Mechanisms of Damage in Hepatitis
The specific mechanism causing hepatic damage varies and depends on the underlying cause of the condition.
In viral hepatitis, the presence of one of the Hepatitis viruses inside the liver cells causes the immune system to attack the hepatocytes. This results in inflammation, fibrin deposits, cell death, altered architecture, and impaired function.
In autoimmune hepatitis, the immune cells target proteins in the liver cells. This can be due to a drug, toxin, or infection which binds to a molecule in or on the liver cells.
In alcoholic hepatitis, fat deposits accumulate in the liver, resulting in a Fatty Liver Disease (FLD) given the name steatohepatitis. The detoxification of alcohol by the liver forms acetaldehyde, which is a free radical that causes damage to the liver cell membrane, functional molecules and cellular organelles.
In NASH (Non-Alcoholic SteatoHepatitis), fatty liver deposits can occur without alcohol, and are caused by excessive calorie consumption, especially (but not necessarily) high carbohydrate/sugar consumption. The liver converts extra/unneeded calories (proteins, carbohydrates, and fat) into fat. The liver then stores some of that fat in the liver, which creates Fatty Liver Disease. Excessive fat stored in the liver is the source of liver injury, since fatty tissue generates free radicals. Free Radicals will damage liver cells if the level of antioxidant molecules in the cells is insufficient to quench them all.