In vivo and in vitro induction of human cytochrome P4503A4 by dexamethasone McCune JS et al. The effect of hormone replacement therapy on CYP3A activity Gorski JC et al. Concludes that neither menopause nor menopause with oestrogen replacement therapy altered intestinal or hepatic CYP3A activity relative to that in a group of young women. The exact pathogenesis of alcoholic liver injury is still not clear but immune mediated and free radical hepatic injury are thought to be important. There is increasing interest in genetic factors predisposing to hepatic injury in susceptible individuals.
Abstinence is the most important aspect of treatment.
Newer drugs such as acamprosate and naltrexone are used to reduce alcohol craving. Vitamin supplements and nutrition are vital while corticosteroids have a role in acute alcoholic hepatitis where there is no evidence of gastrointestinal haemorrhage or sepsis. Liver transplantation has excellent results in abstinent patients with end stage liver disease but there are concerns about recidivism after transplant. Chemotherapy for upper gastrointestinal tumours Thomas AL et al. The aim of this article is to identify current chemotherapy treatment for tumours of the oesophagus, stomach, pancreas, and liver.