Emerging evidence suggests that innate immunity drives alcoholic liver disease (ALD) and that the interferon regulatory factor 3 (IRF3), a transcription factor regulating innate immune responses, is indispensable for the development of ALD. Here we report that IRF3 mediates ALD via linking endoplasmic reticulum (ER) stress with apoptotic signaling in hepatocytes. We found that ethanol induced ER stress and triggered the association of IRF3 with the ER adaptor, stimulator of interferon genes (STING), as well as subsequent phosphorylation of IRF3. Activated IRF3 associated with the proapoptotic molecule Bax [B-cell lymphoma 2 (Bcl2)-associated X protein] and contributed to hepatocyte apoptosis. Deficiency of STING prevented IRF3 phosphorylation by ethanol or ER stress, and absence of IRF3 prevented hepatocyte apoptosis. The pathogenic role of IRF3 in ALD was independent of inflammation or Type-I interferons. Thus, STING and IRF3 are key determinants of ALD, linking ER stress signaling with the mitochondrial pathway of hepatocyte apoptosis. A lcoholic liver disease (ALD) affects over 140 million people worldwide, and currently there is no effective treatment. Acute alcohol consumption induces fatty liver and excessive alcohol use causes progression to steatohepatitis, cirrhosis, and hepatocellular carcinoma. Dysregulation of innate immunity and liver inflammation, triggered by the translocation of gut-derived endotoxin [lipopolysaccharide (LPS)] to the liver, represent major contributors to ALD (1). The recognition of gut-derived LPS by Kupffer cells (KC) requires the Toll-like receptor 4 (TLR4), which triggers two downstream pathways. The TLR4/ myeloid differentiation primary response gene 88 (MyD88) pathway activates transcription of inflammatory cytokines, whereas TLR4/TRAM/TRIF [TIR domain-containing adaptor inducing interferon-beta (TRIF)-related adaptor molecule (TRAM)] triggers Type-I interferons (IFN) regulatory factor 3 (IRF3) to induce IFN (2). The essential role of the TLR4 signaling in ALD was demonstrated in mice lacking functional TLR4 that showed attenuation of alcoholic steatohepatitis (3, 4). In previous studies, we reported that the MyD88-dependent pathway was dispensable for ALD (4) and observed complete protection from alcohol-induced inflammation, steatosis, and injury in mice deficient in IRF3 (5), suggesting that the pathogenic effects of TLR4 in ALD were mediated via the TRAM/TRIF-dependent pathway. However, the mechanisms by which IRF3 causes ALD remain obscure.IRF3 is a constitutively expressed transcription factor that resides in the cytoplasm and dimerizes and translocates to the nucleus upon phosphorylation (6). Phosphorylated IRF3 induces IFN-β during viral infection, but may also contribute to inflammatory cytokine response to LPS (7). IRF3 also promotes apoptosis in virus-infected cells through association with proapoptotic molecule Bax [B-cell lymphoma 2 (Bcl2)-associated X protein] (8). To elucidate the mechanism by which IRF3 determines ALD, we asked three fundamental questions. F...