This chapter will briefly summarize some of the effects of ethanol on the gastrointestinal tract and to identify some areas that merit further investigation. Some deficiencies in present knowledge have also been highlighted in individual chapters. Nevertheless, to mention every potential process thought to be of importance would be an enormous undertaking, particularly as there are some rapidly expanding fields and their significance in the etiology of disease is currently speculative. To circumvent such a problem, a few key disciplines that require investigation have been identified and attention is focused on protein metabolism. The terms protein synthesis, protein turnover or protein metabolism may conjure up gross physiological processes. To a certain extent this is both an over simplification and a misconception, as they also encompass molecular events. Villus atrophy, loss of contractile or membrane proteins, the reductions in the relative amounts of a single protein (i.e., a key enzyme) or groups of proteins (i.e., such as those pertaining to the subcellular organelles) all involve changes in protein pool size and thus by implication protein turnover. The latter may involve changes in mRNA encoding specific proteins or amino acid supply, the availability of initiation factors, or subcellular assembly and processing.
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