ALCOHOLIC LIVER-DISEASE

Ethanol is directly and indirectly hepatotoxic. The toxicity of alcoho l is influenced by genetic factors (including gender differences) on t he one hand and environmental variables (including nutrition, intestin al microflora, interactions with xenobiotics, and so on) on the other, In the past year, research on the pathogenesis of alcohol-induced liv er injury has emphasized the importance of CYP2E1 in producing reactiv e oxygen species and oxidative stress, and the role of acetaldehyde an d hydroxyethyl radicals in producing protein adducts. Research has fur ther implicated a complex cascade of autocrine and paracrine pathways that involves endotoxemia, oxidative stress and activation of Kupffer cells, proliferation and transformation of hepatic stellate cells, and stimulation of sinusoidal endothelial cells.