Alcohol-related liver disease

Czech version

Authors: Eva Mayerová
Authors‘ workplace: II. interní klinika LF UK a FN Plzeň
Published in: Čas. Lék. čes. 2025; 164: 299-305
Category: Review Article

Overview

Alcohol-related liver disease (ALD) represents a broad continuum of pathological conditions caused by excessive alcohol consumption –⁠ from simple steatosis through steatohepatitis and fibrosis to cirrhosis and its complications. The article summarizes the current view on this issue.

Keywords:

Cirrhosis – fibrosis – steatohepatitis – ALD

Sources

Ehrmann J, Aiglová K, Urban O a kol. Onemocnění jater související s alkoholem (ALD). Vnitřní lékařství 2020; 66: e3–e15.
European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of alcohol-related liver disease. J Hepatol 2018; 69 : 154–181.
Suchánková M, Ruprich J, Dofková M a kol. Přehled národních vodítek pro střídmou konzumaci alkoholických nápojů: nízkorizikové dávky alkoholu. Státní zdravotní ústav, 2015.
Rehm J, Samokhvalov AV, Shield KD. Global burden of alcoholic liver diseases. J Hepatol 2013; 59 : 160–168.
Holinka M, Frankova S, Adamcova Selcanova S et al. Genetic drivers of liver cirrhosis: the role of SERPINA1 and PNPLA3 variants in disease onset and progression. PLoS One 2025; 20: e0333051.
Shankarappa B, Mahadevan J, Murthy P et al. A study of genetic variants, genetic risk score and DNA methylation of PNPLA3 and TM6SF2 in alcohol liver cirrhosis. Indian J Gastroenterol 2023; 42 : 800–807.
Global Status Report on Alcohol and Health 2011. World Health Organization. Dostupné na: www.who.int/publications/i/item/global-status-report-on-alcohol-and-health-2011
Zemřelí 2020. Ústav zdravotnických informací a statistiky ČR, 2021. Dostupné na: www.uzis.cz/res/f/008370/demozem2020.pdf
Wood AM, Kaptoge S, Butterworth AS et al. Risk thresholds for alcohol consumption: analysis of individual–participant data from 599 912 current drinkers in 83 prospective studies. Lancet 2018; 391 : 1513–1523.
Crabb DW, Matsumoto M, Chang D, You M. Overview of the role of alcohol dehydrogenase and aldehyde dehydrogenase in the metabolism of ethanol. Proc Nutr Soc 2004; 63 : 49–63.
Lieber CS. Cytochrome P4502E1: its physiological and pathological role. Physiol Rev 1997; 77 : 517–544.
Cederbaum AI, Lu Y, Wu D. Role of oxidative stress in alcohol-induced liver injury. Arch Toxicol 2009; 83 (6): 519–548.
Neuman MG, French SW, Zakhari S et al. Alcohol, microbiome, life style influence alcohol and non–alcoholic organ damage. Exp Mol Pathol 2017; 102 : 162–180.
Tsukamoto H, Lu SC. Current concepts in the pathogenesis of alcoholic liver injury. FASEB J 2001; 15 : 1335–1349.
Romeo S, Kozlitina J, Xing C et al. Genetic variation in PNPLA3 confers susceptibility to nonalcoholic fatty liver disease. Nat Genet 2008; 40 : 1461–1465.
Mitchell EL, Khan Z. Liver disease in alpha-1 antitrypsin deficiency: current approaches and future directions. Curr Pathobiol Rep 2017; 5 : 243–252.
Singal AK, Bataller R, Ahn J et al. ACG clinical guideline: alcoholic liver disease. Am J Gastroenterol 2018; 113 : 175–194.
European Association for the Study of the Liver. EASL-ALEH clinical practice guidelines: non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol 2015; 63 : 237–264.
O’Shea RS, Dasarathy S, McCullough AJ. Alcoholic liver disease. Hepatology 2010; 51 : 307–328.
Yin M, Talwalkar JA, Glaser KJ et al. Assessment of hepatic fibrosis with magnetic resonance elastography. Clin Gastroenterol Hepatol 2007; 5 : 1207–1213.e2.
Yerian L. Histopathological evaluation of fatty and alcoholic liver diseases. J Dig Dis 2011; 12 (1): 17–24.
Tapper EB, Lok AS. Use of liver imaging and biopsy in clinical practice. N Engl J Med 2017; 377 : 756–768.
Huwart L, Peeters F, Sinkus R, et al. Liver fibrosis: non-invasive assessment with MR elastography. NMR Biomed 2006; 19 : 173–179.
Maurice JB, Brodkin E, Arnold F et al. Validation of the Baveno VI recommendations for screening varices. J Hepatol 2016; 65 : 899–905.
Helander A, Beck O. Ethyl sulfate: a metabolite of ethanol in humans and a potential biomarker of acute alcohol intake. J Anal Toxicol 2005; 29 : 270–274.
Niemelä O. Biomarkers in alcoholism. Clin Chim Acta 2007; 377 : 39–49.
Lieber CS. Hepatic and metabolic effects of ethanol: pathogenesis and prevention. Ann Med 1994; 26 : 325–330.
Mathurin P, Lucey MR. Management of alcoholic hepatitis. J Hepatol 2012; 56 (Suppl. 1): S39–S45.
Singh S, Murad MH, Chandar AK et al. Comparative effectiveness of pharmacological interventions for severe alcoholic hepatitis: a systematic review and network meta-analysis. Gastroenterology 2015; 149(4): 958–970.e12.
Altamirano J, Bataller R. Alcoholic liver disease: pathogenesis and new targets for therapy. Nat Rev Gastroenterol Hepatol 2011; 8 : 491–501.
Louvet A, Naveau S, Abdelnour M et al. The Lille model: a new tool for therapeutic strategy in severe alcoholic hepatitis treated with steroids. Hepatology 2007; 45 : 1348–1354.
Cabré E, Rodríguez–Iglesias P, Caballería J et al. Short –⁠ and long–term outcome of severe alcohol-induced hepatitis treated with steroids or enteral nutrition: a multicenter randomized trial. Hepatology 2000; 32 : 36–42.
de Franchis R. Expanding consensus in portal hypertension: report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol 2015; 63 : 743–752.
Fernández J, Acevedo J, Castro M et al. Prevalence and risk factors of infections by multiresistant bacteria in cirrhosis: a prospective study. Hepatology 2012; 55 : 1551–1561.
Ginès P, Solà E, Angeli P et al. Hepatorenal syndrome. Nat Rev Dis Primers 2018; 4 : 23.
Krowka MJ, Fallon MB, Kawut SM et al. International Liver Transplant Society Practice Guidelines: Diagnosis and management of hepatopulmonary syndrome and portopulmonary hypertension. Transplantation 2016; 100 (7): 1440–1452.
Stickel F, Hampe J. Genetic determinants of alcoholic liver disease. Gut 2012; 61 : 150–159.
Louvet A, Labreuche J, Artru F et al. Main drivers of outcome differ between short term and long term in severe alcoholic hepatitis: a prospective study. Hepatology 2017; 66 : 1464–1473.
Kim G, Kang SH, Kim MY, Baik SK. Prognostic value of sarcopenia in patients with liver cirrhosis: a systematic review and meta-analysis. PLoS One 2017; 12: e0186990.
Moreau R, Jalan R, Gines P et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology 2013; 144 : 1426–1437.

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