Update on the pathophysiology of liver fibrosis

Abstract

Fibrogenesis represents the main pathophysiological consequence of chronic liver disease and leads to life-threatening clinical consequences. The knowledge in this field has grown exponentially in the past 20 years and, currently, evaluation and treatment of liver fibrosis are central issues in hepatology. Classic mechanisms of liver fibrogenesis have been expanded and consolidated over the past few years. Concomitantly, novel mechanisms have been suggested and demonstrated. The aim of this article is to provide an update on these mechanisms with an attempt to integrate classic and novel pathways responsible for the evolution of the fibrogenic process and, potentially, for its regression.

Keywords::

• adipokines
• angiogenesis
• cannabinoid system
• chronic wound healing
• cirrhosis
• innate immunity
• liver fibrosis
• macrophages
• myofibroblast
• oxidative stress
• viral proteins

Financial & competing interests disclosure

Jose Macias-Barragan is holding a post-doctoral Sheila Scherlock fellowship by the European Association for the Study of the Liver. Massimo Pinzani is also Adjunct Professor of Medicine in the Department of Medicine, Case Western Reserve University, Cleveland, Ohio, USA. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.