Liver fibrosis: Pathophysiology and clinical implications.
Liver fibrosis: Pathophysiology and clinical implications.
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DOI：
10.1002/wsbm.1499
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发表时间：
2021-01
影响因子：
3.1
通讯作者：
中科院分区：
文献类型：
--
作者：
肝纤维化是一个临床上重要的发现，对患者的发病率和死亡率有重大影响。纤维化的机制涉及许多不同的细胞途径，但涉及的主要细胞类型似乎是肝星状细胞。许多肝脏疾病，包括肝炎B、C和脂肪肝疾病引起持续的肝细胞损伤，导致肝纤维化。无论肝脏疾病的原因如何，肝脏相关的死亡率随着纤维化的增加呈指数级增加。肝硬化的进展带来更显著的死亡率和更高的肝细胞癌发病率。纤维化也会影响成人和儿科患者肝移植后的结果，并需要再次移植。存在治疗B型肝炎和丙型肝炎的药物，其逆转患有这些病毒性疾病的患者的纤维化，但目前没有直接治疗肝纤维化的疗法。几种慢性肝病的小鼠模型已经使用新型药物靶点成功逆转，目前的治疗主要集中在预防肌成纤维细胞活化。在这些领域的进一步研究可能会导致治疗纤维化的药物的开发，这将对患者的生存产生宝贵的影响。
Liver fibrosis is a clinically significant finding that has major impacts on patient morbidity and mortality. The mechanism of fibrosis involves many different cellular pathways, but the major cell type involved appears to be hepatic stellate cells. Many liver diseases, including Hepatitis B, C and fatty liver disease cause ongoing hepatocellular damage leading to liver fibrosis. No matter the cause of liver disease, liver related mortality increases exponentially with increasing fibrosis. The progression to cirrhosis brings more dramatic mortality and higher incidence of hepatocellular carcinoma. Fibrosis can also affect outcomes following liver transplantation in adult and pediatric patients and require retransplantation. Drugs exist to treat Hepatitis B and Hepatitis C that reverse fibrosis in patients with those viral diseases, but there are currently no therapies to directly treat liver fibrosis. Several mouse models of chronic liver diseases have been successfully reversed using novel drug targets with current therapies focusing mostly on prevention of myofibroblast activation. Further research in these areas could lead to development of drugs to treat fibrosis, which will have invaluable impact on patient survival.
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