• Gastroenterology Special Isssue on Alcoholic vs Non-Alcoholic Fatty Liver Disease

Gastroenterology Special Isssue on Alcoholic vs Non-Alcoholic Fatty Liver Disease

A special issue of Gastroenterology is devoted to comparing alcoholic vs nonalcoholic fatty liver disease.

Cover-14th issue_ALD_NAFLD

In an introduction to the issue, Arun Sanyal et al write that alcoholic liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD) have much in common, including histologic features and activation of pathways involved in their pathogenesis. They also have some distinct histologic features, causes, and factors linked to mortality. The goal of this special issue is to review what we know about fatty liver disease and identify common pathways and mechanisms, which could provide important information about pathogenesis or treatment strategies.

For example, Quentin M. Anstee et al discuss the functions of proteins encoded by risk variants in genes such as PNPLA3 and TM6SF2, as well as epigenetic factors that contribute to the pathogenesis of ALD and NAFLD.

Naga S. Betrapally et al review differences in the stages of alcohol-associated disease in patients who continue to drink compared with those who stop, with respect to the composition and function of the intestinal microbiota and intestinal integrity. They also comment on the potential of microbial therapy for patients with NAFLD or ALD.

Laura E. Nagy et al summarize pathogenic mechanisms of ALD, while Mariana Verdelho Machado and Anna Mae Diehl review those of NAFLD.

A higher proportion of patients with NAFLD die from cardiovascular disorders than patients with ALD, whereas a higher proportion of patients with ALD die from liver disease, report Zobair Younossi and Linda Henry. They discuss the morbidity, impairment to health-related quality of life, and economic costs to society of these diseases.

Suthat Liangpunsakul et al explain individual differences in susceptibility to the toxic effects of alcohol, such as pattern of alcohol consumption, sex, environmental factors (such as diet), and genetic factors, which vary widely in different parts of the world. Alcoholic liver disease is becoming more common in many parts of Asia, but is decreasing in Western Europe, so treatment approaches, including availability of medications, models of care, and approach to transplantation, must also differ among regions.

NAFLD is not only an important global problem for adults, but also for children. Valerio Nobili et al review the differences between NAFLD in children and adults, and discuss the question of whether the disease observed in children is only an initial phase of a process that progresses with age.
Pierre Bedossa and Keyur Patel discuss advantages and limitations of biopsy analysis and noninvasive tests as diagnostic and prognostic tools for patients with NAFLD. Mark Thursz and Timothy R. Morgan describe the diagnosis and treatment of alcoholic hepatitis, while Guillaume Lassailly et al cover treatment strategies for NAFLD and endpoints for clinical trials.
M. Shadab Siddiqui and Michael Charlton explain that ALD and NAFLD account for nearly 30% of liver transplants performed in the United States. Patients receiving liver transplants for ALD or NAFLD have similar survival times as patients receiving transplants for other liver disorders, although ALD and NAFLD recur frequently afterward.
The commentaries and reviews in this special issue will allow liver researchers, patient caretakers, and policy makers to more fully understand the overlapping fields of ALD and NAFD research, and improve strategies for treatment and management of these widespread growing disorders.

 

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