Systematic review: hepatic fibrosis – regression with therapy

• Published in: Alimentary pharmacology & therapeutics Vol. 28; no. 10; pp. 1175 - 1187
• Main Authors: ZOIS, C. D., BALTAYIANNIS, G. H., KARAYIANNIS, P., TSIANOS, E. V.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.11.2008; Blackwell
• Subjects: Biological and medical sciences; Biomarkers; Digestive system; Disease Progression; Extracellular Matrix - physiology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver Cirrhosis - diagnosis; Liver Cirrhosis - pathology; Liver Cirrhosis - therapy; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Medical sciences; Other diseases. Semiology; Pharmacology. Drug treatments; Remission Induction - methods; Hepatic fibrosis; Treatment; Regression; Digestive diseases; Hepatic disease; Systematic review; Review
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2008.03840.x

Summary Background  Hepatic fibrosis occurs in response to chronic liver injury, regardless of the cause. An impressive amount of knowledge concerning the pathogenesis and treatment of liver fibrosis has emerged over the past few years. The hallmark of this event is the activation of the hepatic stellate cell. The latter event causes accumulation of extracellular matrix and formation of scar, leading to deterioration in hepatic function. Aim  To assess chronic liver injury, many invasive and non‐invasive methods have been suggested. Methods  Although transient elastography, image analysis of fractal geometry and fibrotest with actitest have been used in clinical practice, liver biopsy remains the recommended choice, especially when histological staging of fibrosis or response to treatment is needed. Conclusions  The recent advances in anti‐viral therapy have resulted in many reports on fibrosis and even on cirrhosis regression, especially early and in young people. A number of new agents have been suggested for the treatment of fibrosis, with promising results in animals; however, their efficacy in humans remains to be elucidated. The investigation of heterogeneity and plasticity of hepatic stellate cells is a topic of scientific interest and may result in improvements in patient management.