Rôle des acides gras alimentaires dans la physiopathologie des hépatopathies alcooliques

Many experimental studies in animals suggest that dietary fat plays an important role in the pathogenesis of alcoholic liver disease. Polyunsaturated fatty acids potentiate alcohol-induced liver injury at least in part by inducing cytochrome P450 2E1, cyclooxygenase-2 and lipid peroxydation. On the other hand, dietary saturated fatty acids reduce steatosis, necrosis, inflammation and fibrosis in conjunction with decreased expression of TNF-α and cyclooxygenase-2, and reduce lipid peroxidation. Dilinoleoyl-phosphatidylcholine prevents alcohol-induced fibrosis and cirrhosis in baboons and stimulates collagenase activity in cultured lipocytes. There are few human studies which confirm these experimental results. Epidemiological studies suggest a relationship between daily fat intake, particularly dietary polyunsaturated fatty acids, and the risk of liver cirrhosis in alcoholics. The studies having demonstrated that being overweight is a risk factor of alcoholic cirrhosis and that the apolipoprotein E polymorphism influences the severity of liver injury in alcoholic cirrhotics strongly favor the role of fatty acids in the pathogenesis of human alcoholic liver disease.