Intestinal dysbiosis and permeability: the yin and yang in alcohol dependence and alcoholic liver disease

2018 ◽  
Vol 132 (2) ◽  
pp. 199-212 ◽  
Author(s):  
Peter Stärkel ◽  
Sophie Leclercq ◽  
Philippe de Timary ◽  
Bernd Schnabl
Keyword(s):  
Liver Disease ◽  
Alcohol Dependence ◽  
Alcoholic Liver Disease ◽  
Drinking Behavior ◽  
Intestinal Barrier ◽  
Public Health Problem ◽  
Current Evidence ◽  
Major Public Health Problem ◽  
Chronic Alcohol ◽  
Chronic Alcohol Abuse

Alcohol dependence and alcoholic liver disease represent a major public health problem with substantial morbidity and mortality. By yet incompletely understood mechanisms, chronic alcohol abuse is associated with increased intestinal permeability and alterations of the gut microbiota composition, allowing bacterial components, bacteria, and metabolites to reach the portal and the systemic circulation. These gut-derived bacterial products are recognized by immune cells circulating in the blood or residing in remote organs such as the liver leading to the release of pro-inflammatory cytokines which are considered important mediators of the liver–gut–brain communication. Although circulating cytokines are likely not the sole factors involved, they can induce liver inflammation/damage and reach the central nervous system where they favor neuroinflammation which is associated with change in mood, cognition, and drinking behavior. In this review, the authors focus on the current evidence describing the changes that occur in the intestinal microbiota with chronic alcohol consumption in conjunction with intestinal barrier breakdown and inflammatory changes sustaining the concept of a gut–liver–brain axis in the pathophysiology of alcohol dependence and alcoholic liver disease.

scholarly journals The Significance of Transaminases and Deritis Ratio for Predicting Alcoholic Liver Disease: A Hospital Based Comparative Study in Western Nepal

1970 ◽  
Vol 1 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Ankush Mittal ◽  
Brijesh Sathian ◽  
Arun Kumar ◽  
Nishida Chandrasekharan ◽  
Shambhu Kumar Yadav
Keyword(s):  
Liver Disease ◽  
Alcoholic Liver Disease ◽  
Odds Ratio ◽  
Public Health Problem ◽  
Analysis Data ◽  
Mean Value ◽  
Major Public Health Problem ◽  
Rational Understanding ◽  
Alcohol Liver Disease ◽  
Extent Of Damage

BackgroundIn Nepal, alcoholic liver disease (ALD) is a major public health problem. In testing for biochemical abnormalities in ALD, Deritis ratio (AST/ALT) is more sensitive than other conventional parameters, at any stage of the disease. The aim of our study was to assess closely the significance of transaminases and deritis ratio and their predictive implications among the patients of alcoholic liver disease in Pokhara valley.Materials and Methods  It was a hospital based retrospective study carried out from the data maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1st January 2009 and 31st July 2010. The variables collected were age, gender, total protein, albumin, AST, ALT and AST/ALT ratio. Descriptive statistics and testing of hypothesis were used for the analysis. Data was analyzed using EPI INFO and SPSS 16 software.ResultsOf the four hundred forty-five patients, there was a slight preponderance of males (55.5%) towards ALD as compared to females (44.5%), projecting the percentage of ALD to around 28.8. Males were 2.3 times more at risk of developing alcoholic liver disease than females (Odds Ratio=2.3, p=0.0001). Patients over 40 years of age had 3.2 times greater propensity of developing alcoholic liver disease (Odds Ratio=3.2, p=0.0001). In ALD patients, mean value of AST (131.5 ± SD94.46 IU/L) was markedly increased in comparison to ALT (85.12 ± SD58.24 IU/L) leading to significantly higher AST/ALT ratio (1.59 ± SD0.58). In cases, mean value of Deritis ratio was 1.59 with  CI (1.49, 1.69) which was significantly increased as compared to the ratio in controls which was 1.04 with CI (1.02, 1.06) (p=0.001). 96.9% of patients with alcoholic liver disease had an AST:ALT ratio of >1.0 with CI (93.9%,99.9%). The mean value of each variable in cases was significantly elevated as compared to controls (p=0.001).ConclusionEthanol consumption leads to a spectrum of liver diseases, the importance of which is magnified by its widespread use. Laboratory tests play an important role in this endeavor. Equally important is the fact that once complications of alcoholism are identified, it is imperative to be able to accurately determine their magnitude. Therefore, the estimation of deritis ratio is useful for the rational understanding of the extent of damage in alcoholic liver disease.Key Words: Transaminase; Deritis ratio; Alcohol Liver Disease; NepalDOI: 10.3126/nje.v1i1.4110Nepal Journal of Epidemiology 2010;1 (1): 33-37

Polymorphism of Alcohol-Metabolizing Genes Affects Drinking Behavior and Alcoholic Liver Disease in Japanese Men

1997 ◽  
Vol 21 (4) ◽  
pp. 596-601 ◽  
Author(s):  
Furnika Tanaka ◽  
Yasushi Shiratori ◽  
Osarnu Yokosuka ◽  
Furnio Imazeki ◽  
Yoshio Tsukada ◽  
...  
Keyword(s):  
Liver Disease ◽  
Alcoholic Liver Disease ◽  
Drinking Behavior ◽  
Japanese Men

scholarly journals Recent advances in managing chronic HCV infection: focus on therapy in patients with severe liver disease

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 367 ◽  
Author(s):  
Raoel Maan ◽  
Adriaan J. van der Meer
Keyword(s):  
Liver Disease ◽  
Treatment Options ◽  
Public Health Problem ◽  
Hcv Infection ◽  
New Drugs ◽  
European Medicines Agency ◽  
Major Public Health Problem ◽  
Advanced Liver Disease ◽  
Specific Patient ◽  
Chronic Hcv

Chronic hepatitis C virus (HCV) infection still represents a major public health problem, as it is thought to be responsible for more than 350,000 deaths around the globe on a yearly basis. Fortunately, successful eradication of the virus has been associated with improved clinical outcome and reduced mortality rates. In the past few years, treatment has improved considerably by the implementation of direct-acting antivirals (DAAs). From 2014 onwards, sofosbuvir, simeprevir, daclatasvir, ledipasvir, paritaprevir, ombitasvir, and dasabuvir have been approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA). Regimens with various combinations of these new drugs, without the use of interferon (IFN), proved to be very effective and well tolerated, even among patients with advanced liver disease. Moreover, treatment duration could be shortened to 12 weeks in the majority of patients. The high costs of these DAAs, however, limit the availability of IFN-free therapy worldwide. Even in wealthy countries, it is deemed necessary to prioritize DAA treatment in order to limit the immediate impact on the health budget. As patients with advanced liver disease are in most need of HCV clearance, many countries decided to treat those patients first. In the current review, we focus on the currently available IFN-free treatment options for patients with cirrhosis. We discuss the virological efficacy as well as the clinical relevance of these regimens among this specific patient population.

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