Журнал включен в российские и международные библиотечные и реферативные базы данных
РИНЦ (Россия)
RINZ (RUSSIA)
Регистрационное агентство DOI (США)
DOI Registration Agency (USA)
Эко-Вектор (Россия)
Eco-Vector (Russia)
Ulrichsweb (Ulrich’s Periodicals Director

Severe alcoholic hepatitis: current concepts and treatment perspectives

DOI: https://doi.org/10.29296/25879979-2024-05-02
Issue: 
5
Year: 
2024

O.P. Dudanova
Federal State Budgetary Educational Institution of Higher Education “Petrozavodsk State University”, 33 Lenina av., Petrozavodsk, 185910, e-mail: [email protected]

The article outlines the current ideas about the most catastrophic form of alcoholic liver disease – severe alcoholic hepatitis. The criteria for clinical and histological diagnosis of alcoholic hepatitis, traditional and new scales for assessing the severity of alcoholic hepatitis are described. Modern innovative methods of treatment aimed at the main pathophysiological mechanisms of development of severe alcoholic hepatitis are presented.Key words: bronchial asthma, asthma school, nurse, basic therapy, prevention, care.
Keywords: 
severe alcoholic hepatitis
modern methods of treating alcoholic hepatitis.

References: 
  1. Ивашкин В.Т., Маевская М.В., Павлов Ч.С. и др. Клинические рекомендации Российского общества по изучению печени по ведению взрослых пациентов с алкогольной болезнью печени. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2017; 27 (6): 20‒40. [Ivashkin V.T., Maevskaya M.V., Pavlov Ch.S. et al. Clinical recommendations of the Russian Society for the Study of the Liver on the management of adult patients with alcoholic liver disease. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2017; 27 (6): 20‒40.] DOI: 10.22416/1382-4376-2017-27-6-20-40.
  2. Лазебник Л.Б., Голованова Е.В., Тарасова Л.В. и др. Алкогольная болезнь печени (АБП) у взрослых. Экспериментальная и клиническая гастроэнтерология. 2020; 2 (174): 4–28. [Lazebnik L.B., Golovanova E.V., Tarasova L.V., et al. Alcoholic liver disease (ALD) in adults. Experimental and clinical gastroenterology. 2020; 2 (174): 4‒28.] DOI: 10.31146/1682–8658-ecg-174–2– 4–28.
  3. Park S.H., Kim D.J. Global and regional impacts of alcohol use on public health: emphasis on alcohol policies. Clin Mol Hepatol. 2020; 26 (4): 652–661. DOI: 10.3350/ cmh.2020.0160.
  4. Philips C.A., Augustine P., Yerol P.K. et al. Severe alcoholic hepatitis: current perspectives. Hepat Med. 2019; 11: 97‒108. DOI: 10.2147/HMER.S197933.
  5. Saunders J.B., Aasland O.G., Babor T.F. et al. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II. Addiction. 1993; 88 (6): 791–804. DOI: 10.1111/j.1360-0443.1993.tb02093.x.
  6. Ewing J.A. Detecting alcoholism. The CAGE questionnaire. JAMA. 1984; 252 (14): 1905–1907. DOI: 10.1001/jama.252.14.1905.
  7. Skinner C., Thompson A.J., Thursz M.R. et al. Intestinal permeability and bacterial translocation in patients with liver disease, focusing on alcoholic aetiology: methods of assessment and therapeutic intervention. Therap Adv Gastroenterol. 2020; (13): 1756284820942616. DOI: 10.1177/1756284820942616.
  8. Stojic J., Kukla M., Grgurevic I. The Intestinal Microbiota in the Development of Chronic Liver Disease: Current Status. Diagnostics (Basel). 2023; 13 (18): 2960. DOI: 10.3390/diagnostics13182960
  9. Gao B., Ahmad M.F., Nagy L.E. et al. Inflammatory pathways in alcoholic steatohepatitis. J. Hepatol. 2019; 70: 249–259. DOI:10.1016/j.jhep.2018.10.023
  10. MacSween R.N., Burt A.D. Histologic spectrum of alcoholic liver disease. Semin Liver Dis. 1986; 6 (3): 221–232. DOI: 10.1055/s-2008-1040605.
  11. Mehta H., Dunn W. Determining Prognosis of ALD and Alcohol-associated Hepatitis. J Clin Exp Hepatol. 2023; 13 (3): 479‒488. DOI: 10.1016/j.jceh.2022.10.010
  12. Forrest E.H., Storey N., Sinha R. et al. Baseline neutrophil-to-lymphocyte ratio predicts response to corticosteroids and is associated with infection and renal dysfunction in alcoholic hepatitis. Aliment Pharmacol. Ther. 2019; 50 (4): 442‒453. DOI: 10.1111/apt.15335.
