School of Medicine, University of California at San Diego La Jolla, CA, USA.
Front Pharmacol. 2014 Jul 22;5:167. doi: 10.3389/fphar.2014.00167. eCollection 2014.
Liver fibrosis results from dysregulation of normal wound healing, inflammation, activation of myofibroblasts, and deposition of extracellular matrix (ECM). Chronic liver injury causes death of hepatocytes and formation of apoptotic bodies, which in turn, release factors that recruit inflammatory cells (neutrophils, monocytes, macrophages, and lymphocytes) to the injured liver. Hepatic macrophages (Kupffer cells) produce TGFβ1 and other inflammatory cytokines that activate Collagen Type I producing myofibroblasts, which are not present in the normal liver. Secretion of TGFβ1 and activation of myofibroblasts play a critical role in the pathogenesis of liver fibrosis of different etiologies. Although the composition of fibrogenic myofibroblasts varies dependent on etiology of liver injury, liver resident hepatic stellate cells and portal fibroblasts are the major source of myofibroblasts in fibrotic liver in both experimental models of liver fibrosis and in patients with liver disease. Several studies have demonstrated that hepatic fibrosis can reverse upon cessation of liver injury. Regression of liver fibrosis is accompanied by the disappearance of fibrogenic myofibroblasts followed by resorption of the fibrous scar. Myofibroblasts either apoptose or inactivate into a quiescent-like state (e.g., stop collagen production and partially restore expression of lipogenic genes). Resolution of liver fibrosis is associated with recruitment of macrophages that secrete matrix-degrading enzymes (matrix metalloproteinase, collagenases) and are responsible for fibrosis resolution. However, prolonged/repeated liver injury may cause irreversible crosslinking of ECM and formation of uncleavable collagen fibers. Advanced fibrosis progresses to cirrhosis and hepatocellular carcinoma. The current review will summarize the role and contribution of different cell types to populations of fibrogenic myofibroblasts in fibrotic liver.
肝纤维化是由于正常伤口愈合、炎症、肌成纤维细胞激活和细胞外基质(ECM)沉积失调引起的。慢性肝损伤导致肝细胞死亡和凋亡小体的形成,凋亡小体反过来释放招募炎症细胞(中性粒细胞、单核细胞、巨噬细胞和淋巴细胞)到损伤肝脏的因子。肝巨噬细胞(枯否细胞)产生 TGFβ1 和其他炎症细胞因子,激活不存于正常肝脏中的胶原 I 产生肌成纤维细胞。TGFβ1 的分泌和肌成纤维细胞的激活在不同病因的肝纤维化发病机制中起关键作用。尽管纤维生成性肌成纤维细胞的组成因肝损伤的病因而异,但在纤维化肝脏中,肝固有星状细胞和门脉成纤维细胞是纤维性肝纤维化实验模型和肝病患者中肌成纤维细胞的主要来源。几项研究表明,肝纤维化在停止肝损伤后可以逆转。肝纤维化的消退伴随着纤维生成性肌成纤维细胞的消失,随后纤维疤痕的吸收。肌成纤维细胞要么凋亡,要么失活成静止样状态(例如,停止胶原产生并部分恢复脂生成基因的表达)。肝纤维化的消退与分泌基质降解酶(基质金属蛋白酶、胶原酶)的巨噬细胞的募集有关,这些巨噬细胞负责纤维化的消退。然而,长期/反复的肝损伤可能导致 ECM 的不可逆转交联和不可切割胶原纤维的形成。晚期纤维化进展为肝硬化和肝细胞癌。本综述将总结不同细胞类型在纤维性肝中对纤维生成性肌成纤维细胞群体的作用和贡献。
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