Advances in the management of alcohol-associated liver disease.

IF 3.8 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Gastroenterology Report Pub Date : 2024-11-05 eCollection Date: 2024-01-01 DOI:10.1093/gastro/goae097
Ahmad Anouti, Thomas A Kerr, Mack C Mitchell, Thomas G Cotter
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引用次数: 0

Abstract

Alcohol-associated liver disease (ALD) is a significant global health challenge, encompassing a spectrum from steatotic liver disease to cirrhosis and alcohol-associated hepatitis, and contributed to 25% of global cirrhosis deaths in 2019. The identification of both modifiable (e.g. heavy drinking, metabolic syndromes) and non-modifiable risk factors (e.g. genetic predispositions) is crucial for effective disease management. Alcohol use assessment and treatment, by using both behavioral therapy and pharmacotherapeutic modalities, nutrition support, and optimization of liver disease modifiers, form the cornerstone of management. Advances in medical therapies, such as fecal microbiota transplantation and novel agents such as IL-22, are being explored for their therapeutic potential. A unifying theme in ALD care is the need for a personalized approach to management, accounting for the spectrum of the disease and individual patient characteristics, to tailor interventions effectively. Finally, it is essential to address the challenges to effective ALD treatment, including socioeconomic, logistical, and stigma-related barriers, to improve patient outcomes. This review discusses the current knowledge on ALD, including epidemiology, pathophysiology, risk factors, and management strategies, highlighting the critical role of integrated care models.

酒精相关肝病的治疗进展。
酒精相关性肝病(ALD)是一项重大的全球性健康挑战,包括从脂肪肝到肝硬化和酒精相关性肝炎的一系列疾病,在 2019 年全球肝硬化死亡病例中,酒精相关性肝病占 25%。识别可改变的风险因素(如大量饮酒、代谢综合征)和不可改变的风险因素(如遗传倾向)对于有效控制疾病至关重要。通过使用行为疗法和药物治疗模式、营养支持和优化肝病调节剂,对酒精使用情况进行评估和治疗是管理的基石。目前正在探索粪便微生物群移植和 IL-22 等新型药物的治疗潜力。ALD 治疗的一个统一主题是,需要根据疾病谱和患者的个体特征采取个性化的治疗方法,以便有效地调整干预措施。最后,必须应对有效 ALD 治疗所面临的挑战,包括社会经济、后勤和与耻辱相关的障碍,以改善患者的预后。本综述讨论了目前有关 ALD 的知识,包括流行病学、病理生理学、风险因素和管理策略,强调了综合护理模式的关键作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Gastroenterology Report
Gastroenterology Report Medicine-Gastroenterology
CiteScore
4.60
自引率
2.80%
发文量
63
审稿时长
8 weeks
期刊介绍: Gastroenterology Report is an international fully open access (OA) online only journal, covering all areas related to gastrointestinal sciences, including studies of the alimentary tract, liver, biliary, pancreas, enteral nutrition and related fields. The journal aims to publish high quality research articles on both basic and clinical gastroenterology, authoritative reviews that bring together new advances in the field, as well as commentaries and highlight pieces that provide expert analysis of topical issues.
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