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Review
. 2023 Jan-Feb;13(1):103-115.
doi: 10.1016/j.jceh.2022.07.246. Epub 2022 Aug 1.

Emerging Biomarkers in Alcohol-associated Hepatitis

Affiliations
Review

Emerging Biomarkers in Alcohol-associated Hepatitis

Gene Y Im. J Clin Exp Hepatol. 2023 Jan-Feb.

Abstract

Alcohol-associated hepatitis (AH) is a clinical syndrome of jaundice, abdominal pain, and anorexia due to prolonged heavy alcohol intake. AH is associated with changes in gene expression, cytokines, immune response, and the gut microbiome. There are limited biomarkers to diagnose and prognosticate in AH, but several non-invasive biomarkers are emerging. In this review, clinical risk-stratifying algorithms, promising AH biomarkers like cytokeratin-18 fragments, genetic polymorphisms, and microRNAs will be reviewed.

Keywords: AH, Alcohol-associated hepatitis; ALD, alcohol-associated liver disease; ASCA, anti–Saccharomyces cerevisiae antibodies; AUC, area under the curve; FGF, fibroblast growth factor; GAHS, Glasgow alcohol-associated hepatitis score; HCC, hepatocellular carcinoma; MELD, model for end-stage liver disease; NASH, non-alcohol-associated steatohepatitis; PPV, positive predictive value; PT, prothrombin time; VCTE, vibration-controlled transient elastography; alcohol-associated hepatitis; biomarkers; cytokines; miRNAs, MicroRNAs; microRNA; microbiome.

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Figures

Figure 1
Figure 1
Cytokine dysregulation and downstream effects in alcohol-associated hepatitis.
Figure 2
Figure 2
Typical course of alcohol-associated liver disease. Chronic excess alcohol intake leads to steatohepatitis, fibrosis, and eventually cirrhosis. There may be super-imposed episodes of alcohol-associated hepatitis or steatohepatitis can be subclinical without overt symptoms of inflammation, but eventual progresses to alcohol-associated cirrhosis. (from Seminars in Liver Disease, Thieme; with permission).
Figure 3
Figure 3
Pathophysiology of alcohol-associated hepatitis changes in the gut microbiome mediate liver inflammation. (from Seminars in Liver Disease, Thieme; with permission).

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