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Semin Immunopathol. 2009 Sep;31(3):359-69. doi: 10.1007/s00281-009-0152-9. Epub 2009 May 14.

The immunopathogenesis of alcoholic and nonalcoholic steatohepatitis: two triggers for one disease?

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  • 1Department of Internal Medicine, Universit√† degli Studi di Milano, Padiglione Granelli, Ospedale Policlinico IRCCS, via F Sforza 35, 20122, Milan, Italy.


Alcoholic liver disease and nonalcoholic liver disease represent a leading cause of liver disease and share similar pathogenic mechanisms among which activation of the immune system plays a key role. The main events consist in (a) activation of Kupffer cells via TLR-4 by LPS and fatty acids (b) complement activation (c) increased release of proinflammatory mediators (d) alteration in NK and NKT cell number/activity (e) activation of the adaptive immune system. At the same time, activation of intracellular pro-inflammatory pathways by cytokines and bacterial products, inhibit insulin signaling favoring lipogenesis, metabolic alterations, and cell damage.

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