Department of Pharmacology, Edward Via College of Osteopathic Medicine, Virginia Tech Corporate Research Center.
Department of Biomedical Sciences and Pathobiology, Virginia Polytechnic Institute and State University.
J Dig Dis. 2012 Mar;13(3):133-142. doi: 10.1111/j.1751-2980.2011.00569.x.
Alcoholic liver disease (ALD) is a major cause of morbidity and mortality in the United States and Europe. The spectrum of ALD ranges from fatty liver to alcoholic hepatitis and cirrhosis, which may eventually lead to hepatocellular carcinoma. In developed countries as well as developing nations, ALD is a major cause of end-stage liver disease that requires liver transplantation. The most effective therapy for ALD is alcohol abstinence; however, for individuals with severe ALD and those in whom alcohol abstinence is not achievable, targeted therapies are absolutely necessary. In this context, advances of our understanding of the pathophysiology of ALD over the past two decades have contributed to the development of therapeutic modalities (e.g., pentoxifylline and corticosteroids) for the disease although the efficacy of the available treatments remains limited. This article is intended to succinctly review the recent experimental and clinical findings of the involvement of oxidative stress and redox signaling in the pathophysiology of ALD and the development of mechanistically based antioxidant modalities targeting oxidative stress and redox signaling mechanisms. The biochemical and cellular sources of reactive oxygen and nitrogen species (ROS/RNS) and dysregulated redox signaling pathways associated with alcohol consumption are particularly discussed to provide insight into the molecular basis of hepatic cell dysfunction and destruction as well as tissue remodeling underlying ALD.
酒精性肝病(ALD)是美国和欧洲发病率和死亡率的主要原因。ALD 的范围从脂肪肝到酒精性肝炎和肝硬化,最终可能导致肝细胞癌。在发达国家和发展中国家,ALD 是导致需要进行肝移植的终末期肝病的主要原因。ALD 最有效的治疗方法是戒酒;然而,对于严重的 ALD 患者和那些无法戒酒的患者,绝对需要有针对性的治疗。在这种情况下,过去二十年来我们对 ALD 病理生理学的理解的进展有助于开发治疗方法(例如,己酮可可碱和皮质类固醇),尽管现有治疗方法的疗效仍然有限。本文旨在简洁地综述氧化应激和氧化还原信号在 ALD 病理生理学以及针对氧化应激和氧化还原信号机制的基于机制的抗氧化治疗方法的发展中的最新实验和临床发现。特别讨论了与饮酒相关的活性氧和氮物种(ROS/RNS)和失调的氧化还原信号通路的生化和细胞来源,以深入了解肝细胞功能障碍和破坏以及 ALD 相关的组织重塑的分子基础。