McClain Craig, Vatsalya Vatsalya, Cave Matthew
Departments of Medicine, Pharmacology & Toxicology, 505 S. Hancock Street, CTR503, Louisville, KY, 40202-1617, USA.
Department of Medicine, 505 S. Hancock Street, CTR503, Louisville, KY, 40202-1617, USA.
Curr Treat Options Gastroenterol. 2017 Jun;15(2):285-295. doi: 10.1007/s11938-017-0132-4.
Many variables, aside from the amount and duration of alcohol consumption, play a role in the development and progression of alcoholic liver disease (ALD). One critical factor that can be modified is diet/nutrition. We have made major recent advances in our understanding of the interactions of nutrition and ALD. In this article, we review advances made in zinc metabolism/therapy for ALD. There is major zinc dyshomeostasis with ALD which is mediated, in part, by poor intake and absorption, increased excretion, and altered zinc transporters, especially ZIP14. Zinc deficiency plays an etiologic role in multiple mechanisms of ALD, ranging from intestinal barrier dysfunction to hepatocyte apoptosis. Zinc supplementation is highly effective at correcting these ALD mechanisms and preventing/treating experimental ALD. There is no Food and Drug Administration (FDA) approved therapy for any stage of ALD. Because animal and human data suggest that zinc deficiency occurs early in the course of ALD, we treat most ALD patients with daily oral zinc supplementation (220 mg zinc sulfate which contains 50 mg elemental zinc).
除饮酒量和饮酒持续时间外，许多变量在酒精性肝病（ALD）的发生和发展过程中都发挥着作用。一个可以改变的关键因素是饮食/营养。我们最近在理解营养与ALD的相互作用方面取得了重大进展。在本文中，我们综述了锌代谢/治疗ALD方面取得的进展。ALD存在严重的锌稳态失衡，部分原因是摄入和吸收不良、排泄增加以及锌转运体改变，尤其是ZIP14。锌缺乏在ALD的多种机制中起病因学作用，从肠道屏障功能障碍到肝细胞凋亡。补充锌对纠正这些ALD机制以及预防/治疗实验性ALD非常有效。目前尚无美国食品药品监督管理局（FDA）批准的用于ALD任何阶段的治疗方法。由于动物和人类数据表明锌缺乏在ALD病程早期就已出现，我们对大多数ALD患者采用每日口服锌补充剂（220毫克硫酸锌，含50毫克元素锌）进行治疗。
