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The present review highlights data focusing on alcohol\u2010thiamine interactions and their relationship to the pathogenesis of Wernicke encephalopathy. Recent findings on the effects of alcohol on thiamine absorption and storage and on thiamine phosphorylation to the enzyme co\u2010factor form (thiamine diphosphate) are discussed with regard to the postulated \u201cbiochemical lesion\u201d of Wernicke encephalopathy. Also discussed are new findings on the molecular genetics of the thiamine\u2010dependent enzyme transketolase in patients with Wernicke encephalopathy. A discussion of the hypotheses regarding the mechanisms underlying the phenomenon of selective neuronal cell death observed in this disorder including cerebral energy deficit, focal lactic acidosis, glutamate excitotoxicity, increased expression of immediate\u2010early genes, free radicals and perturbations of the blood\u2010brain barrier are presented. Finally, the possible role of thiamine deficiency in alcoholic peripheral neuropathy is reviewed.<\/jats:p>","DOI":"10.1080\/13556219971470","type":"journal-article","created":{"date-parts":[[2002,7,26]],"date-time":"2002-07-26T16:11:58Z","timestamp":1027699918000},"page":"261-272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Alcohol\u2010thiamine interactions: an update on the pathogenesis of Wernicke encephalopathy"],"prefix":"10.1111","volume":"4","author":[{"given":"KATHRYN G.","family":"TODD","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ALAN S.","family":"HAZELL","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ROGER F.","family":"BUTTERWORTH","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,6,9]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"15","volume-title":"Alcohol\u2010induced brain damage","author":"Charness ME","year":"1993"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1992.tb01384.x"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00996920"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1982.tb31206.x"},{"key":"e_1_2_1_6_2","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1093\/ajcn\/31.6.938","article-title":"Intestinal thiamine transport: effect of chronic ethanol administration in rats","volume":"31","author":"Hoyumpa AM","year":"1978","journal-title":"Am J Clin Nutr"},{"key":"e_1_2_1_7_2","first-page":"307","article-title":"Effect of ethanol administration on thiamine metabolism and transketolase activity in rats","volume":"47","author":"Abe T","year":"1977","journal-title":"Int J Vit Nutr Res"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0006-2952(86)90002-X"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1971.tb02382.x"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.45.9.838"},{"key":"e_1_2_1_11_2","first-page":"39","volume-title":"Alcohol\u2010induced brain damage","author":"Harper CG","year":"1993"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(88)90209-2"},{"key":"e_1_2_1_13_2","first-page":"61","volume-title":"Pathologic findings. 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