(Press-News.org) Researchers have identified specific gut bacteria and metabolic pathways that drive alcohol production in patients with auto-brewery syndrome (ABS), a rare and often misunderstood condition in which people experience intoxication without drinking alcohol. The research team from Mass General Brigham, in collaboration with colleagues at University of California San Diego, published their findings in Nature Microbiology.
ABS occurs when gut microbes break down carbohydrates and convert them to ethanol (alcohol) that enters the bloodstream. While carbohydrate metabolism can produce small amounts of alcohol in everyone, levels can be high enough to cause intoxication in people with ABS. The condition is extremely rare but likely underdiagnosed due to a lack of awareness, diagnostic challenges, and stigma.
Many patients experience years of misdiagnosis and social, medical, and legal consequences before receiving a diagnosis. Confirmation of ABS is also difficult to obtain, as the gold-standard diagnosis requires monitored blood alcohol testing under supervised conditions.
To better understand the condition, researchers evaluated 22 patients with ABS, 21 unaffected household partners, and 22 healthy control participants. The team then compared gut microbial composition and function across groups.
The study showed that stool samples taken from patients during a flare of ABS produced significantly more ethanol in the lab than samples from household partners or healthy controls—pointing to the potential for a stool-based diagnostic test.
Previously, scientists had very little information about which specific gut microbes (yeasts or bacteria) caused ABS. The stool analysis pointed to several bacterial species as key drivers in patients including Escherichia coli and Klebsiella pneumoniae. In addition, during ABS flares, some patients had much higher levels of enzymes involved in fermentation pathways, compared to controls. While some patients had these organisms, the authors note that finding the causative microbes in individual patients is an arduous process.
Researchers also followed one patient who experienced symptom relief after undergoing a fecal microbiota transplantation when other treatments had failed. Relapse and remission corresponded with shifts in specific bacterial strains and metabolic pathway activity, providing further biological evidence for the condition. After a second fecal transplant, with different antibiotic pretreatment, the patient was symptom-free for more than 16 months.
“Auto-brewery syndrome is a misunderstood condition with few tests and treatments. Our study demonstrates the potential for fecal transplantation,” said co-senior author Elizabeth Hohmann, MD, of the Infectious Disease Division in the Mass General Brigham Department of Medicine. “More broadly, by determining the specific bacteria and microbial pathways responsible, our findings may lead the way toward easier diagnosis, better treatments, and an improved quality of life for individuals living with this rare condition.”
Hohmann is currently working with colleagues at UC San Diego on a study evaluating fecal transplantation in eight patients with ABS.
Authorship: In addition to Hohmann, Mass General Brigham authors include Valeria Magallan. Additional authors include Cynthia L. Hsu, Shikha Shukla, Linton Freund, Annie C. Chou, Yongqiang Yang, Ryan Bruellman, Fernanda Raya Tonetti, Noemí Cabré, Susan Mayo, Hyun Gyu Lim, Barbara J. Cordell, Sonja Lang, Peter Stärkel, Cristina Llorente, Bernhard O. Palsson, Chitra Mandyam, Brigid S. Boland, Elizabeth Hohmann, and Bernd Schnabl.
Disclosures: Schnabl has been consulting for Ambys Medicines, Boehringer Ingelheim, Ferring Research Institute, Gelesis, HOST Therabiomics, Intercept Pharmaceuticals, Mabwell Therapeutics, Patara Pharmaceuticals, Surrozen and Takeda. Schnabl’s institution UC San Diego has received research support from Axial Biotherapeutics, BiomX, CymaBay Therapeutics, Intercept, NGM Biopharmaceuticals, Prodigy Biotech and Synlogic Operating Company. Schnabel is founder of Nterica Bio. Hohman has received research support from Seres Therapeutics, MicrobiomeX/Tend.
Funding: This work was supported by the National Institutes of Health (grants K99 AA031328 and T32 DK007202), the American Association for the Study of Liver Diseases Foundation (Grant #CTORA23-208366), and a Pilot and Feasibility Award from the Southern California Research Center for ALPD and Cirrhosis funded by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health P50AA011999 (to C.L.H), in part by NIH grants R01 AA024726, R01 AA020703, U01 AA026939, by Award Number BX004594 from the Biomedical Laboratory Research & Development Service of the VA Office of Research and Development (to B.S.) and services provided by NIH centers P50 AA011999 and the San Diego Digestive Diseases Research Center (SDDRC) P30 DK120515. This study was supported in part by NIH grants R01 AA029106, 1R21 AA030654, P30 AR073761 the D34 HP31027 UC San Diego’s Hispanic Center of Excellence, and by the Isenberg Endowed Fellowship jointly awarded by the Pilot/Feasibility Program of the San Diego Digestive Diseases Research Center (SDDRC), the Hellman Family Foundation (P30 DK120515) (to C.L.). This work was also supported by the Joint BioEnergy Institute, U.S. Department of Energy, Office of Science, Biological and Environmental Research Program under Award Number DE-AC02-05CH11231. This publication includes data generated at the UC San Diego IGM Genomics Center utilizing an Illumina NovaSeq X Plus that was purchased with funding from a National Institutes of Health SIG grant (#S10 OD026929).
