[Alcoholic liver disease: new aspects of studies]

Although many factors related to the pathogenesis of alcoholic liver disease have been considered, 1) hepatotoxic effects of ethanol and its metabolites, 2) effects of excessive hepatic NADH generation, 3) hypoxia, 4) alterations of the immune system, 5) genetic factors, and 6) nutritional factors may play more important roles to produce alcoholic liver disease. Recently, genetic polymorphism of key enzymes related to metabolism of ethanol and acetaldehyde, alcohol dehydrogenase, cytochrome P4502E1 and aldehyde dehydrogenase, have been discovered. On the other hand, an assay system for hepatitis C virus (HCV) markers has been developed and a high frequency of HCV markers in alcoholics with liver disease has been reported. In this review, we focus on recent gains in our knowledge of pathogenesis of alcoholic liver disease, and discuss the relationship between alcoholic liver disease and HCV, and treatment of alcoholic liver disease.