Published online Nov 7, 2015. doi: 10.3748/wjg.v21.i41.11552
Peer-review started: May 6, 2015
First decision: July 13, 2015
Revised: July 29, 2015
Accepted: September 14, 2015
Article in press: September 14, 2015
Published online: November 7, 2015
Liver cirrhosis (LC) is a chronic illness caused by inflammatory responses and progressive fibrosis. Globally, the most common causes of chronic liver disease include persistent alcohol abuse, followed by viral hepatitis infections and nonalcoholic fatty liver disease. However, regardless of the etiological factors, the susceptibility and degree of liver damage may be influenced by genetic polymorphisms that are associated with distinct ethnic and cultural backgrounds. Consequently, metabolic genes are influenced by variable environmental lifestyle factors, such as diet, physical inactivity, and emotional stress, which are associated with regional differences among populations. This Topic Highlight will focus on the genetic and environmental factors that may influence the metabolism of alcohol and nutrients in the setting of distinct etiologies of liver disease. The interaction between genes and environment in the current-day admixed population, Mestizo and Native Mexican, will be described. Additionally, genes involved in immune regulation, insulin sensitivity, oxidative stress and extracellular matrix deposition may modulate the degree of severity. In conclusion, LC is a complex disease. The onset, progression, and clinical outcome of LC among the Mexican population are influenced by specific genetic and environmental factors. Among these are an admixed genome with a heterogenic distribution of European, Amerindian and African ancestry; a high score of alcohol consumption; viral infections; a hepatopathogenic diet; and a high prevalence of obesity. The variance in risk factors among populations suggests that intervention strategies directed towards the prevention and management of LC should be tailored according to such population-based features.
Core tip: Liver cirrhosis is a global health problem. The onset, progression, and clinical outcome of liver cirrhosis are influenced by several hereditary and lifestyle factors. Worldwide, interactions between genetic and environmental factors involved in liver cirrhosis may be associated with ethnic-based variations. Globally, in populations with admixed genomes, such as the Mexican population, individualized medicine represents a new challenge for hepatologists and gastroenterologists.