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Alcoholic-related liver disease: pathogenesis, management and future therapeutic developments
Argemi, Josepmaria; Ventura-Cots, Meritxell; Rachakonda, Vikrant; Bataller, Ramón.
Afiliação
  • Argemi, Josepmaria; University of Pittsburgh Medical Center. Division of Gastroenterology, Hepatology and Nutrition. Pennsylvania. United States
  • Ventura-Cots, Meritxell; Hospital Universitari de la Vall d'Hebrón-Vall d'Hebrón Institut de Recerca. Liver Unit. Barcelona. Spain
  • Rachakonda, Vikrant; Veterans Administration Northern California Health Care System. California. United States
  • Bataller, Ramón; University of Pittsburgh Medical Center. Division of Gastroenterology, Hepatology and Nutrition. Pennsylvania. United States
Rev. esp. enferm. dig ; 112(11): 869-878, nov. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-198773
Biblioteca responsável: ES1.1
Localização: BNCS
ABSTRACT
Alcohol-related liver disease (ALD) is the most frequent cause of advanced chronic liver disease worldwide. Excessive and prolonged alcohol use leads to ALD, which ranges from early forms such as alcoholic fatty liver (AFL) and alcoholic steatohepatitis (ASH), through progressive fibrosis to cirrhosis and the development of hepatocellular cancer (HCC). In addition, patients with underlying ALD and continuous alcohol use can develop alcoholic hepatitis (AH), which presents a rapid progression of liver failure and has a high short-term mortality. Genetic, environmental and epigenetic factors influence the progression of ALD to more severe forms. The pathogenesis of ALD is complex and involves multiple pathways. Recent translational studies have demonstrated a key role of the gut-liver axis and innate immunity in hepatocellular damage and fibrosis. In severe forms, hepatocellular de-differentiation and systemic inflammation contribute to liver failure and multiorgan failure. Alcohol abstinence is the cornerstone of therapy for ALD and the prevention of its complications, but the efficacy and accessibility of psycho-familial-social interventions is still poor and effective public health policies to limit problematic alcohol use need to be implemented. Prednisolone is the only current option for AH, with a transient beneficial effect over placebo. For patients with decompensated ALD-cirrhosis and/or development of HCC, liver transplantation (LT) may be required. In recent years, early LT is being increasingly offered to carefully selected AH patients, with excellent long-term survival. New trials of AH treatments are currently ongoing, and translational studies in human samples are paving the way to new promising targeted therapies
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Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Hepatopatias Alcoólicas Limite: Humanos Idioma: Inglês Revista: Rev. esp. enferm. dig Ano de publicação: 2020 Tipo de documento: Artigo Instituição/País de afiliação: Hospital Universitari de la Vall d'Hebrón-Vall d'Hebrón Institut de Recerca/Spain / University of Pittsburgh Medical Center/United States / Veterans Administration Northern California Health Care System/United States
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Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Hepatopatias Alcoólicas Limite: Humanos Idioma: Inglês Revista: Rev. esp. enferm. dig Ano de publicação: 2020 Tipo de documento: Artigo Instituição/País de afiliação: Hospital Universitari de la Vall d'Hebrón-Vall d'Hebrón Institut de Recerca/Spain / University of Pittsburgh Medical Center/United States / Veterans Administration Northern California Health Care System/United States
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