gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1473Research ArticleГЕПАТОЛОГИЯHEPATOLOGYНовые направления в изучении алкогольной болезни печениRecent trends in studying of alcohol-induced liver diseaseКомковаИ. И.KomkovaI. I.ЖарковаМ. С.ZharkovaM. S.МаевскаяМ. В.MayevskayaM. V.ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова»Russian Federation2011251220112163341Copyright © Комкова И.И., Жаркова М.С., Маевская М.В., 20112011Комкова И.И., Жаркова М.С., Маевская М.В.Komkova I.I., Zharkova M.S., Mayevskaya M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1473

Цель обзора. Проанализировать основные эпидемиологические тенденции возникновения алкогольной болезни печени, механизмы ее развития, смертность в данной популяции больных. Рассмотреть возможность использования новых мишеней для терапии заболевания.Основные положения. Злоупотребление алкоголем является третьей ведущей причиной заболеваемости и смертности в молодом возрасте. В исследованиях показано, что существует значительная разница в уровне смертности от цирроза печени между странами Европы. К факторам риска заболевания относятся: количество употребляемого алкоголя, его вид, кратность употребления, женский пол, избыточная масса тела. Кроме повреждающего эффекта в ответ на поступление алкоголя запускаются процессы защиты и регенерации печени через активацию рецепторов IL-6, IL-22, системы STATбелков. Изучен механизм действия TNFα, приводящий к апоптозу гепатоцитов через активацию кислой сфингомиелиназы.Заключение. В качестве новых мишеней для терапии алкогольной болезни печени возможно использование кислой сфингомиелиназы, воздействие на фенотип клеток Купфера, на каннабиноидные рецепторы. При лечении больных с тяжелым алкогольным гепатитом активно применяются кортикостероиды, значительно увеличивающие 28-дневную выживаемость. Для повышения эффективности лечения острого алкогольного гепатита рассматривается вопрос добавления к стандартной терапии глюкокортикостероидами IL-22.

The aim of review

The aim of review. To analyze main epidemiologic tendencies of development of alcoholic liver disease, mechanisms of its development, mortality in this population of patients. To discuss an option of new targets for treatment of this disease.

Original positions

Original positions. Alcohol abuse is the third leading cause of morbidity and mortality in the young age. In the studies it was demonstrated, that there is significant difference in death rate of liver cirrhosis between European countries. Disease risk factors include: amount of taken alcohol, its type, frequency of use, female gender, excessive body weight. Besides damaging effect, in response to admission of alcohol processes of protection and neogenesis of the liver through activation of IL-6, IL-22 receptors, STAT-proteins system are initiated. Mechanism of TNFα action, resulting in apoptosis of hepatocytes through activation of acidic sphingomyelinase is investigated.

Conclusion

Conclusion. Application of acidic sphingomyelinase, influence on Kupffer's cells phenotype, cannabinoids receptors as new targets for treatment of alcoholic liver disease is possible. At treatment of patients with severe alcohol-induced hepatitis corticosteroids considerably increasing 28-day's survival rate are actively applied. To increase efficacy of treatment of acute alcoholic hepatitis the issue of addition to standard treatment by glucocorticosteroids IL-22 is taken into account.

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The authors declare that there are no conflicts of interest present.