Very less is known about the pathogenesis of alcoholic hepatitis (AH). Although apoptosis is described in liver injury, its extent and mechanisms in human AH are unclear. A study, on patients with AH, quantified hepatocyte apoptosis, related it with disease severity, and identified the mechanisms of apoptosis induction.

26 patients with AH and 27 controls without liver disease were subjected to the TUNEL assay and immunohistochemistry for activated caspase 3 to determine Hepatocyte apoptosis. Liver specimens were graded to determine disease severity. immunohistochemistry was utilized to evaluate the expression of the death receptors, Fas and tumor necrosis factor-α receptor 1 (TNF-R1).

The following observations were made-

• Livers of patients with AH readily demonstrated TUNEL- and caspase 3-positive hepatocytes than the normal ones. 
• AH group demonstrated marked higher hepatocyte apoptosis in patients with a serum bilirubin of >3 mg/dl. 
• Grade 4 steatohepatitis also showed greater apoptosis. 
• hepatocytes in AH, except normal livers, showed strong expression of the Fas receptor, while the TNF-R1 expression was identical in both groups.

Thus it was concluded that the hepatocyte apoptosis is markedly increased in human AH, thus therapeutic strategies inhibiting apoptosis can be utilized in this disease.

SOURCE- Natori S, Rust C, Stadheim LM, Srinivasan A, Burgart LJ, Gores GJ. Hepatocyte apoptosis is a pathologic feature of human alcoholic hepatitis, Journal of Hepatology, 2001;34(2): 248-253.

https://doi.org/10.1016/S0168-8278(00)00089-1