Alcoholic liver disease is a serious world-wide problem. Although a large amount of research has been done to determine the mechanisms that are responsible for liver damage associated with alcohol abuse it is still not clear what the mechanisms are that result in hepatocyte damage. There is a need for well-trained basic scientists to do research on the cellular and molecular biological aspects of alcoholic liver disease. It is a very recent finding that alcohol abuse is associated with a more severe hepatitis caused by hepatitis C virus, which has further supported the suggestion that there is an association between the suppression of immune responses and an increased susceptibility to infectious agents such as the hepatitis viruses. Very little information is available regarding the mechanisms that lead to more severe infections with these viruses and there is a clear need for individuals trained in this aspect of alcohol's effects. There is a need for clinically trained researchers with an understanding of research. The creation of numerous MD/PhD programs has been proposed to fill the need for research-trained clinicians. It is one aspect of the proposed training grant to train MD/PhD students to assume positions where clinical research on the mechanisms of alcoholic liver disease can be performed. It is proposed that the training faculty located at the Omaha VA Medical Center in Omaha, in collaboration with investigators at the University of Nebraska Medical Center and Creighton University, train pre-doctoral (including MD/PhD students) and post-doctoral students in research in the fundamental mechanisms of alcoholic Ever disease. 'Me training faculty have academic appointments at the University of Nebraska Medical Center and are actively funded to do research and have extensive experience in training pre- and post-doctoral students. Given the expertise of the training faculty, the extensive resources available to the trainees and the multidisciplinary approach to research on alcoholic liver disease at the Omaha VA research unit it is likely that each trainee will be well qualified to continue a research career in alcohol research. The ultimate goal of this training program is to prepare both basic scientists and clinically trained scientists for an active and productive research career on the effects of alcohol on the liver.