Management of Alcohol-Related Liver Disease and Its Complications

Abstract

Alcohol-related liver disease (ALD) is a major healthcare/economic burden and one of the leading causes of liver transplantation. New epidemiological studies that detail the course of the disease are needed since, despite its high prevalence, it is still a stigmatised condition with underlying pathology. Alcoholic hepatitis, as the highest expression of ALD, has high morbidity. Current treatments have suboptimal results with the exception of liver transplantation. Epidemiological studies must also be developed to improve prevention and implement early diagnosis policies. It is essential to develop multidisciplinary health models that allow the liver transplantation candidate to be approached in a holistic way, both for indication and follow up. The implementation of alcohol consumption biomarkers (ethyl glucuronide, phosphatidylethanol) can assist in diagnosing and supporting recovery. There are several initiatives with new therapies that must be validated to establish their effectiveness and indication.

Alcolic liver disease: what’s new in the current decade?

“…Современные методы лечения имеют неоптимальные результаты, за исключением трансплантации печени [67]. Фармакотерапия ограничена глюкокортикостероидами (ГКС), которые улучшают только 28-дневную выживаемость, но увеличивают риск приобретения бактериальных, оппортунистических грибковых и вирусных инфекций [68,69], который возрастает при отсутствие реакции на ГКС у пациентов [70],…”

Symbiotic combination of Akkermansia muciniphila and inosine alleviates alcohol-induced liver injury by modulating gut dysbiosis and immune responses

“…Alcoholic liver disease (ALD) encompasses alcoholic fatty liver disease, alcoholic hepatitis, alcoholic liver fibrosis, cirrhosis, and hepatocellular carcinoma. Globally, in 2020, approximately 1.34 billion men and 312 million women engaged in harmful alcohol consumption, leading to approximately 1.78 million deaths attributed to alcohol consumption ( Cabezas, 2022 ; Huang et al, 2023 ). Reports indicate that 50% of cirrhosis-related mortality is linked to alcohol consumption, which poses a significant threat to human health ( Xiao et al, 2019 ; Avila et al, 2020 ).…”

Anti-miR-873-5p improves alcohol-related liver disease by enhancing hepatic deacetylation via SIRT1

“…Alcohol-related liver disease (ALD) is a complex and multistage disorder that is considered one of the most common liver pathologies and the main cause of liver transplantation. 3 This disease is characterised by an altered redox state primarily caused by the hepatic oxidation of alcohol, resulting in increased NADH levels and the overproduction of toxic acetaldehyde and acetate. 4 The increased NADH/NAD + ratio leads to mitochondrial overactivation, in which respiration and oxygen consumption nearly double to restore NAD + , whereas simultaneously attempting to metabolize toxic acetaldehyde.…”

“…Although alcohol abstinence is the cornerstone of early ALD care, most patients fail to comply. Few suboptimal therapeutic options for ALD are available, apart from liver transplantation 3 , 7 , although there are few organ donors available. Thus, new therapeutic approaches are needed.…”