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2016 ; 22
(15
): 3892-906
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New treatment options for alcoholic hepatitis
#MMPMID27099434
Shasthry SM
; Sarin SK
World J Gastroenterol
2016[Apr]; 22
(15
): 3892-906
PMID27099434
show ga
The burden of alcoholic liver disease has rapidly grown in the past two decades
and is expected to increase further in the coming years. Alcoholic hepatitis, the
most florid presentation of alcoholic liver disease, continues to have high
morbidity and mortality, with significant financial and healthcare burden with
limited treatment options. Steroids remain the current standard of care in severe
alcoholic hepatitis in carefully selected patients. No specific treatments are
available for those patients who are steroid ineligible, intolerant or
unresponsive. Liver transplant has shown good short-term outcome; however,
feasibility, ethical and economic concerns remain. Modification of gut microbiota
composition and their products, such as lipopolysaccharide, nutritional
interventions, immune modulation, increasing steroid sensitivity, genetic
polymorphism and epigenetic modification of alcohol induced liver damage,
augmenting hepatic regeneration using GCSF are potential therapeutic avenues in
steroid non-responsive/ineligible patients. With better understanding of the
pathophysiology, using "Omics" platforms, newer options for patients with
alcoholic hepatitis are expected soon.
|Anti-Bacterial Agents/therapeutic use
[MESH]
|Anti-Inflammatory Agents/adverse effects/*therapeutic use
[MESH]