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Another study implicated disruption of cytochrome P450, tryptophan and kynurenine pathways, cellular energy (NAD+, ADP), mitochondrial and ribosomal metabolisms, neurological dysfunction, and an increase of adverse microbial metabolites 46

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The liver plays a central role in clearing acetaldehyde, a highly reactive and carcinogenic intermediate ( In addition, chronic alcohol intake shifts metabolism toward CYP2E1 because ADH becomes saturated at higher alcohol levels