Alcoholic Liver Disease: Diagnostics and Therapeutics

Dear Colleagues,

Alcoholic liver disease (ALD) is basically a molecular rather than a nutritional disease. It results from disturbances in hepatic functions and subcellular structures due to the metabolism of ethanol as a short-chain chemical derived from natural plant resources, such as grapes. In addition, gut-derived endotoxins further contribute to the disease. Whereas small amounts of alcohol ingested for a short period are well-handled by the liver, prolonged alcohol abuse commonly leads initially to alcoholic fatty liver disease (AFLD) or perhaps alcoholic steatohepatitis (ASH). More severe stages include alcoholic hepatitis (AH), alcoholic cirrhosis (AC), and alcoholic hepatocellular carcinoma (AHCC). Patients with early stages of ALD are commonly asymptomatic, a condition that rarely allows for a timely diagnosis and the recommendation to abstain from alcohol use, which may lead to clinically more severe stages of the disease. For instance, severe AH, which commonly presents as an acute or chronic disease, is a particular clinical challenge for which several options of pharmacotherapy with limited success are available. Thus, liver transplantation, although discussed controversially, is currently under consideration. AC represents the end stage of ALD, and its complications, such as bleeding of esophageal varices, hepatic encephalopathy, or ascites, require specific treatment. Most of these complications can be handled conservatively; however, in a few patients, a liver transplantation may have to be considered. Finally, AHCC occurs rarely and commonly develops from AC. Patients with AHCC have a poor prognosis despite medical treatment, local interventions, or liver transplantation. In essence, ALD is clinical disorder that requires early diagnosis at the AFLD stage or the ASH stage to achieve abstinence from alcohol use and to prevent the late stages of the disease that are irreversible and life-threatening. This Special Issue is intended to bring together experts in the field to present their views on specific issues that may yet be a matter of uncertainty and under discussion. Apart from solicited authors, other contributors are welcome to submit abstracts that will be fairly assessed with the potential for encouragement to submit a full-length paper.

Prof. Dr. Rolf Teschke
Prof. Dr. Helmut K. Seitz
Guest Editors

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