Advances in the treatment of severe alcoholic hepatitis

Abstract

Severe alcoholic hepatitis (SAH) is a costly and worldwide public health issue with high morbidity and mortality. Specific effective treatments for SAH have yet to be established. The aim of the present article is to review the current knowledge of the pathogenesis, assessment and treatment options in patients with SAH. To date, alcohol abstinence and enteral nutrition are the recommended first-line treatments. Although corticosteroids remain the preferred therapy for certain patients with a modified Maddrey discriminant function level greater than 54, they only improve short-term survival rates. New research focuses on liver inflammation, liver regeneration, the gut–liver axis, human induced pluripotent stem cells and extracorporeal albumin dialysis. Liver transplantation is considered the last medical option for patients with SAH who are nonresponsive to other medical treatments.

Keywords:

• Severe alcoholic hepatitis
• gut–liver axis
• new therapy
• interleukin-22

Transparency

Declaration of funding

This work was supported by the National Science and Technology Major Project, under Grant 2017ZX10202202, and National key research plan “precision medicine research” key project under Grant 2017YFC0908100.

Author contributions: W.W., Y.X. and C.J. analyzed the data. W.W. and Y.G. wrote the paper. All authors reviewed the manuscript and accepted the manuscript final version.

Declaration of financial/other relationships

W.W., Y.X., C.J. and Y.G. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

None reported.