Alcohol and the liver.
OBJECTIVE
This review aims to acquaint the reader with advances in 2006 in the epidemiology, genetics, detection, pathogenesis and treatment of alcoholic liver disease.


RESULTS
Important discoveries have been made in pathogenesis and mechanism of disease, with great emphasis on the many pathways leading to oxidative stress, and the novel mechanism of endoplasmic reticulum stress that is proving to be important in the pathogenesis of many liver diseases. The reliability of ethyl glucuronide and other biomarkers for the detection of alcohol abuse is being better established. There have been no treatment advances for alcoholic liver disease but, on balance, steroids are still favored for carefully selected patients with alcoholic hepatitis. Many compounds tested in rodents may now be available for consideration for clinical trials. Criteria for patient selection and refusal for liver transplantation are being established but the 6 months abstinence rule still holds.


CONCLUSIONS
Insights are being made into the pathogenesis of alcoholic liver disease but safe and effective therapies for both alcoholic hepatitis and alcoholic cirrhosis have yet to be discovered.
Reuben
Adrian
A
Liver Service, Division of Gastroenterology and Hepatology, And Liver Transplant Program, Medical University of South Carolina, Charleston, South Carolina, USA. reubena@musc.edu
D000428:Alcohol Drinking / Q000009:adverse effects*; D000818:Animals; D000975:Antioxidants / Q000627:therapeutic use; D014943:Global Health; D006801:Humans; D008082:Lipotropic Agents / Q000627:therapeutic use; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008111:Liver Function Tests; D016031:Liver Transplantation; D009017:Morbidity / Q000639:trends; D011379:Prognosis
D000975:Antioxidants; D008082:Lipotropic Agents