Chapter 105

Hepatic Fibrosis and Cirrhosis

Don C Rockey

Don C Rockey

Medical University of South Carolina, Charleston, SC, USA

Search for more papers by this author
First published: 27 November 2015

Summary

This chapter reviews multiple aspects of hepatic fibrosis, including its pathophysiologic mechanisms, natural history, clinical features, current and future tools for diagnosing fibrosis, as well as emerging antifibrotic therapies. Stellate cells are the predominant cell type involved in the fibrogenic response. During and as part of the activation process, stellate cells exhibit a variety of properties. These include fibrogenesis, proliferation, cellular contractility, motility, cytokine synthesis, chemotaxis, matrix degradation, retinoid loss, and proinflammatory responses. Stellate cell activation is accompanied by depletion of retinoid (vitamin A) droplets. Percutaneous liver biopsy has historically been considered to be the gold standard for assessment of fibrosis and cirrhosis. In many forms of liver disease, treatment of the underlying inciting lesion leads to improvement in fibrosis, even in patients with histological cirrhosis. Angiogenic pathways appear to be important in fibrosis, and represent an attractive therapeutic target.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.