Oxidative damage Oxidative stress is increased by Liver hypermetabolism, caused by alcohol consumption Free radical-induced lipid peroxidative damage Reduction in protective antioxidants (eg, glutathione, vitamins A and E), caused by alcohol-related undernutrition Binding of alcohol oxidation products, such as acetaldehyde, to liver cell proteins, forming neoantigens and resulting in inflammation Accumulation of neutrophils and other white blood cells (WBCs), which are attracted by lipid peroxidative damage and neoantigens Inflammatory cytokines secreted by WBCs Accumulation of hepatic iron, if present, aggravates oxidative damage.