Review article: Alcoholic liver disease - Pathophysiological aspects and risk factors

Background: Alcoholic liver disease has a known aetiology but a complex and incompletely known pathogenesis. It is an extremely common disease with significant morbidity and mortality, but the reason why only a relatively small proportion of heavy drinkers progress to advanced disease remains elusive. Aim: To recognize the factors responsible for the development and progression of alcoholic liver disease, in the light of current knowledge on this matter. Methods: We performed a structured literature review identifying studies focusing on the complex pathogenetic pathway and risk factors of alcoholic liver disease. Results: In addition to the cumulative amount of alcohol intake and alcohol consumption patterns, factors such as gender and ethnicity, genetic background, nutritional factors, energy metabolism abnormalities, oxidative stress, immunological mechanisms and hepatic co-morbid conditions play a key role in the genesis and progression of alcoholic liver injury. Conclusions: Understanding the pathogenesis and risk factors of alcoholic liver disease should provide insight into the development of therapeutic strategies. © 2006 The Authors.