Alcoholic Hepatitis – A Fatal Disease

Liver is the vital organ that metabolizes and excretes nutrients. Failure of the liver leads to death in cases. The complication which causes liver failure is excessive alcohol consumption. Liver metabolizes ethanol and it faces the highest degree of injury by uncontrolled drinking. Alcohol use produces a broad spectrum of diseases; hepatosteatosis, Alcoholic hepatitis, fibrosis & cirrhosis. Pathogenesis of Alcohol related Liver Diseases (ALD) is explained by hepatic lipogenesis, deceleration of hepatic lipid breakdown, defective hepatic lipid export, macrophage induced alcoholic hepatitis (AH), Lipopolysaccharide (LPS) transport into the hepatic bloodstream, Malondialdehyde and acetaldehyde (MAA) adducts formation and hepatocyte stellate cell (HSC) induction. Main symptoms of AH include oxidative stress, metabolism interruption, inflammation, restoration process changes and bacterial byproducts misplacement from the gut into hepatic portal blood circulation. Diagnostic studies of ALD are concluded by medical records, clinical and laboratory declarations. Earlier, Glucocorticoids, Pentoxifylline, TNFα were used in the treatment of AH, alone or combined. Novel treatments include Metadoxine, Caspase inhibitors, Microbiome Modification, Microbial Phage Therapy, and liver transplantation. These treatments are prescribed in combination with addiction psychiatrists, social work, and family counselors. Recent studies confirmed that AH could be prevented by consuming capsaicin daily, which ultimately reduces the global burden.

Download Full-text

Murine Models of Nonalcoholic Fatty Liver Disease and Steatohepatitis

ISRN Hepatology ◽

10.1155/2013/237870 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Masashi Ninomiya ◽

Yasuteru Kondo ◽

Tooru Shimosegawa

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Fatty Liver Disease ◽

Alcoholic Hepatitis ◽

Murine Models ◽

Excessive Alcohol Consumption ◽

Nonalcoholic Fatty Liver ◽

History Of ◽

Excessive Alcohol ◽

Multiple Hit

In 1980, Ludwig et al. first reported patients of steatohepatitis who lacked a history of excessive alcohol consumption but showed liver histology resembling alcoholic hepatitis and progression to cirrhosis of the liver accompanied by inflammation and fibrosis. The development of nonalcoholic steatohepatitis (NASH) is associated with obesity, diabetes mellitus, insulin resistance, and hyperlipidemia. However, the pathogenesis of NASH remains incomplete. A “multiple-hit” hypothesis for the pathogenesis of NASH based on an animal model has been proposed and remains a foundation for research in this field. We review the important dietary and genetic animal models and discuss the pathogenesis of NASH.

Download Full-text

Neuronal modulation of hepatic lipid accumulation induced by bingelike drinking

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00218.2019 ◽

2020 ◽

Vol 318 (5) ◽

pp. E655-E666

Author(s):

Maria Ibars ◽

Matthew T. Maier ◽

Ernie Yulyaningsih ◽

Luz Perez ◽

Rachel Cheang ◽

...

Keyword(s):

