Abstract

Alcoholic liver disease (ALD) refers to the damages to the liver and its functions due to alcohol overconsumption. It consists of fatty liver/steatosis, alcoholic hepatitis, steatohepatitis, chronic hepatitis with liver fibrosis or cirrhosis, and hepatocellular carcinoma. However, the mechanisms behind the pathogenesis of alcoholic liver disease are extremely complicated due to the involvement of immune cells, adipose tissues, and genetic diversity. Clinically, the diagnosis of ALD is not yet well developed. Therefore, the number of patients in advanced stages has increased due to the failure of proper early detection and treatment. At present, abstinence and nutritional therapy remain the conventional therapeutic interventions for ALD. Moreover, the therapies which target the TNF receptor superfamily, hormones, antioxidant signals, and MicroRNAs are used as treatments for ALD. In particular, mesenchymal stem cells (MSCs) are gaining attention as a potential therapeutic target of ALD. Therefore, in this review, we have summarized the current understandings of the pathogenesis and diagnosis of ALD. Moreover, we also discuss the various existing treatment strategies while focusing on promising therapeutic approaches for ALD.

Highlights

  • Alcoholic liver disease (ALD) is the second most common cause of total human death every year [1]

  • Another study found that when liver fibrosis or fatty liver is present in patients with alcoholic liver disease, the combination of Carbohydrate-deficient transferrin (CDT) and other biochemical indicators can further improve the accuracy of FibroTest and SteatoTest which is recommended by World Health Organization (WHO) for testing patients with metabolic conditions or who consume excessive amounts of alcohol [83]

  • mesenchymal stem cells (MSCs) can differentiate into hepatocyte-like cells in vitro and in vivo and secrete a wide range of cytokines, including IL-10 which inhibits the apoptosis of hepatic parenchymal cells, vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (BFGF), insulin-like growth factor (IGF), hepatocyte growth factor (HGF), epidermal growth factor (EGF), chemokines, transforming growth factor β3 (TGF-β3), and TNF-α [163,164]

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Summary

Introduction

Alcoholic liver disease (ALD) is the second most common cause of total human death every year [1]. The diagnosis of early stage ALD and treatment with correct strategies is pivotal to treat ALD successfully if irreversible liver damage has not yet occurred [6]. The current researchers have focused on more therapeutic strategies, such as improving patient survival and prognosis, prevention of ALD and early diagnosis and targeted therapies [7]. The accumulating evidence has shown that the effects of non-toxic compounds extracted from natural food and herbal plants prevent ALD [8]. It has shown the potential application of mesenchymal stem cells (MSCs)-based therapies for ALD treatment [9,10]. We summarized the possible therapeutic strategies to treat or prevent ALD

Alcohol Metabolism
The Spectrum of ALD
Molecular Mechanisms of ALD
Alcohol and Its Metabolites Damage the Liver
Oxidative Stress and Lipid Peroxidation
Endotoxin Enteric Leakage
Hepcidin Regulation
Apoptotic Signaling Pathway and Autophagy in ALD
Imaging Examination
Detection of Specific Biomarkers
Current Therapies
Nutritional Therapy
Alcohol Withdrawal Therapies
Hormone Related Therapies
Liver Transplantation
TNF Receptor Superfamily Target Therapies
Antioxidant Signal Targeting Therapies
Targeting the Inhibition of Hepatocyte Apoptosis
MicroRNAs Targeted Therapies
Specific Treatment Options for AH
Pluripotent Mesenchymal Stem Cells for the Treatment of Liver Fibrosis
Promotes the Proliferation and Regeneration of Hepatocytes
Research Studies on the Effects of Natural Plant Extractions for ALD
Findings
Conclusions and Future Directions
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