Review article: alcoholic liver disease--pathophysiological aspects and risk factors.
BACKGROUND
Alcoholic liver disease has a known aetiology but a complex and incompletely known pathogenesis. It is an extremely common disease with significant morbidity and mortality, but the reason why only a relatively small proportion of heavy drinkers progress to advanced disease remains elusive.


OBJECTIVE
To recognize the factors responsible for the development and progression of alcoholic liver disease, in the light of current knowledge on this matter.


METHODS
We performed a structured literature review identifying studies focusing on the complex pathogenetic pathway and risk factors of alcoholic liver disease. Results In addition to the cumulative amount of alcohol intake and alcohol consumption patterns, factors such as gender and ethnicity, genetic background, nutritional factors, energy metabolism abnormalities, oxidative stress, immunological mechanisms and hepatic co-morbid conditions play a key role in the genesis and progression of alcoholic liver injury.


CONCLUSIONS
Understanding the pathogenesis and risk factors of alcoholic liver disease should provide insight into the development of therapeutic strategies.
Gramenzi
A
A
Dipartimento di Medicina Interna, Cardioangiologia ed Epatologia, Università di Bologna, Policlinico S. Orsola, Via Massarenti 9, 40138 Bologna, Italy.
Caputo
F
F
Biselli
M
M
Kuria
F
F
Loggi
E
E
Andreone
P
P
Bernardi
M
M
D000428:Alcohol Drinking; D019392:Cytochrome P-450 CYP2E1 / Q000235:genetics; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D007501:Iron / Q000378:metabolism; D008108:Liver Diseases, Alcoholic / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D008297:Male; D009748:Nutrition Disorders / Q000150:complications / Q000503:physiopathology; D018384:Oxidative Stress / Q000502:physiology; D012307:Risk Factors; D012737:Sex Factors
D007501:Iron; D019392:Cytochrome P-450 CYP2E1