Current Understanding of Alcoholic Liver Disease: A prevalent "hidden" disease of increasing clinical importance

抄録

Alcoholic liver disease (ALD) continues to be a major metabolic liver disease in the world and is responsible for at least one third of 1.8 million annual deaths caused by cirrhosis and liver cancer. It is a disease caused by alcohol addiction but its initiation and progression are also predicated by secondary genetic and environmental factors. Its pathologic spectra are manifested by diverse and complex layers of cellular perturbation caused by metabolism of a simple molecule, ethyl alcohol. Alcoholic hepatitis defined as acute on chronic liver failure, is a very unique entity with high short-term mortality and limited therapeutic options. However, last three decades have witnessed remarkable advancements in our understanding of molecular mechanisms underlying the disease which even shaped basic science at the most fundamental level. Indeed, the ALD field has always been a forefront of research on oxidant stress, organelle stress, gut dysbiosis, endotoxin, inflammasome, macrophage and hepatic stellate cell biology, tumorigenesis, and metabolic reprogramming. Based on these new findings and better stratification of patients, novel therapeutic approaches have emerged and are being tested. This article will review the current understanding of molecular mechanisms of ALD and important challenges our society faces with the disease.