New Discoveries About Severe Alcoholic Hepatitis

A new study reveals what happens to the body when an individual develops severe alcoholic hepatitis and how it could be treated in the future. “Alcohol-associated hepatitis is the most severe form of liver injury happening in patients who drink excessively,” said Suthat Liangpunsakul, MD, MPH, a co-corresponding author of the study and professor of medicine at IU School of Medicine, Indiana, USA. “In severe cases, the short-term mortality is extremely high. One in three people will die when they develop it. But so far, not much is known about the mechanism of how all of this happens.”

In the translational study recently published in the Journal of Clinical Investigation, scientists focused on describing the patterns of neutrophils, which are a type of white blood cell, and their involvement in severe alcoholic hepatitis pathogenesis. When someone develops severe alcoholic hepatitis, their neutrophil levels increase, but it is unclear how those neutrophils can trigger inflammation or what is happening in the liver.

Alcoholic Hepatitis: New Insights

Researchers looked at a cohort of almost 40 patients and observed two groups of inflammatory cell infiltration—one with high neutrophils, the other with low neutrophils. They completed gene sequencing to identify target genes and how they interact with neutrophils and studied what happened to the liver when manipulating the genes in animal models.

“We are able to characterize the two distinct phenotypes based on these cells, suggesting there is a separate mechanism driving liver injury and/or failure in these patients,” Liangpunsakul said.

“When you have low neutrophils but high T cells, steroids may work better because steroids effectively block the T cell-mediated inflammatory cascade. But another group of patients with high neutrophils may have a different inflammatory driven process to begin with, so if they receive steroids, we may not get a response because neutrophils poorly respond to steroid treatment,” said Bin Gao, MD, PhD, another co-corresponding author and the Chief of Laboratory of Liver Diseases at the National Institute on Alcohol Abuse and Alcoholism. “More study is needed to identify how high versus low neutrophils can impact responses to treatment.”

Source-Eurekalert