  13. Arroyo V., Moreau R., Jalan R. Acute-on-Chronic Liver Failure. N. Engl. J. Med. 2020; 382 (22): 2137‒2145. DOI: 10.1056/NEJMra1914900.
  14. Degré D., Wandji L.C.N., Moreno C. et al. Alcoholic hepatitis: Towards an era of personalised management. United European Gastroenterol J. 2020; 8 (9): 995‒1002. DOI: 10.1177/2050640620945886.
  15. Родина А.С., Дуданова О.П. Эффективность применения глюкокортикостероидов при тяжелом алкогольном гепатите. Медицинский совет. 2023; 17 (8): 135‒141. [Rodina A.S., Dudanova O.P. Efficiency of glucocorticosteroid use in severe alcoholic hepatitis. Medical Council. 2023; 17 (8): 135‒141.] DOI: 10.21518/ms2022-055.
  16. Vergis N., Atkinson S.R., Knapp S. et al. In patients with severe alcoholic hepatitis, prednisolone increases susceptibility to infection and infection-related mortality, and is associated with high circulating levels of bacterial DNA. Gastroenterology. 2017; (152): 1068‒1077.e4. DOI: 10.1053/j.gastro.2016.12.019
  17. Thursz M.R., Richardson P., Allison M. et al. Prednisolone or Pentoxifylline for Alcoholic Hepatitis. N Engl J Med. 2015; 372 (17): 1619‒1628. DOI: 10.1056/NEJMoa1412278
  18. Szabo G., Mitchell M., McClain C.J. et al. IL-1 receptor antagonist plus pentoxifylline and zinc for severe alcohol-associated hepatitis. Hepatology. 2022; 76 (4): 1058‒1068. DOI: 10.1002/hep.32478
  19. Vergis N., Patel V., Bogdanowicz K. et al. IL-1 Signal Inhibition In Alcoholic Hepatitis (ISAIAH): a study protocol for a multicentre, randomised, placebo-controlled trial to explore the potential benefits of canakinumab. Trials. 2021; 22 (1): 792. DOI: 10.1186/s13063-021-05719-2.
  20. Ambade A., Lowe P., Kodys K. et al. Pharmacological Inhibition of CCR2/5 Signaling Prevents and Reverses Alcohol-Induced Liver Damage, Steatosis, and Inflammation in Mice. Hepatology. 2019; 69 (3): 1105‒1121. DOI: 10.1002/hep.30249.
  21. Liu M., Cao S., He L. et al. Super enhancer regulation of cytokine-induced chemokine production in alcoholic hepatitis. Nat Commun. 2021; 12 (1): 4560. DOI: 10.1038/s41467-021-24843-w.
  22. Hassanein T., McClain C.J., Vatsalya V. et al. Safety, Pharmacokinetics, and Efficacy Signals of Larsucosterol (DUR-928) in Alcohol-Associated Hepatitis. Am J Gastroenterol. 2024; 119 (1): 107‒115. DOI: 10.14309/ajg.0000000000002275.
  23. Wang Y., Ren J., Ren S. Larsucosterol: endogenous epigenetic regulator for treating chronic and acute liver diseases. Am. J. Physiol. Endocrinol. Metab. 2024; 326 (5): E577‒E587. DOI: 10.1152/ajpendo.00406.2023.
  24. Jophlin L.L., Singal A.K., Bataller R. et al. ACG Clinical Guideline: Alcohol-Associated Liver Disease. Am. J. Gastroenterol. 2024; 119 (1): 30‒54. DOI: 10.14309/ajg.0000000000002572.
  25. Singh S., Murad M.H., Chandar A.K. et al. Comparative Effectiveness of Pharmacological Interventions for Severe Alcoholic Hepatitis: A Systematic Review and Network Meta-analysis. Gastroenterology. 2015; 149 (4): 958‒70.e12. DOI: 10.1053/j.gastro.2015.06.006.
  26. Tkachenko P., Maevskaya M., Pavlov A. et al. Prednisolone plus S-adenosil-L-methionine in severe alcoholic hepatitis. Hepatol. Int. 2016; 10 (6): 983–987. DOI: 10.1007/s12072-016-9751-4.
  27. Jimаnez C., Ventura-Cots M., Sala M. et al. Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH). Liver Int. 2022; 42 (5): 1109‒1120. DOI: 10.1111/liv.15207.
  28. Philips C.A., Ahamed R., Rajesh S. et al. Long-term Outcomes of Stool Transplant in Alcohol-associated Hepatitis-Analysis of Clinical Outcomes, Relapse, Gut Microbiota and Comparisons with Standard Care. J Clin Exp Hepatol. 2022; 12 (4): 1124‒1132. DOI: 10.1016/j.jceh.2022.01.001
  29. Sidhu S.S., Dusseja A., Shalimar et al. A multicenter double-blind, placebo-controlled randomized trial to evaluate the safety and efficacy of bovine colostrum in the treatment of severe alcoholic hepatitis (SAH). Trials. 2023; 24 (1): 515. DOI: 10.1186/s13063-023-07505-8.