Ismail Mona H, Pinzani Massimo
Department of Internal Medicine, Division of Gastroenterology, King Fahad University Hospital, Al-Khobar, Saudi Arabia.
Dipartimento di Medicina Interna Center for Research, High Education and Transfer, Università degli Studi di Firenze, Florence, Italy.
Hepat Med. 2011 Jul 4;3:69-80. doi: 10.2147/HMER.S9051.
Chronic liver injuries of different etiologies eventually lead to fibrosis, a scarring process associated with increased and altered deposition of extracellular matrix in the liver. Progression of fibrosis has a major worldwide clinical impact due to the high number of patients affected by chronic liver disease which can lead to severe complications, expensive treatment, a possible need for liver transplantation, and death. Liver fibrogenesis is characterized by activation of hepatic stellate cells and other extracellular matrix producing cells. Liver fibrosis may regress following specific therapeutic interventions. Other than removing agents causing chronic liver damage, no antifibrotic drug is currently available in clinical practice. The extent of liver fibrosis is variable between individuals, even after controlling for exogenous factors. Thus, host genetic factors are considered to play an important role in the process of liver scarring. Until recently it was believed that this process was irreversible. However, emerging experimental and clinical evidence is starting to show that even cirrhosis in its early stages is potentially reversible.
不同病因的慢性肝损伤最终会导致肝纤维化，这是一种与肝脏中细胞外基质沉积增加和改变相关的瘢痕形成过程。由于受慢性肝病影响的患者数量众多，肝纤维化的进展在全球范围内具有重大临床影响，慢性肝病可导致严重并发症、昂贵的治疗、可能需要肝移植以及死亡。肝纤维化的特征是肝星状细胞和其他产生细胞外基质的细胞被激活。经过特定的治疗干预后，肝纤维化可能会消退。除了去除导致慢性肝损伤的因素外，目前临床实践中尚无抗纤维化药物。即使在控制了外部因素之后，个体之间肝纤维化的程度也存在差异。因此，宿主遗传因素被认为在肝脏瘢痕形成过程中起重要作用。直到最近，人们还认为这个过程是不可逆的。然而，新出现的实验和临床证据开始表明，即使是早期肝硬化也可能是可逆的。
