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Inflammation and fibrosis in chronic liver diseases including non-alcoholic fatty liver disease and hepatitis C

At present chronic liver disease (CLD), the third commonest cause of premature death in the United Kingdom is detected late, when interventions are ineffective, resulting in considerable morbidity and mortality. Injury to the liver, the largest solid organ in the body, leads to a cascade of inflamma...

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Autores principales: Tanwar, Sudeep, Rhodes, Freya, Srivastava, Ankur, Trembling, Paul M, Rosenberg, William M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6962431/
https://www.ncbi.nlm.nih.gov/pubmed/31969775
http://dx.doi.org/10.3748/wjg.v26.i2.109
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author Tanwar, Sudeep
Rhodes, Freya
Srivastava, Ankur
Trembling, Paul M
Rosenberg, William M
author_facet Tanwar, Sudeep
Rhodes, Freya
Srivastava, Ankur
Trembling, Paul M
Rosenberg, William M
author_sort Tanwar, Sudeep
collection PubMed
description At present chronic liver disease (CLD), the third commonest cause of premature death in the United Kingdom is detected late, when interventions are ineffective, resulting in considerable morbidity and mortality. Injury to the liver, the largest solid organ in the body, leads to a cascade of inflammatory events. Chronic inflammation leads to the activation of hepatic stellate cells that undergo trans-differentiation to become myofibroblasts, the main extra-cellular matrix producing cells in the liver; over time increased extra-cellular matrix production results in the formation of liver fibrosis. Although fibrogenesis may be viewed as having evolved as a “wound healing” process that preserves tissue integrity, sustained chronic fibrosis can become pathogenic culminating in CLD, cirrhosis and its associated complications. As the reference standard for detecting liver fibrosis, liver biopsy, is invasive and has an associated morbidity, the diagnostic assessment of CLD by non-invasive testing is attractive. Accordingly, in this review the mechanisms by which liver inflammation and fibrosis develop in chronic liver diseases are explored to identify appropriate and meaningful diagnostic targets for clinical practice. Due to differing disease prevalence and treatment efficacy, disease specific diagnostic targets are required to optimally manage individual CLDs such as non-alcoholic fatty liver disease and chronic hepatitis C infection. To facilitate this, a review of the pathogenesis of both conditions is also conducted. Finally, the evidence for hepatic fibrosis regression and the mechanisms by which this occurs are discussed, including the current use of antifibrotic therapy.
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spelling pubmed-69624312020-01-22 Inflammation and fibrosis in chronic liver diseases including non-alcoholic fatty liver disease and hepatitis C Tanwar, Sudeep Rhodes, Freya Srivastava, Ankur Trembling, Paul M Rosenberg, William M World J Gastroenterol Review At present chronic liver disease (CLD), the third commonest cause of premature death in the United Kingdom is detected late, when interventions are ineffective, resulting in considerable morbidity and mortality. Injury to the liver, the largest solid organ in the body, leads to a cascade of inflammatory events. Chronic inflammation leads to the activation of hepatic stellate cells that undergo trans-differentiation to become myofibroblasts, the main extra-cellular matrix producing cells in the liver; over time increased extra-cellular matrix production results in the formation of liver fibrosis. Although fibrogenesis may be viewed as having evolved as a “wound healing” process that preserves tissue integrity, sustained chronic fibrosis can become pathogenic culminating in CLD, cirrhosis and its associated complications. As the reference standard for detecting liver fibrosis, liver biopsy, is invasive and has an associated morbidity, the diagnostic assessment of CLD by non-invasive testing is attractive. Accordingly, in this review the mechanisms by which liver inflammation and fibrosis develop in chronic liver diseases are explored to identify appropriate and meaningful diagnostic targets for clinical practice. Due to differing disease prevalence and treatment efficacy, disease specific diagnostic targets are required to optimally manage individual CLDs such as non-alcoholic fatty liver disease and chronic hepatitis C infection. To facilitate this, a review of the pathogenesis of both conditions is also conducted. Finally, the evidence for hepatic fibrosis regression and the mechanisms by which this occurs are discussed, including the current use of antifibrotic therapy. Baishideng Publishing Group Inc 2020-01-14 2020-01-14 /pmc/articles/PMC6962431/ /pubmed/31969775 http://dx.doi.org/10.3748/wjg.v26.i2.109 Text en ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Review
Tanwar, Sudeep
Rhodes, Freya
Srivastava, Ankur
Trembling, Paul M
Rosenberg, William M
Inflammation and fibrosis in chronic liver diseases including non-alcoholic fatty liver disease and hepatitis C
title Inflammation and fibrosis in chronic liver diseases including non-alcoholic fatty liver disease and hepatitis C
title_full Inflammation and fibrosis in chronic liver diseases including non-alcoholic fatty liver disease and hepatitis C
title_fullStr Inflammation and fibrosis in chronic liver diseases including non-alcoholic fatty liver disease and hepatitis C
title_full_unstemmed Inflammation and fibrosis in chronic liver diseases including non-alcoholic fatty liver disease and hepatitis C
title_short Inflammation and fibrosis in chronic liver diseases including non-alcoholic fatty liver disease and hepatitis C
title_sort inflammation and fibrosis in chronic liver diseases including non-alcoholic fatty liver disease and hepatitis c
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6962431/
https://www.ncbi.nlm.nih.gov/pubmed/31969775
http://dx.doi.org/10.3748/wjg.v26.i2.109
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