Advances in alcoholic liver disease

被引:66
作者
Beier J.I. [1 ,2 ]
Arteel G.E. [1 ,2 ]
McClain C.J. [1 ,2 ,3 ,4 ]
机构
[1] Department of Pharmacology and Toxicology, University of Louisville Health Sciences Center, Louisville
[2] University of Louisville Alcohol Research Center, University of Louisville Health Sciences Center, Louisville
[3] Department of Medicine, University of Louisville Health Sciences Center, Clinical and Translational Research Building, Louisville, KY 40292
[4] Robley Rex Veterans Administration Medical Center, Louisville
关键词
Alcoholic liver disease; Coagulation; Ethanol; Fibrosis/cirrhosis; Inflammation; Lipopolysaccharide; Nutrition; Oxidative stress; Stress kinases;
D O I
10.1007/s11894-010-0157-5
中图分类号
学科分类号
摘要
Alcoholic liver disease (ALD) remains a leading cause of death from liver disease in the United States. In studies from the Veterans Administration, patients with cirrhosis and superimposed alcoholic hepatitis had greater than 60% mortality over a 4-year period, with most of those deaths occurring in the first month. Thus, the prognosis for this disease is more ominous than for many common types of cancer (eg, breast, prostate, and colon). Moreover, ALD imposes a significant economic burden from lost wages, health care costs, and lost productivity. Unfortunately, there is still no Food and Drug Administration-approved or widely accepted drug therapy for any stage of ALD. Thus, a pressing need exists for a more detailed understanding of mechanisms of liver injury. This article reviews recent advances in mechanisms and therapy related to five major areas of direct relevance to ALD: oxidative stress; gut-liver axis and cytokine signaling; malnutrition; fibrin/clotting; and stellate cell activation/fibrosis. We also review why therapies related to these mechanisms have performed well in experimental animals and in vitro systems, but have not necessarily translated into effective therapy for humans with ALD. © 2010 Springer Science+Business Media, LLC (outside the USA).
引用
收藏
页码:56 / 64
页数:8
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