アルコール性肝障害

WordNet

pursue a positive and satisfying existence; "You must accept yourself and others if you really want to live"
actually being performed at the time of hearing or viewing; "a live television program"; "brought to you live from Lincoln Center"; "live entertainment involves performers actually in the physical presence of a live audience" (同)unrecorded
abounding with life and energy; "the club members are a really live bunch"
charged with an explosive; "live ammunition"; "a live bomb"
exerting force or containing energy; "live coals"; "tossed a live cigarette out the window"; "got a shock from a live wire"; "live ore is unmined ore"; "a live bomb"; "a live ball is one in play"
highly reverberant; "a live concert hall"
in current use or ready for use; "live copy is ready to be set in type or already set but not yet proofread"
lead a certain kind of life; live in a certain style; "we had to live frugally after the war"
not recorded; "the opera was broadcast live"
of current relevance; "a live issue"; "still a live option"
any physical damage to the body caused by violence or accident or fracture etc. (同)hurt, harm, trauma
an act that causes someone or something to receive physical damage
wrongdoing that violates anothers rights and is unjustly inflicted
an accident that results in physical damage or hurt (同)accidental injury
characteristic of or containing alcohol; "alcoholic drinks"
a person who drinks alcohol to excess habitually (同)alky, dipsomaniac, boozer, lush, soaker, souse
addicted to alcohol; "alcoholic expatriates in Paris"- Carl Van Doren (同)alcohol-dependent
a person who has a special life style; "a high liver"
large and complicated reddish-brown glandular organ located in the upper right portion of the abdominal cavity; secretes bile and functions in metabolism of protein and carbohydrate and fat; synthesizes substances involved in the clotting of the blood; sy
liver of an animal used as meat
someone who lives in a place; "a liver in cities"
any of a series of volatile hydroxyl compounds that are made from hydrocarbons by distillation
a liquor or brew containing alcohol as the active agent; "alcohol (or drink) ruined him" (同)alcoholic drink, alcoholic_beverage, intoxicant, inebriant

PrepTutorEJDIC

『生きている』,生命がある / 《副詞[句]を伴って》〈人などが〉『生き続ける』 / 〈物事が〉長く続く,存続する / 《場所を表す副詞[句]を伴って》〈人などが〉『住む』,居住する / 《副詞[句]を伴って》『生活する』,暮らす / 生人を楽しむ,おもしろく桟らす / 《a+形容詞癌lifeを目的語にして》〈…を生活〉‘を'する / 〈思想など〉‘を'実銭する
《名詞の前にのみ用いて》『生きている』 / 『活気のある』 / (問題などが)当面の / 燃えている / (弾丸などが)まだ爆発してない,未発の / まだ動いている(働いている),有効な / 電流が通じている / (放走が)生の,実況の
『負傷』,『損害』,損傷 / (名誉などを)傷つけること,侮辱《+『to』+『名』》
アルコールの,アルコール性の / アルコールのはいった;アルコール漬けの / アルコール中毒の / アルコール中毒[患]者
(ある態度で)生活する人;居住者
〈C〉『肝臓』 / 〈U〉(食用にする)動物の肝臓,レバー
『アルコール』,酒精 / 『アルコール飲料』,酒

UpToDate Contents

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1. アルコール性肝疾患の病因 pathogenesis of alcoholic liver disease
2. アルコール性脂肪性肝炎およびアルコール性肝硬変の臨床症状および診断 clinical manifestations and diagnosis of alcoholic fatty liver disease and alcoholic cirrhosis
3. アルコール性肝疾患における肝移植 liver transplantation in alcoholic liver disease
4. アルコール性脂肪性肝疾患およびアルコール性肝硬変の予後および治療 prognosis and management of alcoholic fatty liver disease and alcoholic cirrhosis
5. 非肝硬変性門脈圧亢進症 noncirrhotic portal hypertension

English Journal

Silymarin suppresses hepatic stellate cell activation in a dietary rat model of non-alcoholic steatohepatitis: Αnalysis of isolated hepatic stellate cells.

Kim M, Yang SG, Kim JM, Lee JW, Kim YS, Lee JI.SourceDepartment of Internal Medicine, Division of Gastroenterology, Inha University School of Medicine, Jung-Gu, Incheon, Republic of Korea.
International journal of molecular medicine.Int J Mol Med.2012 Sep;30(3):473-9. doi: 10.3892/ijmm.2012.1029. Epub 2012 Jun 14.
Non-alcoholic steatohepatitis (NASH) is characterized by hepatocellular injury and initial fibrosis severity has been suggested as an important prognostic factor of NASH. Silymarin was reported to improve carbon tetrachloride-induced liver fibrosis and reduce the
PMID 22710359

Evaluation of inflammatory and angiogenic factors in patients with non-alcoholic fatty liver disease.

