ALDH2

ALDH2 (aldehyde dehydrogenase 2) is a mitochondrial NAD(P)+-dependent enzyme that catalyzes the irreversible oxidation of acetaldehyde and other reactive aldehydes into their corresponding carboxylic acids, thereby maintaining cellular detoxification and redox homeostasis[1][2]. Mechanistically, ALDH2 participates in the major oxidative pathway of alcohol metabolism and also eliminates lipid peroxidation-derived aldehydes, including 4-hydroxynonenal (4-HNE) and malondialdehyde (MDA), which accumulate during oxidative stress and mitochondrial dysfunction[3][4]. Through detoxification of these highly reactive aldehydes, ALDH2 limits protein modification, oxidative injury, and disruption of intracellular signaling pathways associated with cardiovascular and metabolic disorders[3][4]. In disease models, reduced ALDH2 activity has been linked to myocardial injury, heart failure, diabetes, neurodegenerative diseases, stroke, and cancer, highlighting its broad role in stress-response mechanisms and tissue protection[4][5]. Compared with related ALDH isoforms, ALDH2 is distinguished by its mitochondrial localization and high catalytic efficiency toward acetaldehyde, whereas ALDH1A family members primarily regulate retinoic acid biosynthesis and ALDH1A1 or ALDH3A1 contribute to ocular protection and other tissue-specific functions[1][2]. A common inactive variant, ALDH22, markedly reduces enzymatic activity and promotes acetaldehyde accumulation, providing a widely used genetic model for studying aldehyde toxicity, oxidative stress, and disease susceptibility in East Asian populations[1]. For experimental applications, both ALDH2-selective activators and inhibitors have been developed to investigate isoform-specific functions, mitochondrial aldehyde metabolism, and therapeutic modulation of oxidative stress pathways[1][5].