Redefining Successful Treatment of Severe Alcoholic Hepatitis

Lucey, Michael R.

doi:10.1002/hep.29398

Hepatology

2017

DOI: 10.1002/hep.29398

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Redefining Successful Treatment of Severe Alcoholic Hepatitis

Michael R. Lucey

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Cited by 3 publications

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“…Severe alcoholic hepatitis (SAH) is a serious form of acute decompensation of alcoholic liver disease characterised by elevated bilirubin, tender hepatomegaly and features of systemic inflammatory response syndrome resulting in high short‐term mortality 1 . Corticosteroids are the only current treatment with evidence of clinical effect (modified discriminant function ≥32 or presence of encephalopathy) 2 . However, it is only beneficial in a proportion of patients with SAH, and only on 1 month survival 3 .…”

mentioning

confidence: 99%

Editorial: microbiome modulation by rifaximin in severe alcoholic hepatitis

Youn

Suk

2021

Aliment Pharmacol Ther

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mentioning

confidence: 99%

Editorial: microbiome modulation by rifaximin in severe alcoholic hepatitis

Youn

Suk

2021

Aliment Pharmacol Ther

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Advances in the treatment of severe alcoholic hepatitis

Wang

Xü

Chang

et al. 2018

Current Medical Research and Opinion

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Severe alcoholic hepatitis (SAH) is a costly and worldwide public health issue with high morbidity and mortality. Specific effective treatments for SAH have yet to be established. The aim of the present article is to review the current knowledge of the pathogenesis, assessment and treatment options in patients with SAH. To date, alcohol abstinence and enteral nutrition are the recommended first-line treatments. Although corticosteroids remain the preferred therapy for certain patients with a modified Maddrey discriminant function level greater than 54, they only improve short-term survival rates. New research focuses on liver inflammation, liver regeneration, the gut-liver axis, human induced pluripotent stem cells and extracorporeal albumin dialysis. Liver transplantation is considered the last medical option for patients with SAH who are nonresponsive to other medical treatments.

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Severe alcoholic hepatitis: why do we know a lot, but can do so little?

2018

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Severe alcoholic hepatitis (SAH) is characterized by high both immediate and long - term mortality, caused by these patients ’ a special form of liver failure development which is acute on the background of chronic one (acute-on-chronic liver failure). Steatosis, oxidative stress, increased permeability of the intestinal wall, the formation of toxic metabolites and the cytokine cascade are considered to be the main pathogenetic elements of the SAH. The course of SAH is accompanied by the so-called liver-associated immunodeficiency, which is associated with a high risk of fatal infectious complications, causing up to А of all deaths. This variant of immunodeficiency is characterized by hyperactivation of some elements of the immune system along with suppression of the activity of others. Despite advances in the study of pathogenesis, today the only therapeutic agent affecting the survival of patients with SAH are corticosteroids. A significant improvement in prognosis in the absence of response to corticosteroid therapy can only be achieved by performing an urgent liver transplant. Currently, several new treatment options for patients with SAH are being developed. We believe that selective influence on key immunopathological processes deserves special attention.

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Redefining Successful Treatment of Severe Alcoholic Hepatitis

Cited by 3 publications

References 10 publications

Editorial: microbiome modulation by rifaximin in severe alcoholic hepatitis

Editorial: microbiome modulation by rifaximin in severe alcoholic hepatitis

Advances in the treatment of severe alcoholic hepatitis

Severe alcoholic hepatitis: why do we know a lot, but can do so little?

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