Coulon S, Francque S, Colle I, Verrijken A, Blomme B, Heindryckx F, De Munter S, Prawitt J, Caron S, Staels B, Van Vlierberghe H, Van Gaal L, Geerts A.SourceDepartment of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium.
Cytokine.Cytokine.2012 Aug;59(2):442-9. Epub 2012 May 31.
The liver is a major target of injury in obese patients. Non-alcoholic fatty liver disease (NAFLD) is present in 60-90% of obese Americans and can range from simple steatosis to the more severe non-alcoholic steatohepatitis (NASH). The onset of a chronic inflammatory reaction marks the progression f
PMID 22658783

Japanese Journal

A Novel Soluble Beta-Glucan Salecan Protects against Acute Alcohol-Induced Hepatotoxicity in Mice

CHEN Peng,WANG Zhongqiu,ZENG Liyan,YANG Xiao,WANG Shiming,DONG Wei,JIA Aiqun,CAI Chun,ZHANG Jianfa
Bioscience, biotechnology, and biochemistry 75(10), 1990-1993, 2011-10-23
… This investigation was designed to determine the effect of a novel soluble beta-glucan salecan on acute alcohol-induced hepatic injury in mice. … These findings suggest that salecan might represent a novel protective strategy against alcoholic liver injury. …
NAID 10029873051

Interleukin-22 Protects against Acute Alcohol-Induced Hepatotoxicity in Mice

XING Wei-Wei,ZOU Min-Ji,LIU Shen,XU Tao,WANG Jia-Xi,XU Dong-Gang
Bioscience, biotechnology, and biochemistry 75(7), 1290-1294, 2011-07-23
… The protective effects of interleukin-22 (IL-22) on acute alcohol-induced liver injury were investigated. …
NAID 10029329085

「アルコール性肝障害」

　　[★]

英: alcoholic liver disease, alcoholic hepatopathy, alcoholic liver injury

分類

組織型により分類。

病態

アルコールによる肝細胞障害

アルコール代謝の過程でNADHが蓄積し、脂肪の合成が亢進()、血糖低下(糖新生抑制、ATPが必要だから？)、乳酸の増加(NADH増加のため。また、おそらくTCA回路がNADH増加のために回しにくくなっているため)
ミトコンドリア機能活性化により酸素消費の増大　＋　アルコール脱水素酵素ADH、アルデヒド脱水素酵素ALDHは、zone3(肝小葉中心部)に存在　→　虚血による障害を受けやすい　→　zone3はAST優位なのでAST>ALT、と思われる。

アルコール代謝産物による線維化亢進

アルデヒドがクッパー細胞、単核球などを刺激して放出されたサイトカインに対して、星細胞や線維芽細胞が活性化しコラーゲンを合成

症状

アルコール性肝炎：腹痛、発熱、黄疸、悪心・嘔吐
重症型アルコール性肝炎：腹痛、発熱、黄疸、悪心・嘔吐　＋　意識障害

検査

トランスアミナーゼ↑(AST　＞　ALT)、γ-GTP　↑、ALP↑、TG↑、尿酸↑
IgA↑ (小腸のパイエル板におけるリンパ球の活性が亢進するため？。急性アルコール性肝炎では65 kDaの熱ショック蛋白に対するIgA抗体の産生が増加するという報告がある(参考4))

アルコール性肝炎：白血球増加
重症型アルコール性肝炎：白血球著明に増加
アルコール性肝硬変

参考

1. [charged] Pathogenesis of alcoholic liver disease - uptodate [1]
2. [charged] Clinical manifestations and diagnosis of alcoholic liver disease - uptodate [2]
3. [charged]Prognosis and treatment of alcoholic liver disease and alcoholic hepatitis - uptodate [3]
4. Circulating IgA antibody against a 65 kDa heat shock protein in acute alcoholic hepatitis.

Winrow VR, Bird GL, Koskinas J, Blake DR, Williams R, Alexander GJ.SourceARC Bone and Joint Research Unit, London Hospital Medical College, UK.
Journal of hepatology.J Hepatol.1994 Mar;20(3):359-63.
Heat shock proteins are known to be immunogenic in a number of diverse conditions and can be induced by hypoxia, tumour necrosis factor and alcohol--all potential triggers in patients with acute alcoholic hepatitis. In the present study, sera from 23 patients with acute alcoholic hepatitis, 18 liver
PMID 8014447