Essay Example on Alcoholic Fatty Liver

Alcoholic Fatty Liver The liver is a highly metabolic organ Viollet et al 2009 It acts as a pivot point between the fasting and feeding states and as such has both catabolic and anabolic capabilities These processes are implicated when an excess of alcohol results in inadequate metabolism endoplasmic reticulum stress and increased fatty acid and triglyceride synthesis all of which lead to steatosis The peroxisome proliferator activated receptor α is critical for alcohol metabolism and when down regulated or depleted results in massive fat accumulation Zeng et al 2012 Bala et al 2016 Sterol regulatory element binding proteins SREBP and 50 adenosine monophosphate activated protein kinase AMPK are also implicated in ALD since they play an important role in regulating lipid metabolism and their expression is altered under alcohol consumption Altamirano and Bataller 2011 Zhang et al 2015 Down regulation of AMPK by alcohol decreases its ability to inactivate SREBP and increases adenylyl cyclase activity contributing to steatosis Garcia et al 2008 

 In the United States the prevalence of cirrhosis is 0 27 corresponding to 633 323 adults in 2015 Scaglione et al 2015 higher than previously estimated Thus liver cirrhosis is an important public health concern and a significant cause of morbidity and mortality worldwide In most cases in addition to alcohol consumption lifestyle gender ethnic and socioeconomic factors may contribute or synergize in the progression of the disease In patients with decompensated ALD cirrhosis is more frequent and features of hepatocellular damage lobular inflammation hepatocellular ballooning degeneration and hepatocyte drop out megamitochondria and the appearance of Mallory Denk bodies are more dominant Lackner et al 2016 Liver cirrhosis leads to severe complications such as variceal bleeding ascites and hepatic encephalopathy When cirrhosis occurs the sinusoidal space ensuring blood supply to the parenchyma decreases sinusoidal endothelial cell fenestrations collapse and numerous new vessels formed around the cirrhotic nodules bypass the obstructed normal route This vascular proliferation contributes to the remodeling of the liver architecture collateral flow and portal hypertension The latter is a frequent and severe complication of cirrhosis a leading cause of death and an indicator for liver transplantation Lemoinne et al 2015