Arun J. Sanyal, Veronica Miller Gastroenterology

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Presentation transcript:

Regulatory Science and Drug Approval for Alcoholic and Nonalcoholic Steatohepatitis Arun J. Sanyal, Veronica Miller Gastroenterology Volume 150, Issue 8, Pages 1723-1727 (June 2016) DOI: 10.1053/j.gastro.2016.02.044 Copyright © 2016 AGA Institute Terms and Conditions

Figure 1 Pathophysiological drivers of alcoholic hepatitis are shown. Several of these are potentially targetable for therapeutics. Alcohol impairs the integrity of the intestinal barrier leading to enhanced endotoxemia and systemic exposure to bacterial products, which activate the innate immune system and sensitize hepatic macrophages. Frequently, after a bout of binge drinking, there is increased endotoxemia and activation of severe hepatic inflammation and cholestasis along with liver injury and cell death. The intestinal barrier function (1), cytokines (2), bile acid-related cholestatic and immune-inflammatory pathways (3), genetics and inflammasome (4), and cell death−modifying pathways (5) have been or are under active clinical investigation. LPS, lipopolysaccharide. Gastroenterology 2016 150, 1723-1727DOI: (10.1053/j.gastro.2016.02.044) Copyright © 2016 AGA Institute Terms and Conditions

Arun J. Sanyal Gastroenterology 2016 150, 1723-1727DOI: (10.1053/j.gastro.2016.02.044) Copyright © 2016 AGA Institute Terms and Conditions

Veronica Miller Gastroenterology 2016 150, 1723-1727DOI: (10.1053/j.gastro.2016.02.044) Copyright © 2016 AGA Institute Terms and Conditions