title: Alcoholic liver disease: mechanisms of injury and targeted treatment.
abstract: Alcoholic liver disease (ALD) is a complex process that includes a wide spectrum of hepatic lesions, from steatosis to cirrhosis. Cell injury, inflammation, oxidative stress, regeneration and bacterial translocation are key drivers of alcohol-induced liver injury. Alcoholic hepatitis is the most severe form of all the alcohol-induced liver lesions. Animal models of ALD mainly involve mild liver damage (that is, steatosis and moderate inflammation), whereas severe alcoholic hepatitis in humans occurs in the setting of cirrhosis and is associated with severe liver failure. For this reason, translational studies using humans and human samples are crucial for the development of new therapeutic strategies. Although multiple attempts have been made to improve patient outcome, the treatment of alcoholic hepatitis is still based on abstinence from alcohol and brief exposure to corticosteroids. However, nearly 40% of patients with the most severe forms of alcoholic hepatitis will not benefit from treatment. We suggest that future clinical trials need to focus on end points other than mortality. This Review discusses the main pathways associated with the progression of liver disease, as well as potential therapeutic strategies targeting these pathways.
authors.affiliation: Service des Maladies de L'appareil Digestif et Unité INSERM 995, Hôpital Huriez, Rue Polonovski, 59037 Lille Cedex, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Louvet
authors.affiliation: Service des Maladies de L'appareil Digestif et Unité INSERM 995, Hôpital Huriez, Rue Polonovski, 59037 Lille Cedex, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Mathurin
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects; D000818:Animals; D002492:Central Nervous System Depressants / Q000009:adverse effects; D004195:Disease Models, Animal; D018450:Disease Progression; D000431:Ethanol / Q000009:adverse effects; D006801:Humans; D008099:Liver / Q000473:pathology*; D008108:Liver Diseases, Alcoholic / Q000378:metabolism / Q000628:therapy
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol