Abstract

Background: Alcoholic liver disease (ALD) caused by chronic ethanol overconsumption is a common type of liver disease with a severe mortality burden throughout the world. The pathogenesis of ALD is complex, and no effective clinical treatment for the disease has advanced so far. Prolonged alcohol abstinence is the most effective therapy to attenuate the clinical course of ALD and even reverse liver damage. However, the molecular mechanisms involved in alcohol abstinence-improved recovery from alcoholic fatty liver remain unclear. This study aims to systematically evaluate the beneficial effect of alcohol abstinence on pathological changes in ALD.Methods: Using the Lieber-DeCarli mouse model of ALD, we analysed whether 1-week alcohol withdrawal reversed alcohol-induced detrimental alterations, including oxidative stress, liver injury, lipids metabolism, and hepatic inflammation, by detecting biomarkers and potential targets.Results: Alcohol withdrawal ameliorated alcohol-induced hepatic steatosis by improving liver lipid metabolism reprogramming via upregulating phosphorylated 5′-AMP -activated protein kinase (p-AMPK), peroxisome proliferator-activated receptor-α (PPAR-α), and carnitine palmitoyltransferase-1 (CPT-1), and downregulating fatty acid synthase (FAS) and diacylglycerol acyltransferase-2 (DGAT-2). The activities of antioxidant enzymes, including superoxide dismutase (SOD) and glutathione peroxidase (GSH-px), were significantly enhanced by alcohol withdrawal. Importantly, the abstinence recovered alcohol-fed induced liver injury, as evidenced by the improvements in haematoxylin and eosin (H&E) staining, plasma alanine aminotransferase (ALT) levels, and liver weight/body weight ratio. Alcohol-stimulated toll-like receptor 4/mitogen-activated protein kinases (TLR4/MAPKs) were significantly reversed by alcohol withdrawal, which might mechanistically contribute to the amelioration of liver injury. Accordingly, the hepatic inflammatory factor represented by tumour necrosis factor-alpha (TNF-α) was improved by alcohol abstinence.Conclusion: In summary, we reported that alcohol withdrawal effectively restored hepatic lipid metabolism and reversed liver injury and inflammation by improving metabolism reprogramming. These findings enhanced our understanding of the biological mechanisms involved in the beneficial role of alcohol abstinence as an effective treatment for ALD.

Highlights

  • Alcoholic liver disease (ALD), one of the main causes of chronic liver disease, ranges from alcoholic fatty liver (AFL) to alcohol hepatitis, alcoholic hepatic fibrosis, alcoholic cirrhosis, and even hepatocellular carcinoma (Seitz et al, 2018)

  • The inhibition of β-oxidation and the increase in the de-novo biosynthesis of free fatty acids (FFAs) caused by alcohol consumption play an important role in the development of AFL (Ceni et al, 2014)

  • We systematically examined whether alcohol withdrawal reverses alcohol-induced alterations in lipid metabolism, liver injury, oxidative stress, and inflammation

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Summary

Introduction

Alcoholic liver disease (ALD), one of the main causes of chronic liver disease, ranges from alcoholic fatty liver (AFL) to alcohol hepatitis, alcoholic hepatic fibrosis, alcoholic cirrhosis, and even hepatocellular carcinoma (Seitz et al, 2018). Multiple factors are involved in the progression of ALD, including sex, obesity, and genetics, but how these aspects influence the clinical outcome remains unclear (Becker et al, 1996). Long-term excess alcohol consumption is a predominant etiological factor of ALD progression (Zakhari and Li, 2007). The pathogenesis of ALD is complex, and no effective clinical treatment for the disease has advanced so far. Prolonged alcohol abstinence is the most effective therapy to attenuate the clinical course of ALD and even reverse liver damage.

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