Effects of Alcohol on Liver

chroni inges tien of Ethanol Gut Pormaadilly Adducts Acetaldehyde + Endotox chamcal addicts Prokin adduch system LWF-1-6-Inflamaty Response Autoimmune response Acety acid Proxilanh MAD+ T ↓Antioxidad! Oxidative stress •Lipid peoxidation •Low glutathiorse Stellate cells in span of Disse COLLAGEN DEPOSITION FIBROSIS ALCOHOUC CIRRHOSIS susceptibily MECHANISM OF STEATOSIS IN CHRONIC ALCOHOLISM Alcohol is a hepatotoxin & Steatosis is the manifestation. Reversible Increases the cato bolim of fat in peripheral tissues anal mareases the delivery of free fats acids to livver Inc.sysimesis of fatty acids in the liver Dec (oxidativi) of fatty acids by mitochondria Inc production of triglycerides) Impairs the assembly & secretion /release of lipoproteins. 2 MECHANISM OF FIBROSIS / CIRRHOSIS. Alcohol activitates, hopectin stealato call trassimmel into highs fibrogenic cells with regulibroldact) like contractile property produe degen (IBROSIS Inc Vascular Resistad in Liver Guse of stellate cell. Activat -Colokare & chemokine - prada & Kupfer cells, endothelicts, hepabaytes, (TAF-B) Inf cytokines: Chronic Mflammatin -TNF, IL-18 - -oxidative stores MORPHOLOGY HEPATIC STEATOSIS (FATTY LIVER GROSS Liver is chlorged (4-6 kg), Soft, yellow, greasy MICROSCOPY Miwns vesicular steatosis) accumulation of small, dear vacuoles of lipid within the cytoplasm of hepatocytes. it affects centrilobular (Acities zol-3) region whee alcabal datuphrogenase is located. Nider contey located Gtoplasm looks Foary. 2Macro Vesicular steatosis develops within continuing alcohol ingestion Create Large lipid vacoules which compress and displace the hepatocyte nucleus to periphery of the cell. # No Inflammation No Fibrosis Reversible. ALCOHOL HEPATITIS MORPHO LONy Gross:- Eglarged, yellow, due to steatosis and (Firm) due to increased Fibrosis MICROSCOPY BALLONING DECOENERATION OF HEPATOCYTE chavorited by Swollen liver call which is Pale-stained, limpsed cytoplasm Due to accumulatice of Fat water, protein. Predominat m CENTRILOBULAR REGION severe HEPATOCYTE NECROSIS. MALLORY BODIES tangled skeins of cytokeratin Mlermediate filaments. Apparas dense Cosmophilic (rapery) Eytoplasmic Inclusions in prioncler location in degeneratiy hepatocytes DERCI NEUTROPHILIC INPILTRATION Soon around ballooned hepatocytes (cunty MB). (PORTAL TRACTS INF by Macrophages and Lymphocyte ALCOHOLIC TEATOFIBROSIS -Activate sinusoidal stellate cells & Portal Fibroblasts. sclerosis of central vei perisinusoidal Fibrosis in Space of Desse (Nodularib →CIRRHOSIS CV space of ALCOHOLIC CIRHOSIS Chronic, Irreversible, end-stage. ¡bittuse loss of architecture & noduler regeneration// MORPHOLONY ( Early stage - Liver appears gello ton, fate, and enlarged (>2k) GROSS Later stage:- Liver appess Brownt, non-falt, diffuses nodules and fun (<11g) Capsular skin of liver is NODULAR ar my have piy-skin surface Nodularit becomes prominent & HOBNA" nodules less than 3 mm app Liver// Nodules may coalers to form Corge nodules and forms mixed micronoduler + macronoduler pattern. MICROSCOPY •Loss of Architecture Hepalogte injury & fibrosis diffuse lose of architecture/ 2) Regenerating Nodules Surv Hap aloytes. by Fibrous septa stimulate → politret Nodules surrounded micronodules (20.3mm in diameta). > Macronodules. mixed. 3 FIBROSIS CP PTPT Broad Brands 4 VASCULAR REORGANIZATION Parente denge & Fibrosp ditmpt archites New chemels septa LAST ALT popoten - Rev. of A-G Raho HE SAP Proty Prothombe Anemie