Leevy Carroll B, Elbeshbeshy Hany A
University of Medicine and Dentistry of New Jersey-Newark, New Jersey Medical School, Liver Center, Sammy Davis Jr. National Liver Institute, 150 Bergen Street, P.O. Box 1709, Newark, NJ 07101-1709, USA.
Clin Liver Dis. 2005 Feb;9(1):55-66. doi: 10.1016/j.cld.2004.11.002.
Alcohol-induced liver injury is a reflection of the immunologic response of the liver to this stimulus. Reported studies of immunologic abnormalities in alcoholic liver disease (ALD) patients suggest that immunologic response plays a key role in the pathogenesis of chronic liver disease in alcoholics, and have contributed to the understanding of how some patients with ALD progress into alcoholic liver cirrhosis. The immunologic response of the liver is reflected in alcoholic fatty liver disease, hyaline necrosis, and cirrhosis, promoted by the role of neutrophils in damaging liver cells through cytotoxicity, and lymphocytes through cytotoxicity, inducing fibrogenesis of the liver and formation of immune complexes responsible for immune complex-mediated cytotoxicity, in addition to the role of different chemokines in attracting leucocytes, inducing fibrogenesis and liver cell apoptosis, with the established mechanism by which Mallory bodies evoke both cellular and humoral immunity contributing to the process of alcoholic liver cirrhosis, which plays a key role in transformation of alcoholic hepatitis to cirrhosis. At present, research is underway to find modalities to correct the induced immunologic changes, so at this time, it is necessary to avoid alcoholism, with the use of social and educational programs to stop alcoholism.
酒精性肝损伤反映了肝脏对这种刺激的免疫反应。对酒精性肝病(ALD)患者免疫异常的报道研究表明,免疫反应在酗酒者慢性肝病的发病机制中起关键作用,有助于理解一些ALD患者如何进展为酒精性肝硬化。肝脏的免疫反应体现在酒精性脂肪肝病、透明样坏死和肝硬化中,中性粒细胞通过细胞毒性损伤肝细胞,淋巴细胞通过细胞毒性发挥作用,诱导肝脏纤维化和形成负责免疫复合物介导细胞毒性的免疫复合物,此外,不同趋化因子在吸引白细胞、诱导纤维化和肝细胞凋亡方面也发挥作用,Mallory小体引发细胞免疫和体液免疫的既定机制也促成了酒精性肝硬化的进程,这在酒精性肝炎向肝硬化的转变中起关键作用。目前,正在进行研究以寻找纠正诱导免疫变化的方法,所以此时,有必要通过社会和教育项目来避免酗酒以戒酒。