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. 2019 Apr 3;6(1):e000260. doi: 10.1136/bmjgast-2018-000260

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© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Scheme of the immune system in HCC surveillance and the metabolic effects of alcohol exposure on hepatocyte. The metabolism of ethanol through the CYP2E1-dependent pathway produces acetaldehyde, radicals and lipid peroxidation products, such as MDA and 4HNE. Alcohol consumption reduces the number of CD8⁺ T cells and NK cells, and reduces the NKG2D expression on NK cells. 4HNE, 4-hydroxy-2-nonenal; ADH, alcohol dehydrogenase; ALDH, aldehyde dehydrogenase; CYP2E1, cytochrome P450 2E1; ER, endoplasmic reticulum; HCC, hepatocellular carcinoma; MDA, malondialdehyde; NK, natural killer; NKG2D, NK group 2D.