Internal medicine residency program, Rochester General Hospital, 1425 Portland Avenue, Rochester, NY, 14621, USA.
Rainier Springs Behavioral Health Hospital, 2805 NE 129th St, Vancouver, WA, 98686, USA.
Pharmacol Rep. 2024 Oct;76(5):944-961. doi: 10.1007/s43440-024-00638-w. Epub 2024 Aug 20.
Liver fibrosis is the formation of a fibrous scar resulting from chronic liver injury, independently from etiology. Although many of the mechanical details remain unknown, activation of hepatic stellate cells (HSCs) is a central driver of liver fibrosis. Extracellular mechanisms such as apoptotic bodies, paracrine stimuli, inflammation, and oxidative stress are critical in activating HSCs. The potential for liver fibrosis to reverse after removing the causative agent has heightened interest in developing antifibrotic therapies. Polyphenols, the secondary plant metabolites, have gained attention because of their health-beneficial properties, including well-recognized antioxidant and anti-inflammatory activities, in the setting of liver fibrosis. In this review, we present an overview of the mechanisms underlying liver fibrosis with a specific focus on the activation of resident HSCs. We highlight the therapeutic potential and promising role of natural polyphenols to mitigate liver fibrosis pathogenesis, focusing on HSCs activation. We also discuss the translational gap from preclinical findings to clinical treatments involved in natural polyphenols in liver fibrosis.
肝纤维化是由慢性肝损伤引起的纤维瘢痕形成,与病因无关。尽管许多机械细节仍不清楚,但肝星状细胞(HSCs)的激活是肝纤维化的主要驱动因素。细胞外机制,如凋亡小体、旁分泌刺激、炎症和氧化应激,在激活 HSCs 中起着关键作用。在去除致病因子后,肝纤维化有逆转的可能,这使得人们对开发抗纤维化治疗产生了浓厚的兴趣。多酚是植物的次生代谢产物,由于其具有抗氧化和抗炎等有益健康的特性,引起了人们的关注。在肝纤维化的背景下,多酚的这些特性已得到充分证实。在本文中,我们概述了肝纤维化的发生机制,并特别关注了驻留 HSCs 的激活。我们强调了天然多酚在减轻肝纤维化发病机制方面的治疗潜力和前景,重点关注 HSCs 的激活。我们还讨论了天然多酚从临床前研究到肝纤维化临床治疗的转化差距。