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Alcoholic liver disease
Abstract
Alcoholic liver disease (ALD) is the most prevalent type of chronic liver disease worldwide. ALD can progress from alcoholic fatty liver (AFL) to alcoholic steatohepatitis (ASH), which is characterized by hepatic inflammation. Chronic ASH can eventually lead to fibrosis and cirrhosis and in some cases hepatocellular cancer (HCC). In addition, severe ASH (with or without cirrhosis) can lead to alcoholic hepatitis, which is an acute clinical presentation of ALD that is associated with liver failure and high mortality. Most individuals consuming >40 g of alcohol per day develop AFL; however, only a subset of individuals will develop more advanced disease. Genetic, epigenetic and non-genetic factors might explain the considerable interindividual variation in ALD phenotype. The pathogenesis of ALD includes hepatic steatosis, oxidative stress, acetaldehyde-mediated toxicity and cytokine and chemokine-induced inflammation. Diagnosis of ALD involves assessing patients for alcohol use disorder and signs of advanced liver disease. The degree of AFL and liver fibrosis can be determined by ultrasonography, transient elastography, MRI, measurement of serum biomarkers and liver biopsy histology. Alcohol abstinence achieved by psychosomatic intervention is the best treatment for all stages of ALD. In the case of advanced disease such as cirrhosis or HCC, liver transplantation may be required. Thus, new therapies are urgently needed.
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“Chronic and excessive alcohol intake is known to cause liver injury from mild steatosis (simple fat accumulation in so-called alcoholic fatty liver disease, AFLD) to more advanced liver disease such as inflammation (alcoholic steatohepatitis, ASH), fibrosis/cirrhosis, hepatic cancer, liver failure, and death203–213.”
From Advanced glycation end products (AGEs) and other adducts in aging-related diseases and alcohol-mediated tissue injury (2021) · cites this paper as [212]
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Metadata
- Authors
- Seitz, H. K., Bataller, R., Cortez-Pinto, H., Gao, B., Gual, A., Lackner, C., Mathurin, P., Mueller, S., Szabo, G., & Tsukamoto, H.
- Affiliations
- Heidelberg University (DE)
- University of Pittsburgh (US)
- National Institutes of Health (US)
- Hospital Clínic de Barcelona (ES)
- Medical University of Graz (AT)
- Inserm (FR)
- University of Southern California (US)
- ORCID
- Venue
- Nature Reviews Disease Primers
- Published
- 2018-08-16
- Volume
- 4
- Issue
- 1
- Pages
- 16-16
- ISSN
- 2056-676X (ISSN-L)
- OpenAlex
- W4210980460
- Cited by
- 1,271
- References
- 244
- Citations by year
- 2026: 126 · 2025: 200 · 2024: 249 · 2023: 230 · 2022: 176 · 2021: 145 · 2020: 75 · 2019: 57 · 2018: 9
- FWCI
- 10.57
- Type
- journal article
- Language
- en
- Update notices
- correction (2018-08-28)
- Open access
- closed
- Licence
- Locations
- Nature Reviews Disease Primers (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs (IK6BX004205, I01 BX001991)
- National Institute on Alcohol Abuse and Alcoholism (R01AA011576)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Keywords
- alcoholic liver disease, alcoholic fatty liver, alcoholic steatohepatitis, alcoholic hepatitis, liver cirrhosis, hepatocellular carcinoma, liver fibrosis, hepatic steatosis, oxidative stress, acetaldehyde toxicity, liver inflammation, alcoholism, liver fibrosis diagnosis, serum biomarkers, alcohol abstinence, liver transplantation
- MeSH terms
- Global Burden of Disease, Alcohol Drinking, Fatty Liver, Alcoholic, Humans, Liver Diseases, Alcoholic, Liver Neoplasms, Quality of Life, Liver Transplantation
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