Alcoholism: A systemic proinflammatory condition

Table 1 Central nervous system alterations in alcoholic patients

Anatomo-clinical forms of chronic central nervous system damage	Brain cortical and subcortical atrophy
	Cerebellar degeneration
	Decreased blood flow
	Pellagra
	Wernicke-Korsakoff encephalopathy
	Marchiafava-Bignami disease
	Central pontine myelinolysis
	Increased prevalence of stroke
	Cerebral trauma
Clinical features of brain atrophy	May vary from frank dementia to subtle alterations
	Reversible with prolonged ethanol withdrawal
Underlying anatomic lesions of brain atrophy	Neuronal death
	Apoptosis
	Decreased neuronogenesis
	White matter alterations
Main mechanisms of brain atrophy	Effects of ethanol and lipopolysaccharide
	Cytokine (especially TNF-α) mediated neuroinflammation.
	Oxidative damage (mainly ethanol-mediated), iron excess
	Vitamins (antioxidants?) deficiency
	Protein deficiency and malnutrition?
	Excitotoxicity?
	Co-existing liver disease?

TNF: Tumor necrosis factor.