Alcoholic liver disease (ALD) observes a wide prevalence globally as chronic liver disease. ALD can range from alcoholic fatty liver (AFL) to alcoholic steatohepatitis (ASH), which causes hepatic inflammation. Chronic ASH can further progress to fibrosis and cirrhosis and in some instances, hepatocellular cancer (HCC). Additionally, severe ASH (with or without cirrhosis) can lead to alcoholic hepatitis, an acute clinical presentation of ALD, associated with liver failure and high mortality. 

Most individuals with >40 g daily consumption of alcohol develop AFL; however, only a few individuals develop more advanced disease. Genetic, epigenetic and non-genetic factors are responsible for the interindividual variation in ALD phenotype. Hepatic steatosis, oxidative stress, acetaldehyde-mediated toxicity and cytokine and chemokine-induced inflammation are involved in the pathogenesis of ALD.

Diagnosis of ALD includes assessing patients for alcohol use disorder and looking for signs of advanced liver disease. Ultrasonography, transient elastography, MRI, measurement of serum biomarkers and liver biopsy histology can be utilized to determine the degree of AFL and liver fibrosis.

The best treatment for all stages of ALD is Alcohol abstinence acquired by psychosomatic intervention. However, advanced diseases like cirrhosis or HCC may demand liver transplantation. Thus, new therapies are urgently required.

Source- Seitz HK, Bataller R, Cortez-Pinto H. et al. Alcoholic liver disease. Nat Rev Dis Primers,2018; 4, (16). https://doi.org/10.1038/s41572-018-0014-7