Alcoholic liver disease: A current molecular and clinical perspective.
Alcoholic liver disease: A current molecular and clinical perspective.
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DOI：
10.1016/j.livres.2018.11.002
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发表时间：
2018-12-01
期刊：
影响因子：
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通讯作者：
Seki, Ekihiro
中科院分区：
文献类型：
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作者：
Ohashi, Koichiro;Pimienta, Michael;Seki, Ekihiro
酒精性肝病（ALD）的病因有哪些？ALD的范围从酒精性脂肪变性到脂肪性肝炎、纤维化和肝硬化。在西方国家，大约50%的肝硬化相关死亡是由于饮酒造成的。虽然酒精性肝硬化不再被认为是一种完全不可逆的疾病，但目前还没有有效的抗纤维化疗法。ALD的另一个重要临床方面是酒精性肝炎（AH）。AH是一种急性炎症性疾病，通常与肝硬化共病，严重的AH具有高死亡率。ALD的治疗选择有限。AH的既定治疗是皮质类固醇，其改善短期生存但不影响长期生存。肝移植是酒精性肝硬化和AH的治愈性治疗选择，但患者必须戒酒6个月才有资格。需要其他有效的治疗。ALD的分子机制是复杂的，尚未完全阐明。各种分子、信号通路和多个肝细胞和肝外细胞之间的串扰有助于ALD进展。本文综述重点介绍了酒精性肝脏病临床病理学中已确立和新兴的概念、其潜在的分子机制以及当前和未来的酒精性肝脏病治疗方案。
Heavy alcohol use is the cause of alcoholic liver disease (ALD). The ALD spectrum ranges from alcoholic steatosis to steatohepatitis, fibrosis, and cirrhosis. In Western countries, approximately 50% of cirrhosis-related deaths are due to alcohol use. While alcoholic cirrhosis is no longer considered a completely irreversible condition, no effective anti-fibrotic therapies are currently available. Another significant clinical aspect of ALD is alcoholic hepatitis (AH). AH is an acute inflammatory condition that is often comorbid with cirrhosis, and severe AH has a high mortality rate. Therapeutic options for ALD are limited. The established treatment for AH is corticosteroids, which improve short-term survival but do not affect long-term survival. Liver transplantation is a curative treatment option for alcoholic cirrhosis and AH, but patients must abstain from alcohol use for 6 months to qualify. Additional effective therapies are needed. The molecular mechanisms underlying ALD are complex and have not been fully elucidated. Various molecules, signaling pathways, and crosstalk between multiple hepatic and extrahepatic cells contribute to ALD progression. This review highlights established and emerging concepts in ALD clinicopathology, their underlying molecular mechanisms, and current and future ALD treatment options.