Safadi Rifaat, Friedman Scott L
Faculty, Hebrew University School of Medicine, Hadassah Medical Center, Jerusalem, Israel.
MedGenMed. 2002 Jul 15;4(3):27.
Hepatic fibrosis is a reversible wound healing response characterized by accumulation of extracellular matrix (ECM), or "scar," that follows chronic but not self-limited liver disease. The ECM components in fibrotic liver are similar regardless of the underlying cause. Activation of hepatic stellate cells is the central event in hepatic fibrosis. These perisinusoidal cells orchestrate an array of changes including degradation of the normal ECM of liver, deposition of scar molecules, vascular and organ contraction, and release of cytokines. Not only is hepatic fibrosis reversible, but it is also increasingly clear that cirrhosis may be reversible as well. The exact stage at which fibrosis/cirrhosis becomes truly irreversible is not known. Antifibrotic therapies will soon be a clinical reality. Emerging therapies will be targeted to those patients with reversible disease. The paradigm of stellate cell activation provides an important framework for defining therapeutic targets.
肝纤维化是一种可逆的伤口愈合反应，其特征是细胞外基质（ECM）或“瘢痕”的积累，这种积累发生在慢性而非自限性肝病之后。无论潜在病因如何，纤维化肝脏中的ECM成分都是相似的。肝星状细胞的激活是肝纤维化的核心事件。这些窦周细胞协调一系列变化，包括肝脏正常ECM的降解、瘢痕分子的沉积、血管和器官收缩以及细胞因子的释放。肝纤维化不仅是可逆的，而且越来越清楚的是肝硬化也可能是可逆的。纤维化/肝硬化真正变得不可逆的确切阶段尚不清楚。抗纤维化疗法很快将成为临床现实。新兴疗法将针对那些患有可逆性疾病的患者。星状细胞激活的模式为定义治疗靶点提供了一个重要的框架。