Alcohol Consumption ◽

Fatty Liver ◽

Hepatic Steatosis ◽

Lipid Accumulation ◽

Excessive Alcohol Consumption ◽

Hepatic Lipid ◽

Hepatic Lipid Accumulation ◽

Excessive Alcohol ◽

Sympathetic Nervous ◽

The Brain

Excessive alcohol consumption, including binge drinking, is a common cause of fatty liver disease. Binge drinking rapidly induces hepatic steatosis, an early step in the pathogenesis of chronic liver injury. Despite its prevalence, the process by which excessive alcohol consumption promotes hepatic lipid accumulation remains unclear. Alcohol exerts potent effects on the brain, including hypothalamic neurons crucial for metabolic regulation. However, whether or not the brain plays a role in alcohol-induced hepatic steatosis is unknown. In the brain, alcohol increases extracellular levels of adenosine, a potent neuromodulator, and previous work implicates adenosine signaling as being important for the development of alcoholic fatty liver disease. Acute alcohol exposure also increases both the activity of agouti-related protein (AgRP)-expressing neurons and AgRP immunoreactivity. Here, we show that adenosine receptor A2B signaling in the brain modulates the extent of alcohol-induced fatty liver in mice and that both the AgRP neuropeptide and the sympathetic nervous system are indispensable for hepatic steatosis induced by bingelike alcohol consumption. Together, these results indicate that the brain plays an integral role in alcohol-induced hepatic lipid accumulation and that central adenosine signaling, hypothalamic AgRP, and the sympathetic nervous system are crucial mediators of this process.

Download Full-text

"Self-medication": Does Social Anxiety Promote Excessive Alcohol Consumption in a Non-clinical Population?

PsycEXTRA Dataset ◽

10.1037/e413812005-163 ◽

2002 ◽

Author(s):

E. Y. Strahan

Keyword(s):

Social Anxiety ◽

Alcohol Consumption ◽

Clinical Population ◽

Self Medication ◽

Excessive Alcohol Consumption ◽

Excessive Alcohol

Download Full-text

Does Excessive Alcohol Consumption Increase Economic Cost? An Investigation from Thailand

Systematic Reviews in Pharmacy ◽

10.31838/srp.2020.4.15 ◽

2020 ◽

Vol 11 (04) ◽

Keyword(s):

Alcohol Consumption ◽

Economic Cost ◽

Excessive Alcohol Consumption ◽

Excessive Alcohol

Download Full-text

Regulation of Alcohol and Acetaldehyde Metabolism by a Mixture of Lactobacillus and Bifidobacterium Species in Human

Nutrients ◽

10.3390/nu13061875 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1875

Author(s):

Su-Jin Jung ◽

Ji-Hyun Hwang ◽

Eun-Ock Park ◽

Seung-Ok Lee ◽

Yun-Jo Chung ◽

...

Keyword(s):

Alcohol Dehydrogenase ◽

Blood Levels ◽

Double Blind ◽

Excessive Alcohol Consumption ◽

Bifidobacterium Species ◽

Placebo Capsule ◽

Safety Parameters ◽

Excessive Alcohol ◽

Clinically Significant ◽

Acetaldehyde Metabolism

Excessive alcohol consumption is one of the most significant causes of morbidity and mortality worldwide. Alcohol is oxidized to toxic and carcinogenic acetaldehyde by alcohol dehydrogenase (ADH) and further oxidized to a non-toxic acetate by aldehyde dehydrogenase (ALDH). There are two major ALDH isoforms, cytosolic and mitochondrial, encoded by ALDH1 and ALDH2 genes, respectively. The ALDH2 polymorphism is associated with flushing response to alcohol use. Emerging evidence shows that Lactobacillus and Bifidobacterium species encode alcohol dehydrogenase (ADH) and acetaldehyde dehydrogenase (ALDH) mediate alcohol and acetaldehyde metabolism, respectively. A randomized, double-blind, placebo-controlled crossover clinical trial was designed to study the effects of Lactobacillus and Bifidobacterium probiotic mixture in humans and assessed their effects on alcohol and acetaldehyde metabolism. Here, twenty-seven wild types (ALDH2*1/*1) and the same number of heterozygotes (ALDH2*2/*1) were recruited for the study. The enrolled participants were randomly divided into either the probiotic (Duolac ProAP4) or the placebo group. Each group received a probiotic or placebo capsule for 15 days with subsequent crossover. Primary outcomes were measurement of alcohol and acetaldehyde in the blood after the alcohol intake. Blood levels of alcohol and acetaldehyde were significantly downregulated by probiotic supplementation in subjects with ALDH2*2/*1 genotype, but not in those with ALDH2*1/*1 genotype. However, there were no marked improvements in hangover score parameters between test and placebo groups. No clinically significant changes were observed in safety parameters. These results suggest that Duolac ProAP4 has a potential to downregulate the alcohol and acetaldehyde concentrations, and their effects depend on the presence or absence of polymorphism on the ALDH2 gene.

