Pathogenesis of alcoholic liver disease

Metabolism of alcohol in the liver takes place in three ways, result being the same, and in the liver takes place in three ways, result being the same, and acetaldehyde is metabolized with high hepato toxicity. Those three ways are:
1. alcoholdehydrogenasis path is the major way of metabolizing alcohol.
2. microsomal oxidation system - P450, interfere in oxidation of alcohol when its concentration is more than 50 mg/dl.
3. catalyze way, which has a seconday role.

Acetaldehyde is later oxidated up to acetate, but in alcoholics, the capacity of mitochondrion to oxidate acetaldehyde is reduced. Their accumulation leads to the promotion of lipid peroxidates and the formation of complex proteins. Besides the toxic effect of the acetaldehyde, alcohol has its role in developing cirrhosis. It has been proven that adipocytes involved in fibrogenesis are active after chronic consumption of alcohol.

Morphologic aspects in alcoholic liver: there are three typer of hepatic histologic lesions in consumers of alcohol.
1. Alcoholic fatty liver is a genign reversible form produced by accumulation of some drops of lipids in hepatocyte.
2. Alcoholic hepatic comprise of degeneration and necrosis of the hepatocyte, acute infiltration of neutrophyles sometimes pericellular, sinusoidal line and venular line fibrosis, as well characteristic Mallory corpuscles (alcoholic hialin). Alcoholic hepatitis may be reversible, but the lesions are much more severe being the most important precursors of cirrhosis.
3. Alcoholic cirrhosis comprise of fibrosis in all hepatic tissue, from the portal space up to centrolobular vein, and nodule of regeneration.