Alcohol Misuse and Alcoholic Liver Disease

Alcohol is part of our culture—it helps us celebrate and socialize, and it enhances our religious ceremonies. But drinking too much—on a single occasion or over time—can have serious consequences for our health. Most Americans recognize that drinking too much can lead to accidents and dependence.  However, in addition to these serious problems, alcohol misuse and abuse can damage organs, weaken the immune system, and contribute to cancers.

Globally, alcohol misuse was the fifth leading risk factor for premature death and disability in 2010. Among people between the ages of 15 and 49, it is the first.  Among people between the ages of 20 and 39, approximately 25% of the total deaths are alcohol attributable.

Considering this prevalent use of alcohol, its misuse is expected to have a global impact.   Indeed, 3.3 million deaths were caused by alcohol misuse in 2012, corresponding to 5.9% of all deaths in the world.  Excessive alcohol intake which causes more than 200 diseases including alcohol use disorder (AUD) and liver cirrhosis, was the 5th leading risk factor for premature death and disability and responsible for 5.1% of the burden of disease and injury around the globe in 2010.  This means alcohol misuse reduced healthy life years of people by 5.1% worldwide. In the U.S., 15.1 million adults aged 18 and older (6.2% of this age group population), have AUD with the male to female gender ratio of 2:1.

Youth drinking is becoming an important issue worldwide, and in the U.S. approximately 0.6 million adolescents aged 12-17, have AUD with the gender ratio of roughly 1:1. This is an alarming statistic because youth drinking is closely associated with eventual addiction to alcohol.  Alcohol is the 3rd leading preventable cause of death and responsible for 88,000 deaths in the U.S. with 11% caused by drunk driving.  In 2010, alcohol misuse cost the U.S. $249 billion. More specifically for liver disease, in 2015, 78,529 deaths were caused by liver disease, and 47% were due to alcohol. Similarly, 47.9% of cirrhosis deaths were alcohol-related. In 2009, one third of liver transplantations performed in the U.S. was due to alcohol-related liver disease.

What is Cirrhosis?
Cirrhosis is a chronic liver disease in which normal liver cells are damaged and replaced by scar tissue. This scar tissue prevents the liver from performing important functions. Continue

such as processing nutrients, hormones, and detoxifying drugs and poisons, including alcohol. Excessive alcohol intake is the most common cause of cirrhosis.

Liver cirrhosis is ranked as the 5th to 7th leading cause of death among adults 25-60 years old. It is responsible for approximately 25,000 deaths per year in the United States, a mortality rate which is roughly equivalent to that caused by stroke, HIV or type 1diabetes.

Approximately 90% of deaths attributed to cirrhosis are estimated to be preventable since excessive alcohol use is the most common cause of cirrhosis. However, it is also estimated that 40% of chronic liver disease is related to hepatitis c virus (HCV) infection, the most chronic bloodborne infection in the United States, with approximately 4 million people infected.  About 20% of the HCV infected individuals develop chronic liver disease and cirrhosis. Chronic liver disease often shows no symptoms and many patients are found to have the disease during the course of physical examination for an unrelated illness.

No curative therapy is currently available for cirrhosis except for liver transplantation, Due to an insufficient pool of donors, many patients die while they are on the donor waiting list.

Scientists of the Cirrhosis Research Program are working to find new ways to treat cirrhosis. Their goals are to develop gene therapies for the treatment of liver cirrhosis, to develop a new generation of bioartificial liver systems, and to promote cutting-edge science in non-parenchymal liver cell biology.

 Pathogenesis of ALD
Chronic liver disease continues to be one of the leading medical causes of mortality in the United States. Every half hour, one person dies in the this nation from complications associated with irreversible chronic liver disease. Continue