Download Full-text

Clinical Significance of Gamma-Glutamyltranspeptidase Combined with Carbohydrate-Deficient Transferrin for the Assessment of Excessive Alcohol Consumption in Patients with Alcoholic Cirrhosis

Medicines ◽

10.3390/medicines8070039 ◽

2021 ◽

Vol 8 (7) ◽

pp. 39

Author(s):

Akihiko Shibamoto ◽

Tadashi Namisaki ◽

Junya Suzuki ◽

Takahiro Kubo ◽

Satoshi Iwai ◽

...

Keyword(s):

Alcohol Consumption ◽

Biological Markers ◽

Prediction Accuracy ◽

Total Bilirubin ◽

Alcoholic Cirrhosis ◽

Serum Total Bilirubin ◽

Excessive Alcohol Consumption ◽

Significant Difference ◽

Carbohydrate Deficient Transferrin ◽

Excessive Alcohol

: Background: This study aimed to compare the diagnostic performance of carbohydrate-deficient transferrin (CDT) and gamma-glutamyltranspeptidase (γ-GTP) to assess the single and combined benefits of these biological markers for the detection of chronic excessive alcohol consumption in patients with alcoholic cirrhosis. Methods: Biological markers were determined in blood samples from patients with alcoholic cirrhosis (drinking group, n = 35; nondrinking group, n = 81). The prediction accuracy of %CDT alone, γ-GTP alone, and their combination for the detection of excessive alcohol consumption was determined in patients with alcoholic cirrhosis. Results: Serum total bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-GTP, and alkaline phosphatase levels and %CDT were significantly higher and serum albumin levels were significantly lower in the drinking group than in the nondrinking group. The combination of %CDT and γ-GTP compared with %CDT or γ-GTP alone showed a higher prediction accuracy. The combination of %CDT and γ-GTP exhibited a higher specificity than γ-GTP alone. However, in terms of sensitivity, no significant difference was found between single or combined markers. Conclusions: The combination of %CDT and γ-GTP is considered a useful biomarker of chronic excessive alcohol consumption in patients with alcoholic cirrhosis.

Download Full-text

Methods for Estimating Avoidable Costs of Excessive Alcohol Consumption

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094964 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4964

Author(s):

Beata Gavurova ◽

Miriama Tarhanicova

Keyword(s):

Czech Republic ◽

Alcohol Consumption ◽

Data Availability ◽

Excessive Alcohol Consumption ◽

Public Authorities ◽

The Czech Republic ◽

Cost Of Disease ◽

Lost Productivity ◽

Excessive Alcohol ◽

The Cost

Background: Alcohol is a risk factor with serious consequences for society and individuals. This study aims to present methods and approaches that might be used to estimate the costs related to excessive alcohol consumption. It emphasizes the need for general methods and approaches that are easily applicable, because the level of digitalization and data availability vary across regions. The lack of data makes many methods inapplicable and useless. The ease of applicability will help to make cost-of-illness studies and their results comparable globally. Methods: This study is based on data from the Czech Republic in 2017. Drinking alcohol results in costs of healthcare, social care, law enforcement, and administrative costs of public authorities. To quantify the cost of drinking in the Czech Republic, the top-down approach, bottom-up approach, human capital approach and attributable fractions were used. Results: In 2017, the cost related to alcohol was estimated at 0.66% of the national GDP. Lost productivity represented 54.45% of total cost related to alcohol. All cost related to alcohol is considered to be avoidable. Conclusions: The methods and approaches applied to estimate the cost of disease or any other health issue should be generalized regarding the availability of data and specifics of provided services to people who are addicted or have any kind of disability.

Download Full-text