Malondialdehyde–Acetaldehyde (MAA) Protein Adducts Are Found Exclusively in the Lungs of Smokers with Alcohol Use Disorders and Are Associated with Systemic Anti-MAA Antibodies

Muna Sapkota, Ellen L. Burnham, Jane M. Devasure, Jenea M. Sweeter, Carlos D. Hunter, Michael J. Duryee, Lynell Warren Klassen, Kusum Kharbanda, Joseph Harold Sisson, Geoffrey Milton Thiele, Todd A Wyatt

Research output: Contribution to journalArticle

3 Scopus citations


Background: Malondialdehyde (MDA) and acetaldehyde (AA) exist following ethanol metabolism and tobacco pyrolysis. As such, lungs of individuals with alcohol use disorders (AUDs) are a target for the effects of combined alcohol and cigarette smoke metabolites. MDA and AA form a stable protein adduct, malondialdehyde–acetaldehyde (MAA) adduct, known to be immunogenic, profibrotic, and proinflammatory. MAA adduct is the dominant epitope in anti-MAA antibody formation. We hypothesized that MAA-adducted protein forms in lungs of those who both abuse alcohol and smoke cigarettes, and that this would be associated with systemically elevated anti-MAA antibodies. Methods: Four groups were established: AUD subjects who smoked cigarettes (+AUD/+smoke), smokers without AUD (−AUD/+smoke), AUD without smoke (+AUD/−smoke), and non-AUD/nonsmokers (−AUD/−smoke). Results: We observed a significant increase in MAA adducts in lung cells of +AUD/+smoke versus −AUD/−smoke. No significant increase in MAA adducts was observed in −AUD/+smoke or in +AUD/−smoke compared to −AUD/−smoke. Serum from +AUD/+smoke had significantly increased levels of circulating anti-MAA IgA antibodies. After 1 week of alcohol that MAA-adducted protein is formed in the lungs of those who smoke cigarettes and abuse alcohol, leading to a subsequent increase in serum IgA antibodies. Conclusions: MAA-adducted proteins could play a role in pneumonia and other diseases of the lung in the setting of AUD and smoking.

Original languageEnglish (US)
Pages (from-to)2093-2099
Number of pages7
JournalAlcoholism: Clinical and Experimental Research
Issue number12
StatePublished - Dec 2017



  • Adduct
  • Alcohol
  • Cigarette Smoke
  • IgA
  • Macrophage

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Toxicology
  • Psychiatry and Mental health

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