Advances in alcoholic liver disease.
Alcoholic liver disease (ALD) remains a major cause of morbidity and mortality worldwide. For example, the Veterans Administration Cooperative Studies reported that patients with cirrhosis and superimposed alcoholic hepatitis had a 4-year mortality of >60%. Interactions between acetaldehyde, reactive oxygen and nitrogen species, inflammatory mediators and genetic factors appear to play prominent roles in the development of ALD. The cornerstone of therapy for ALD is lifestyle modification, including drinking and smoking cessation and losing weight, if appropriate. Nutrition intervention has been shown to play a positive role on both an inpatient and outpatient basis. Corticosteroids are effective in selected patients with alcoholic hepatitis and pentoxifylline appears to be a promising anti-inflammatory therapy. Some complementary and alternative medicine agents, such as milk thistle and S-adenosylmethionine, may be effective in alcoholic cirrhosis. Treatment of the complications of ALD can improve quality of life and, in some cases, decrease short-term mortality.
Arteel
Gavin
G
University of Louisville Medical Center, Building A, Room 1319, Louisville, KY 40292, USA.
Marsano
Luis
L
Mendez
Christian
C
Bentley
Frederick
F
McClain
Craig J
CJ
D000818:Animals; D000963:Antimetabolites / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D003078:Colchicine / Q000627:therapeutic use; D016207:Cytokines; D000431:Ethanol / Q000378:metabolism / Q000633:toxicity; D006801:Humans; D018836:Inflammation Mediators; D008019:Life Style; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D016031:Liver Transplantation; D009569:Nitric Oxide; D044623:Nutrition Therapy; D018384:Oxidative Stress; D010431:Pentoxifylline / Q000627:therapeutic use; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D011110:Polymorphism, Genetic; D011441:Propylthiouracil / Q000627:therapeutic use; D012307:Risk Factors
D000963:Antimetabolites; D000975:Antioxidants; D016207:Cytokines; D018836:Inflammation Mediators; D010726:Phosphodiesterase Inhibitors; D009569:Nitric Oxide; D000431:Ethanol; D011441:Propylthiouracil; D010431:Pentoxifylline; D003078:Colchicine