Pathogenesis of Alcoholic Liver Disease.

Alcoholic Liver Disease includes a broad clinical-histological spectrum from simple steatosis, cirrhosis, acute alcoholic hepatitis with or without cirrhosis to hepatocellular carcinoma as a complication of cirrhosis. The pathogenesis of ALD can be conceptually divided into 1) Ethanol mediated liver injury, 2) Inflammatory Immune response to injury, 3) Intestinal permeability and microbiome changes. Corticosteroids may improve outcomes, but this is controversial and probably only impacts short-term survival. New pathophysiology-based therapies are under study, including IL22, anakinra, and others. These studies provide hope for better future outcomes for this difficult disease.

酒精性肝病涵盖了广泛的临床 - 组织学谱系，从单纯性脂肪变性、肝硬化、伴有或不伴有肝硬化的急性酒精性肝炎，到作为肝硬化并发症的肝细胞癌。酒精性肝病（ALD）的发病机制从概念上可分为：1）乙醇介导的肝损伤；2）对损伤的炎症免疫反应；3）肠道通透性和微生物组变化。糖皮质激素可能改善预后，但这存在争议，且可能仅影响短期生存。基于新的病理生理学的疗法正在研究中，包括白细胞介素 - 22（IL - 22）、阿那白滞素（anakinra）等。这些研究为这种疑难疾病未来能有更好的预后带来了希望。