Mitochondria are thought to play a major role in hepatic oxidative stress associated with alcohol-induced liver injury. Thus, the hypothesis that delivery of the mitochondrial isoform of superoxide dismutase (Mn-SOD) via recombinant adenovirus would reduce alcohol-induced liver injury was tested. Rats were given recombinant adenovirus containing Mn-SOD (Ad.SOD2) or -galactosidase (Ad.lacZ) and then fed alcohol enterally for 4 weeks. Mn-SOD expression and activity of Ad.SOD2 in liver mitochondria of infected animals was increased nearly 3-fold compared with Ad.lacZ-infected controls. Mitochondrial glutathione levels in Ad.lacZinfected animals were decreased after 4 weeks of chronic ethanol, as expected, but were unchanged in Ad.SOD2-infected animals. Alanine aminotransferase was elevated significantly by ethanol, an effect that was prevented by Ad.SOD2. Moreover, pathology (e.g. the sum of steatosis, inflammation, and necrosis) was elevated dramatically by ethanol in Ad.lacZ-treated rats. This effect was also blunted in animals infected with Ad.SOD2. Neutrophil infiltration was increased about 3-fold in livers from both Ad.lacZ-and Ad.SOD2-infected rats by ethanol treatment. Moreover, ESR-detectable free radical adducts in bile were increased about 8-fold by ethanol. Using 13 C-labeled ethanol, it was determined that nearly 60% of total adducts were due to the ␣-hydroxyethyl radical adduct. This increase in radical formation was blocked completely by Ad.SOD2 infection. Furthermore, apoptosis of hepatocytes was increased about 5-fold by ethanol, an effect also blocked by Ad.SOD2. Interestingly, tumor necrosis factor-␣ mRNA was elevated to the same extent in both Ad.lacZ-and Ad.SOD2-infected animals follows ethanol exposure. These data suggest that hepatocyte mitochondrial oxidative stress is involved in alcohol-induced liver damage and likely follows Kupffer cell activation, cytokine production, and neutrophil infiltration. These results also support the hypothesis that mitochondrial oxidant production is a critical factor in parenchymal cell death caused by alcohol.Alcoholic liver disease results from dose-and time-dependent exposure to alcohol (1), but precise mechanisms of pathology are still largely unknown. Endotoxin and Kupffer cells have been implicated in the mechanism of early alcoholinduced liver injury using the enteral feeding model of Tsukamoto-French (2). For example, endotoxin derived from the gut activates Kupffer cells in the liver (3). In support of this idea, gut sterilization with nonabsorbable antibiotics or inactivation of Kupffer cells by gadolinium chloride (GdCl 3 ) prevents alcohol-induced liver injury in this model (4, 5). Furthermore, Kupffer cells, which release effectors and cytokines, are a major source of TNF␣ 1 in the liver (6). Indeed, TNF␣ messenger RNA in liver increased after 4 weeks of treatment with ethanol (7). Moreover, early alcohol-induced liver injury was attenuated by anti-TNF␣ antibodies and largely prevented in TNF receptor 1 knockout mice (8, 9). Thus, it is clear t...