Paper cited: Hsu CL et al. “Gut microbial ethanol metabolism contributes to auto-brewery syndrome in an observational cohort” Nature Microbiology DOI: 10.1038/s41564-025-02225-y
###
About Mass General Brigham
Mass General Brigham is an integrated academic health care system, uniting great minds to solve the hardest problems in medicine for our communities and the world. Mass General Brigham connects a full continuum of care across a system of academic medical centers, community and specialty hospitals, a health insurance plan, physician networks, community health centers, home care, and long-term care services. Mass General Brigham is a nonprofit organization committed to patient care, research, teaching, and service to the community. In addition, Mass General Brigham is one of the nation’s leading biomedical research organizations with several Harvard Medical School teaching hospitals. For more information, please visit massgeneralbrigham.org.
END
Researchers find promising new way to boost the immune response to cancer
Multi-pronged antibodies more effective in activating cancer-killing cells
Researchers at the University of Southampton have developed a promising new way to bolster the body’s immune system response to cancer.
In a study published in Nature Communications, researchers used specially engineered multi-pronged antibodies to better activate cancer-killing T cells.
The antibodies work by ‘grabbing’ and ‘clustering’ multiple immune cell receptors – boosting the signal ...
To ensure that the tissue structures of biological samples are easily recognisable under the electron microscope, they are treated with a staining agent. The standard staining agent for this is uranyl acetate. However, some laboratories are not allowed to use this highly toxic and radioactive substance for safety reasons. A research team at the Institute of Electron Microscopy and Nanoanalysis (FELMI-ZFE) at Graz University of Technology (TU Graz) has now found an environmentally friendly alternative: ordinary espresso. Images of the samples treated with it were of equally good quality as images of comparative samples, which were prepared with uranyl ...
Tsukuba, Japan—Animals, including humans, rely on their sense of smell to locate food, avoid predators, and communicate. This sensory ability depends on specialized receptor proteins. In vertebrates, four major receptor families mediate olfaction; these include olfactory receptors (ORs), vomeronasal type 1 receptors (V1Rs), vomeronasal type 2 receptors (V2Rs), and trace amine-associated receptors (TAARs). However, the evolutionary origin and early diversification patterns of these receptor classes remain poorly understood.
In this study, University of Tsukuba researchers examined the hagfish genome for genes linked to ORs. In total, they identified 48 OR genes, 2 V1R genes, ...
A new technology has been developed that enables cuffless non-invasive blood pressure monitoring by using ultrasonic to track real-time changes in vascular diameter—without the need for a traditional cuff. The technology is expected to serve as a core component in future wearable healthcare devices and smart medical monitoring platforms.
A research team led by Dr. Shin Hur at the Korea Institute of Machinery and Materials (KIMM, President Seog-Hyeon Ryu), including Syed Turab Haider Zaidi, a student researcher from the UST–KIMM ...
A new study of over 32,000 US Veterans has found that the longer people stay on medications for opioid use disorder (buprenorphine, methadone, or extended-release naltrexone), the greater the probability of short- and medium-term survival. This benefit continues to increase at least for four years of ongoing treatment, considerably longer than most patients currently stay in treatment.
People with opioid use disorder run the risk of dying from accidental overdose but opioid use disorder also increases the risk of death from other health conditions, most notably infectious ...
Research has shown that conservation campaigns could turn the tide on the illegal ivory trade if they focused less on themes of ‘guilt’ and more on why people want to buy ivory in the first place.
Despite decades of awareness campaigns and trade bans, ivory buying in Asia still persists. At the recent 20th meeting of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) in Uzbekistan, the international ban on ivory trade was upheld.
Researchers at the University of York say many anti-ivory campaigns have struggled because they miss the human side of the problem - why ...
Using metagenomic sequencing across a realistic temperature gradient, researchers show that carcass decay triggers a surge in carbon-degradation genes, while warming selectively favors pathways that rapidly consume easily degradable carbon.
Animal death and decomposition are natural but powerful drivers of nutrient release. Each year, large quantities of animal carcasses enter terrestrial and aquatic ecosystems, releasing carbon-rich fluids that alter water chemistry and microbial activity. Aquatic systems are especially important, accounting for more than half of global primary production and playing a central role in carbon fixation and degradation. ...
Background
Micro-jumping robots offer unique advantages in scenarios such as confined space exploration and post-disaster search and rescue. However, traditional designs have consistently faced two major bottlenecks. On one hand, actuators based on elastic energy storage mechanisms like springs struggle to accumulate sufficient energy for effective jumping when miniaturized, while their reset mechanisms incur additional energy losses. On the other hand, low-power actuators made from piezoelectric or dielectric materials reduce energy consumption but fail ...
By boosting antibiotic uptake and disabling bacterial defense systems, these plant-derived molecules act as potent antibiotic adjuvants, restoring the efficacy of an aging but essential antibiotic and offering a promising strategy to combat resistant infections.
As antibiotic resistance increasingly undermines long-standing treatments, extending the lifespan of existing drugs has emerged as a faster and more affordable alternative to developing new antibiotics. New antibiotic discovery typically requires over a decade and more than a billion dollars, while resistance can arise within only a few years, contributing to a sharp ...
Microbes often display cooperative behaviour in which individual cells put in work and sacrifice resources to collectively benefit the group. But sometimes, “cheater” cells in the group may reap the benefits of this cooperation without incurring any cost themselves. Scientists have suggested that in such cases, population bottlenecks – reduction in the total number of individuals – can help stabilise cooperative behaviour in the group.
A new study in PLOS Biology reveals that population bottlenecks can fundamentally reshape how cooperation ...
