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Emerging medical therapies for severe alcoholic hepatitis

Clinical and Molecular Hepatology 2020년 26권 4호 p.686 ~ 696
Tornai David, Szabo Gyongyi,
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 ( Tornai David ) - Harvard Medical School Beth Israel Deaconess Medical Center
 ( Szabo Gyongyi ) - Harvard Medical School Beth Israel Deaconess Medical Center

Abstract


Severe alcoholic hepatitis (AH) is an acute and often devastating form of alcohol-associated liver disease. Clinically, AH is characterized by elevated bilirubin, model for end stage liver disease scores >20, and nonspecific symptoms that are caused by underlying inflammation, hepatocyte injury, and impaired intestinal barrier function. Compromised immune defense in AH contributes to infections, sepsis and organ failure. To date, corticosteroids are the only recommended treatment for severe AH, however it does not provide survival benefits beyond 1 month. Recent preclinical and early clinical studies in AH aided understanding of the disease and presented opportunities for new therapeutic options targeting inflammation, oxidative stress, liver regeneration and modification of intestinal microbiota. In this comprehensive review, we discuss promising preclinical results and ongoing clinical trials evaluating novel therapeutic agents for the treatment of severe AH.

키워드

Fatty liver; Fibrosis; Hepatocytes; Oxidative stress; Gastrointestinal microbiome

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