New treatment options for alcoholic hepatitis

Table 1 Potential new avenues for research and therapy in severe alcoholic hepatitis

Gut microbiota modification

Antibiotics (luminal, systemic)

Prebiotics and probiotics

Fecal microbiota transplantation (FMT)

Blockade of LPS and its downstream pathways e.g., PD-1 and TIM-3 inhibition

Immune modulation

Chemokines e.g., CCL20 inhibition

IL-8, IL-17 inhibition

Recombinant IL-22, recombinant human IL-10

Osteopontin inhibition

TNF-alfa superfamily receptor modulation

ADAMTS 13 enhancement

Inhibition of complement activation

Inhibition of inflammasome activation

Increasing steroid sensitivity

E.g., Basiliximab, Theophylline

Modification of genetic polymorphism of alcohol metabolizing enzymes

Epigenetic modification of alcohol induced liver damage

Liver regeneration and Early liver transplantation

Granulocyte colony stimulating factor (G-CSF)

Liver transplantation (DDLT/LDLT)

Setting up of alcohol units for post transplant support

Others

Extracorporeal liver support

Granulocytopheresis

Anti-oxidants - N-Acetyl Cysteine, S-Adenosyl Methionine