摘要
“酒逢知己千杯少”,酒文化在中国源远流长.无酒不成席,酒与国民生活密不可分,深刻影响着政治、文化和经济.“酒桌文化”背后可能隐藏着巨大的健康威胁,即酒精相关性肝病(alcohol-related liver disease,ALD).随着生活水平的提高,包括ALD在内的代谢性肝病的患病率不断上升,最终导致了终末期肝病(肝功能衰竭、肝硬化、肝癌)的病例增多.在过去的30年里,一些国家为肝脏学领域的基础/临床研究、免疫接种以及药物发现和开发提供了强有力的激励措施.中国也做了诸多的努力,在全国范围内启动肝病预防措施,建立全球伙伴关系,并为年轻的肝病医生提供指导计划.国家自然科学基金的持续支持促进了中国几乎所有肝脏病学研究方向的蓬勃发展.本文总结近些年来国内外ALD患病现状及相关研究的基金资助情况,并综述ALD发病机制和治疗的研究进展.
The wine culture of“knowing yourself with a thousand drinks”has a long history in China.Wine is inseparable from daily life and has a profound influence on politics,culture and the economy.The lofty rhetoric over drinks may be behind a huge health threat:Alcohol-related liver disease(ALD).ALD is a type of liver disease caused by alcohol dependence addiction and long-term excessive drinking.ALD includes alcoholic fatty liver(AFL),alcoholic steatohepatitis(ASH)and cirrhosis and its complications.AFL is characterized by simple hepatocyte steatosis(accumulation of triglycerides),while ASH is accompanied by hepatocyte steatosis with hepatocyte injury and inflammatory cells infiltration.With the improvement in living standards,the prevalence of metabolic liver diseases in China,including ALD,is increasing,which eventually leads to an increase in the number of cases of end-stage liver diseases(liver failure,liver cirrhosis,and liver cancer).There is a relationship between the amount of alcohol consumed and the risk of ALD.The vast majority(90%-100%)of chronic heavy drinkers will develop AFL.However,only 10%-20%of chronic heavy drinkers develop advanced ALD.Therefore,other factors may alter the course of the disease,such as genetics,environment,gender,etc.Based on the natural history of human liver progression from simple steatodegeneration to inflammation/fibrosis,it is estimated that the incidence of alcoholic steatohepatitis and liver fibrosis/cirrhosis will peak in China in the next 10 to 20 years.The pathogenesis of ALD has not been fully elucidated.Although alcohol-induced hepatotoxicity,oxidative stress and lipid metabolism disorder are key factors in its pathogenesis,a large number of studies have confirmed that immune response also promotes the development of ALD to a large extent.Emerging evidence from preclinical and clinical studies suggests that all stages of ALD involve novel immune mechanisms,including stages of immune response initiation,inflammatory response,and tissue repair.The new focus of clinical trials for ALD treatment includes probiotics,antioxidants,growth factors,empirical use of monoclonal antibodies against key inflammatory mediators,and enhanced behavioral interventions.However,up to now,there is still a lack of effective and specific ALD treatment drugs in clinic.Over the past 30 years,some countries have provided strong incentives for basic/clinical research,immunization,and drug discovery and development in the field of hepatology.To discard the reputation of“liver diseases in large countries”,China has also made many efforts to launch liver disease prevention measures nationwide,establish global partnerships,and provide guidance programs for young liver doctors.This progress has been facilitated by the continued support of the National Natural Science Foundation of China(NSFC),which has helped almost all research areas in hepatology in China to flourish.This article summarizes the incidence rate of ALD and the related research funding situation in recent years in China and worldwide.In addition,this article also reviews the research progress of pathogenesis and treatment of ALD.
作者
王华
Hua Wang(Inflammation and Immune Mediated Diseases Laboratory of Anhui Province,Department of Oncology,the First Affiliated Hospital of Anhui Medical University,Anhui Medical University,Hefei 230032,China)
出处
《科学通报》
EI
CAS
CSCD
北大核心
2023年第20期2606-2618,共13页
Chinese Science Bulletin
基金
国家杰出青年科学基金(82225008)资助
关键词
酒精相关性肝病
肝脏免疫
肝损伤炎症
肝再生修复
alcohol-related liver disease
liver immunity
liver injury and inflammation
liver repair and regeneration
作者简介
王华,E-mail:wanghua@ahmu.edu.cn
