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What Makes Cirrhosis Irreversible?—Consideration on Structural Changes

Several studies have shown that liver fibrosis, and even cirrhosis can be reversed, disproving the old “dogma” that cirrhosis is irreversible. In addition to scaring, vascular alterations appear to be critically important in the progression of chronic liver diseases. To overcome the “tipping-point”...

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Autores principales: Dezső, Katalin, Paku, Sándor, Kóbori, László, Thorgeirsson, Snorri S., Nagy, Péter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9091510/
https://www.ncbi.nlm.nih.gov/pubmed/35572980
http://dx.doi.org/10.3389/fmed.2022.876293
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author Dezső, Katalin
Paku, Sándor
Kóbori, László
Thorgeirsson, Snorri S.
Nagy, Péter
author_facet Dezső, Katalin
Paku, Sándor
Kóbori, László
Thorgeirsson, Snorri S.
Nagy, Péter
author_sort Dezső, Katalin
collection PubMed
description Several studies have shown that liver fibrosis, and even cirrhosis can be reversed, disproving the old “dogma” that cirrhosis is irreversible. In addition to scaring, vascular alterations appear to be critically important in the progression of chronic liver diseases. To overcome the “tipping-point” of cirrhosis, we need to understand in depth what might make it irreversible in some cases. Morphologically, the initial, as well as the advanced stages of cirrhosis are characterized by specific structural changes. The hallmark of the initial stage is the division of the original liver parenchyma by centro-central or porto-portal septa. No significant vascular changes are observed in this stage. The advanced stage is characterized by several morphological alterations: (i) The main feature is the parenchymal extinction, with intact portal vein branches, hepatic artery branches, and biliary ductules; (ii) In the extinct areas we observed numerous loops in the ductular network, indicating the disruption of the hepato-biliary junctions; (iii) Although the ductular progenitor cells are able to generate hepatocytes via the budding process, the newly formed hepatocyte nodules cannot re-establish the original lobular architecture due to their disorganized growth. In conclusion, this regenerative process characteristic for the advanced stage, contributes to circulatory disorders, perpetuates parenchymal injury and may lead to the irreversibility of cirrhosis.
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spelling pubmed-90915102022-05-12 What Makes Cirrhosis Irreversible?—Consideration on Structural Changes Dezső, Katalin Paku, Sándor Kóbori, László Thorgeirsson, Snorri S. Nagy, Péter Front Med (Lausanne) Medicine Several studies have shown that liver fibrosis, and even cirrhosis can be reversed, disproving the old “dogma” that cirrhosis is irreversible. In addition to scaring, vascular alterations appear to be critically important in the progression of chronic liver diseases. To overcome the “tipping-point” of cirrhosis, we need to understand in depth what might make it irreversible in some cases. Morphologically, the initial, as well as the advanced stages of cirrhosis are characterized by specific structural changes. The hallmark of the initial stage is the division of the original liver parenchyma by centro-central or porto-portal septa. No significant vascular changes are observed in this stage. The advanced stage is characterized by several morphological alterations: (i) The main feature is the parenchymal extinction, with intact portal vein branches, hepatic artery branches, and biliary ductules; (ii) In the extinct areas we observed numerous loops in the ductular network, indicating the disruption of the hepato-biliary junctions; (iii) Although the ductular progenitor cells are able to generate hepatocytes via the budding process, the newly formed hepatocyte nodules cannot re-establish the original lobular architecture due to their disorganized growth. In conclusion, this regenerative process characteristic for the advanced stage, contributes to circulatory disorders, perpetuates parenchymal injury and may lead to the irreversibility of cirrhosis. Frontiers Media S.A. 2022-04-27 /pmc/articles/PMC9091510/ /pubmed/35572980 http://dx.doi.org/10.3389/fmed.2022.876293 Text en Copyright © 2022 Dezső, Paku, Kóbori, Thorgeirsson and Nagy. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Dezső, Katalin
Paku, Sándor
Kóbori, László
Thorgeirsson, Snorri S.
Nagy, Péter
What Makes Cirrhosis Irreversible?—Consideration on Structural Changes
title What Makes Cirrhosis Irreversible?—Consideration on Structural Changes
title_full What Makes Cirrhosis Irreversible?—Consideration on Structural Changes
title_fullStr What Makes Cirrhosis Irreversible?—Consideration on Structural Changes
title_full_unstemmed What Makes Cirrhosis Irreversible?—Consideration on Structural Changes
title_short What Makes Cirrhosis Irreversible?—Consideration on Structural Changes
title_sort what makes cirrhosis irreversible?—consideration on structural changes
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9091510/
https://www.ncbi.nlm.nih.gov/pubmed/35572980
http://dx.doi.org/10.3389/fmed.2022.876293
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