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肝纤维化的病理生理学、信号通路及临床前模型指南。

A guide to pathophysiology, signaling pathways, and preclinical models of liver fibrosis.

作者信息

Sultana Mehonaz, Islam Md Asrarul, Khairnar Rhema, Kumar Sunil

机构信息

Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, 11439, USA.

Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, 11439, USA.

出版信息

Mol Cell Endocrinol. 2025 Mar 1;598:112448. doi: 10.1016/j.mce.2024.112448. Epub 2025 Jan 2.

Abstract

Liver fibrosis is potentially a reversible form of liver disease that evolved from the early stage of liver scarring as a consequence of chronic liver injuries. Recurrent injuries in the liver without any appropriate medication cause the injuries to get intense and deeper, which gradually leads to the progression of irreversible cirrhosis or carcinoma. Unfortunately, there are no approved treatment strategies for reversing hepatic fibrosis, making it one of the significant risk factors for developing advanced liver disorders and liver disease-associated mortality. Consequently, the interpretation of the fundamental mechanisms, etiology, and pathogenesis is crucial for identifying the potential therapeutic target as well as evaluating novel anti-fibrotic therapy. However, despite innumerable research, the functional mechanism and disease characteristics are still obscure. To accelerate the understanding of underlying disease pathophysiology, molecular pathways and disease progression mechanism, it is crucial to mimic human liver disease through the formation of precise disease models. Although various in vitro and in vivo liver fibrotic models have emerged and developed already, a perfect clinical model replicating human liver diseases is yet to be established, which is one of the major challenges in discovering proper therapeutics. This review paper will shed light on pathophysiology, signaling pathways, preclinical models of liver fibrosis, and their limitations.

摘要

肝纤维化是一种潜在可逆的肝脏疾病形式,它源于慢性肝损伤导致的肝脏瘢痕形成早期阶段。肝脏反复受伤而未得到任何适当药物治疗,会使损伤加剧并加深,进而逐渐导致不可逆转的肝硬化或癌变。不幸的是,目前尚无经批准的逆转肝纤维化的治疗策略,这使其成为发展为晚期肝脏疾病和肝病相关死亡的重要危险因素之一。因此,阐释其基本机制、病因和发病机制对于确定潜在治疗靶点以及评估新型抗纤维化疗法至关重要。然而,尽管进行了无数研究,其功能机制和疾病特征仍不明确。为加快对潜在疾病病理生理学、分子途径和疾病进展机制的理解,通过构建精确的疾病模型来模拟人类肝脏疾病至关重要。尽管已经出现并发展了各种体外和体内肝纤维化模型,但尚未建立能够复制人类肝脏疾病的完美临床模型,这是发现合适治疗方法的主要挑战之一。本文将阐明肝纤维化的病理生理学、信号通路、临床前模型及其局限性。

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