detoxification

An animal's metabolism can produce harmful substances which it can then make less toxic through reduction, oxidation (collectively known as redox reactions), conjugation and excretion of molecules from cells or tissues. [7] This is called xenobiotic metabolism. [8] [9] [10] [11] Enzymes that are important in detoxification metabolism include cytochrome P450 oxidases, [12] UDP-glucuronosyltransferases, [13] and glutathione S-transferases. [14] These processes are particularly well-studied as part of drug metabolism, as they influence the pharmacokinetics of a drug in the body. [15] [16] [17]

Alternative medicine

Certain approaches in alternative medicine claim to remove alleged "toxins" from the body through herbal, electrical, electromagnetic or other treatments. These toxins may not be linked to symptoms and treatments have no scientific evidence, [18] [19] making the validity of such techniques questionable. There is little evidence for toxic accumulation in these cases, [19] as the liver and kidneys automatically detoxify and excrete many toxic materials including metabolic wastes. Under this theory, if toxins are too rapidly released without being safely eliminated (such as when metabolizing fat that stores toxins), they can damage the body and cause malaise. Such alternative therapies include contrast showers, detoxification foot pads, oil pulling, Gerson therapy, snake-stones, body cleansing, Scientology's and Narconon's Purification Rundown, water fasting, and metabolic therapy. [20]

See also

Related Research Articles

A xenobiotic is a chemical substance found within an organism that is not naturally produced or expected to be present within the organism. It can also cover substances that are present in much higher concentrations than are usual. Natural compounds can also become xenobiotics if they are taken up by another organism, such as the uptake of natural human hormones by fish found downstream of sewage treatment plant outfalls, or the chemical defenses produced by some organisms as protection against predators. The term xenobiotic is also used to refer to organs transplanted from one species to another.

<span class="mw-page-title-main">Hepatotoxicity</span> Liver damage caused by a drug or chemical

Hepatotoxicity implies chemical-driven liver damage. Drug-induced liver injury is a cause of acute and chronic liver disease caused specifically by medications and the most common reason for a drug to be withdrawn from the market after approval.

<span class="mw-page-title-main">Hyperammonemia</span> Medical condition

Hyperammonemia is a metabolic disturbance characterised by an excess of ammonia in the blood. It is a dangerous condition that may lead to brain injury and death. It may be primary or secondary.

Drug metabolism is the metabolic breakdown of drugs by living organisms, usually through specialized enzymatic systems. More generally, xenobiotic metabolism is the set of metabolic pathways that modify the chemical structure of xenobiotics, which are compounds foreign to an organism's normal biochemistry, such as any drug or poison. These pathways are a form of biotransformation present in all major groups of organisms and are considered to be of ancient origin. These reactions often act to detoxify poisonous compounds. The study of drug metabolism is called pharmacokinetics.

Toxication, toxification or toxicity exaltation is the conversion of a chemical compound into a more toxic form in living organisms or in substrates such as soil or water. The conversion can be caused by enzymatic metabolism in the organisms, as well as by abiotic chemical reactions. While the parent drug are usually less active, both the parent drug and its metabolite can be chemically active and cause toxicity, leading to mutagenesis, teratogenesis, and carcinogenesis. Different classes of enzymes, such as P450-monooxygenases, epoxide hydrolase, or acetyltransferases can catalyze the process in the cell, mostly in the liver.

Glutathione <i>S</i>-transferase Family of enzymes

Glutathione S-transferases (GSTs), previously known as ligandins, are a family of eukaryotic and prokaryotic phase II metabolic isozymes best known for their ability to catalyze the conjugation of the reduced form of glutathione (GSH) to xenobiotic substrates for the purpose of detoxification. The GST family consists of three superfamilies: the cytosolic, mitochondrial, and microsomal—also known as MAPEG—proteins. Members of the GST superfamily are extremely diverse in amino acid sequence, and a large fraction of the sequences deposited in public databases are of unknown function. The Enzyme Function Initiative (EFI) is using GSTs as a model superfamily to identify new GST functions.

Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has developed within the individual from psychoactive substance consumption that results in the experience of withdrawal and that necessitates the re-consumption of the drug. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.

Glucuronidation is often involved in drug metabolism of substances such as drugs, pollutants, bilirubin, androgens, estrogens, mineralocorticoids, glucocorticoids, fatty acid derivatives, retinoids, and bile acids. These linkages involve glycosidic bonds.

<span class="mw-page-title-main">Fomepizole</span> Medication

Fomepizole, also known as 4-methylpyrazole, is a medication used to treat methanol and ethylene glycol poisoning. It may be used alone or together with hemodialysis. It is given by injection into a vein.

Detoxification is a type of alternative-medicine treatment which aims to rid the body of unspecified "toxins" – substances that proponents claim accumulate in the body over time and have undesirable short-term or long-term effects on individual health. Activities commonly associated with detoxification include dieting, fasting, consuming exclusively or avoiding specific foods, colon cleansing, chelation therapy, certain kinds of IV therapy and the removal of dental fillings containing amalgam.

<span class="mw-page-title-main">Glucuronosyltransferase</span> Class of enzymes

Uridine 5'-diphospho-glucuronosyltransferase is a microsomal glycosyltransferase that catalyzes the transfer of the glucuronic acid component of UDP-glucuronic acid to a small hydrophobic molecule. This is a glucuronidation reaction.

<span class="mw-page-title-main">NAPQI</span> Toxic byproduct of acetaminophen

NAPQI, also known as NAPBQI or N-acetyl-p-benzoquinone imine, is a toxic byproduct produced during the xenobiotic metabolism of the analgesic paracetamol (acetaminophen). It is normally produced only in small amounts, and then almost immediately detoxified in the liver.

<span class="mw-page-title-main">Hydrocodone/paracetamol</span> Combination pain relief drug

Hydrocodone/paracetamol is the combination of the pain medications hydrocodone and paracetamol (acetaminophen). It is used to treat moderate to severe pain. It is taken by mouth. Recreational use is common in the United States.

<span class="mw-page-title-main">Alcohol detoxification</span> Abrupt cessation of alcohol intake

Alcohol detoxification is the abrupt cessation of alcohol intake in individuals that have alcohol use disorder. This process is often coupled with substitution of drugs that have effects similar to the effects of alcohol in order to lessen the symptoms of alcohol withdrawal. When withdrawal does occur, it results in symptoms of varying severity.

Drug detoxification is variously construed or interpreted as a type of "medical" intervention or technique in regards to a physical dependence mediated by a drug; as well as the process and experience of a withdrawal syndrome or any of the treatments for acute drug overdose (toxidrome). The first definition however, in relation to substance dependence and its treatment is arguably a misnomer and even directly contradictory since withdrawal is neither contingent upon nor alleviated through biological excretion or clearance of the drug. In fact, excretion of a given drug from the body is one of the very processes that leads to withdrawal since the syndrome arises largely due to the cessation itself and the drug being absent from the body; especially the blood plasma, not from ‘leftover toxins’ or traces of the drug still being in the system.

Detoxification is the physiological or medicinal removal of toxic substances from a living organism, including the human body.

<span class="mw-page-title-main">4-Ipomeanol</span> Chemical compound

4-Ipomeanol (4-IPO) is a pulmonary pre-toxin isolated from sweet potatoes infected with the fungus Fusarium solani. One of the 4-IPO metabolites is toxic to the lungs, liver and kidney in humans and animals. This metabolite can covalently bind to proteins, thereby interfering with normal cell processes.

