title: Pathogenesis of Alcoholic Liver Disease.
abstract: 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.
authors.affiliation: Gastroenterology & Hepatology, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
authors.forename: Winston
authors.initials: W
authors.lastname: Dunn
authors.affiliation: Gastroenterology Research Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA. Electronic address: shah.vijay@mayo.edu.
authors.forename: Vijay H
authors.initials: VH
authors.lastname: Shah
mesh_terms: D001343:Autophagy; D006528:Carcinoma, Hepatocellular / Q000209:etiology; D044127:Epigenesis, Genetic; D000069196:Gastrointestinal Microbiome; D006801:Humans; D007249:Inflammation / Q000276:immunology; D050356:Lipid Metabolism; D008108:Liver Diseases, Alcoholic / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D008113:Liver Neoplasms / Q000209:etiology; D012307:Risk Factors
keywords: Alcoholic hepatitis; Alcoholic liver disease; Corticosteroids; Intestinal permeability; Microbiome; Sterile necrosis