Alcohol-associated liver disease
Bryan Mackowiak, … , Luca Maccioni, Bin Gao
Bryan Mackowiak, … , Luca Maccioni, Bin Gao
Published February 1, 2024
Citation Information: J Clin Invest. 2024;134(3):e176345. https://doi.org/10.1172/JCI176345.
View: Text | PDF
Review

Alcohol-associated liver disease

Abstract

Alcohol-associated liver disease (ALD) is a major cause of chronic liver disease worldwide, and comprises a spectrum of several different disorders, including simple steatosis, steatohepatitis, cirrhosis, and superimposed hepatocellular carcinoma. Although tremendous progress has been made in the field of ALD over the last 20 years, the pathogenesis of ALD remains obscure, and there are currently no FDA-approved drugs for the treatment of ALD. In this Review, we discuss new insights into the pathogenesis and therapeutic targets of ALD, utilizing the study of multiomics and other cutting-edge approaches. The potential translation of these studies into clinical practice and therapy is deliberated. We also discuss preclinical models of ALD, interplay of ALD and metabolic dysfunction, alcohol-associated liver cancer, the heterogeneity of ALD, and some potential translational research prospects for ALD.

Authors

Bryan Mackowiak, Yaojie Fu, Luca Maccioni, Bin Gao

×

Figure 1

Spectrum of ALD, risk factors, and comorbidities.

Options: View larger image (or click on image) Download as PowerPoint
Spectrum of ALD, risk factors, and comorbidities. Almost all individuals...
Almost all individuals who drink heavily (90%–95%) develop steatosis; some of them may develop more severe forms of ALD, including alcohol-associated steatohepatitis (ASH), cirrhosis, and hepatocellular carcinoma (HCC). Some patients with underlying ALD develop acute alcohol-associated hepatitis (AH) with the typical clinical syndrome jaundice. AH is often referred to as a severe form of AH that has a high short-term morality. ASH is diagnosed based on histology, while AH is diagnosed based on clinical symptoms. Many risk factors promote the development of the severe forms of ALD. Alcohol intake and comorbid factors synergistically promote the progression of ALD. Adapted with permission from Gastroenterology (4).