TY - JOUR
T1 - Pathogenesis of Alcoholic Liver Disease
AU - Dunn, Winston
AU - Shah, Vijay H.
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Alcoholic liver disease includes a broad clinical-histological spectrum from simple steatosis, cirrhosis, acute alcoholic hepatitis with or without cirrhosis to hepatocellular carcinoma as a complication of cirrhosis. The pathogenesis of alcoholic liver disease can be conceptually divided into (1) ethanol-mediated liver injury, (2) inflammatory immune response to injury, (3) intestinal permeability and microbiome changes. Corticosteroids may improve outcomes, but this is controversial and probably only impacts short-term survival. New pathophysiology-based therapies are under study, including antibiotics, caspase inhibition, interleukin-22, anakinra, FXR agonist and others. These studies provide hope for better future outcomes for this difficult disease.
AB - Alcoholic liver disease includes a broad clinical-histological spectrum from simple steatosis, cirrhosis, acute alcoholic hepatitis with or without cirrhosis to hepatocellular carcinoma as a complication of cirrhosis. The pathogenesis of alcoholic liver disease can be conceptually divided into (1) ethanol-mediated liver injury, (2) inflammatory immune response to injury, (3) intestinal permeability and microbiome changes. Corticosteroids may improve outcomes, but this is controversial and probably only impacts short-term survival. New pathophysiology-based therapies are under study, including antibiotics, caspase inhibition, interleukin-22, anakinra, FXR agonist and others. These studies provide hope for better future outcomes for this difficult disease.
KW - Alcoholic hepatitis
KW - Alcoholic liver disease
KW - Corticosteroids
KW - Intestinal permeability
KW - Microbiome
KW - Sterile necrosis
UR - http://www.scopus.com/inward/record.url?scp=84991709187&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84991709187&partnerID=8YFLogxK
U2 - 10.1016/j.cld.2016.02.004
DO - 10.1016/j.cld.2016.02.004
M3 - Review article
C2 - 27373608
AN - SCOPUS:84991709187
SN - 1089-3261
VL - 20
SP - 445
EP - 456
JO - Clinics in liver disease
JF - Clinics in liver disease
IS - 3
ER -