Misnomers such as “Alcohol Flush Reaction (AFR),” “Asian Flush,” and “Asian Glow” are deceptive because they lead people to think that alcohol is the cause. In reality, ALDH2 Deficiency is an inherited genetic variant that compromises the body’s ability to produce enough ALDH2 enzyme for the rapid detoxification of acetaldehyde—a highly toxic byproduct.
This toxicity can begin early in life—often before noticeable symptoms appear—due to continuous exposure to acetaldehyde from multiple sources.
Alcohol may exacerbate visible symptoms because acetaldehyde accumulates and expands blood vessels, creating a flushed appearance. This misleads people into thinking that avoiding alcohol eliminates the risk. However, alcohol is not the only source of acetaldehyde, and toxicity can persist even in its absence.
When acetaldehyde is not efficiently detoxified through the primary ALDH2 pathway, the secondary detoxification pathway—endogenous glutathione conjugation—can become dominant. This increases glutathione demand, leading to glutathione depletion and ultimately oxidative stress.
Delivery of the rate-limiting cysteine to the cells enables endogenous (naturally produced) glutathione production.
