The immune response in the pathogenesis of alcoholic liver disease

Many hypotheses have been put forward to explain ethanolinduced liver damage, including direct and indirect toxicity. Despite many years of intensive research, the molecular mechanisms involved in the toxicity of this simple compound have still not been fully clarified. Initial studies investigated the direct toxic effects of ethanol on tissues, but it is now believed that the products of ethanol metabolism are the major factors causing alcoholic liver disease (ALD). The metabolic products and metabolic events induced by alcohol ingestion are varied in nature and vast in scope. Major research interest has focused on the effects of aldehyde production, oxygen radical formation, mitochondrial membrane permeability defects, endotoxins, and infectious agents as factors in hepatocellular dysfunction and cell death. At the same time, increasing evidence suggests that immune-mediated mechanisms are involved in ALD.