A xenobiotic-sensing receptor is a receptor that binds xenobiotics. They include the following nuclear receptors:

<span class="mw-page-title-main">Detoxification foot baths</span> Pseudoscientific alternative medicine

Detoxification foot baths, also known as foot detox, ionic cleansing, ionic foot bath and aqua/water detox are pseudoscientific alternative medical devices marketed as being able to remove toxins from the human body. They work by providing an electric current to an electrode array immersed in a salt water solution. When switched on, the electrodes rapidly rust in a chemical process called electrolysis which quickly turns the water brown. This reaction happens regardless of whether or not a person's feet are immersed in the water and no toxins from the human body have ever been detected in the water after use.

<span class="mw-page-title-main">Andre Waismann</span> Israeli physician

Andre Waismann is an Israeli doctor and medical practitioner, notable for development of the ANR treatment of Opiate addiction. Waismann currently serves as the head of the ANR unit at the Barzilai Medical Center and director at the ANR Clinic in Florida, US.

References

  1. "detoxification - definition of detoxification by the Free Online Dictionary, Thesaurus and Encyclopedia". Thefreedictionary.com. Retrieved April 21, 2013.
  2. "detoxify - definition of detoxify in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia". Medical-dictionary.thefreedictionary.com. Retrieved April 21, 2013.
  3. "Toxicology Primer". UIC. Archived from the original on October 31, 2013. Retrieved April 21, 2013.
  4. "Get the Lead Out - Autumn 2009 Living Bird". Birds.cornell.edu. October 15, 2009. Retrieved April 21, 2013.
  5. "Scientists dismiss detox schemes". BBC News. January 3, 2006. Retrieved July 26, 2016.
  6. "No proof so-called detox products work: scientists". CTV News . January 5, 2009. Retrieved December 25, 2023.
  7. "Detox". Archived from the original on August 4, 2009. Retrieved July 18, 2009.
  8. xenobiotic metabolic process (April 13, 2013). "AmiGO: xenobiotic metabolic process Details". Amigo.geneontology.org. Archived from the original on July 25, 2009. Retrieved April 21, 2013.
  9. L-60: Xenobiotic Metabolism (archived version).
  10. "Metabolism of Xenobiotics". Zoology.muohio.edu. Archived from the original on June 1, 2013. Retrieved April 21, 2013.
  11. Xenobiotic Metabolism-Oxford Biomedical Research Inc (archived version).
  12. Danielson P (2002). "The cytochrome P450 superfamily: biochemistry, evolution and drug metabolism in humans". Curr Drug Metab. 3 (6): 561–97. doi:10.2174/1389200023337054. PMID   12369887.
  13. King C, Rios G, Green M, Tephly T (2000). "UDP-glucuronosyltransferases". Curr Drug Metab. 1 (2): 143–61. doi:10.2174/1389200003339171. PMID   11465080.
  14. Sheehan D, Meade G, Foley V, Dowd C (2001). "Structure, function and evolution of glutathione transferases: implications for classification of non-mammalian members of an ancient enzyme superfamily". Biochem J. 360 (Pt 1): 1–16. doi:10.1042/0264-6021:3600001. PMC   1222196 . PMID   11695986.
  15. "Small Molecule Drug Metabolism". Ionsource.com. September 1, 2012. Retrieved April 21, 2013.
  16. "Comparison of the Levels of Enzymes Involved in Drug Metabolism between Transgenic or Gene-knockout and the Parental Mice". Tpx.sagepub.com. January 1, 2001. Retrieved April 21, 2013.
  17. D M Dulik & C Fenselau (April 1, 1988). "Use of immobilized enzymes in drug metabolism studies". FASEB Journal. 2 (7): 2235–40. doi: 10.1096/fasebj.2.7.3127263 . PMID   3127263. S2CID   27415918 . Retrieved April 21, 2013.
  18. Scott Gravure (January 1, 2015). "Detox: What 'They' Don't Want You To Know". Science-Based Medicine.
  19. 1 2 Zeratsky, Katherine. "Do detox diets offer any health benefits?". Mayo Clinic . Archived from the original on March 3, 2022. Retrieved July 26, 2016.
  20. "More information on complementary and alternative medicine". American Cancer Society. Archived from the original on June 2, 2008. Retrieved July 26, 2016.