Juliane I. Beier, Gavin E. Arteel. Environmental exposure as a risk-modifying factor in liver diseases: Knowns and unknowns[J]. Acta Pharmaceutica Sinica B, 2021, 11(12): 3768-3778

Environmental exposure as a risk-modifying factor in liver diseases: Knowns and unknowns
Juliane I. Beiera,b,c, Gavin E. Arteela,b
a. Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh, Pittsburgh, PA 15213, USA;
b. Pittsburgh Liver Research Center and University of Pittsburgh, Pittsburgh, PA 15213, USA;
c. Department of Environmental and Occupational Health, University of Pittsburgh, PA 15213, USA
Liver diseases are considered to predominantly possess an inherited or xenobiotic etiology. However, inheritance drives the ability to appropriately adapt to environmental stressors, and disease is the culmination of a maladaptive response. Thus “pure” genetic and “pure” xenobiotic liver diseases are modified by each other and other factors, identified or unknown. The purpose of this review is to highlight the knowledgebase of environmental exposure as a potential risk modifying agent for the development of liver disease by other causes. This exercise is not to argue that all liver diseases have an environmental component, but to challenge the assumption that the current state of our knowledge is sufficient in all cases to conclusively dismiss this as a possibility. This review also discusses key new tools and approaches that will likely be critical to address this question in the future. Taken together, identifying the key gaps in our understanding is critical for the field to move forward, or at the very least to “know what we don't know.”
Key words:    Hepatic injury    Exposomics    Liver disease    Drug-induced liver injury    Alcoholic liver disease    Non-alcoholic liver disease    Inherited liver disease    Autoimmune liver disease   
Received: 2021-04-29     Revised: 2021-06-24
DOI: 10.1016/j.apsb.2021.09.005
Funds: Supported, in part, by grants from NIH (R01 AA021978, P30 DK120531, and R21 ES031531, USA).
Corresponding author: Juliane I. Beier,;Gavin E. Arteel,;
Author description:
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Juliane I. Beier
Gavin E. Arteel

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