Chae Hee Bok
Department of Internal Medicine, Chungbuk National University College of Medicine and Medical Research Institute, Heungdeok-gu, Cheongju, Korea.
Korean J Gastroenterol. 2009 May;53(5):275-82. doi: 10.4166/kjg.2009.53.5.275.
A study conducted 15-year ago showed that only 13.5% of chronic alcoholics developed alcohol-induced liver damage, which misled some people to believe a lack of relationship between the amount of alcohol and the occurrence of liver disease. However, it is true that a significant correlation exists between per capita consumption and the prevalence of cirrhosis. Alcoholic fatty liver is observed in most of chronic alcoholics even though the severity is not uniform. Abstinence remains the cornerstone of therapy for alcoholic liver disease (ALD). There is also consensus for the use of corticosteroids and pentoxifylline in severe alcoholic hepatitis maintaining good nutritional status to treat comorbidities in all forms of ALD, and liver transplantation in the end-stage ALD patients who can stop drinking for 6 months pre-transplantation period. Several clinical trials targeting tumor necrosis factor (TNF-alpha) and reducing oxidative stress have not been successful at this time. There is still a large field of alcohol research to explore in order to go farther in the area of pathophysiology. We need to understand a role of various cytokines and immune cells in the development of ALD to have more treatment tools to cope with ALD.
一项15年前进行的研究表明，只有13.5%的慢性酗酒者会出现酒精性肝损伤，这使一些人误以为酒精摄入量与肝病的发生之间缺乏关联。然而，人均饮酒量与肝硬化患病率之间确实存在显著相关性。大多数慢性酗酒者都会出现酒精性脂肪肝，尽管其严重程度并不一致。戒酒仍然是酒精性肝病（ALD）治疗的基石。对于重度酒精性肝炎患者，在维持良好营养状况以治疗所有形式ALD的合并症方面，使用皮质类固醇和己酮可可碱也已达成共识，对于终末期ALD患者，若能在移植前6个月戒酒，则可进行肝移植。目前，针对肿瘤坏死因子（TNF-α）和减轻氧化应激的几项临床试验尚未取得成功。为了在病理生理学领域取得更大进展，酒精研究仍有很大的探索空间。我们需要了解各种细胞因子和免疫细胞在ALD发生发展中的作用，以便拥有更多应对ALD的治疗手段。
