Reversal of Liver Fibrosis: A Review

Abstract

Liver fibrosis is the final pathway for most chronic liver disease and is the main reason for increased mortality in affected patients. The extent of liver fibrosis displays great individual variation, even after controlling for age (at infection), gender & exogenous factors. Thus, host genetic factors are likely to play an important role in the process of liver scarring. (Weber et al., 2008). Inflammation is strongly associated with chronic liver injury, and fibrosis is part of the liver’s wound-healing response. Inflammation represents the driving force for the progressive accumulation of extracellular matrix (ECM) components, eventually leading to liver cirrhosis and hepatic failure. Although even acute injury will activate mechanisms of fibrogenesis, the sustained signals of inflammation associated with chronic liver disease caused by infection, drugs, metabolic disorders, or immune attacks are required for significant fibrosis to accumulate. Cirrhosis is the result of many liver diseases and consists of fibrosis and regenerating nodules. Clinical presentations vary from asymptomatic to advanced end stage liver diseases with complications. In addition, a significant need exists for developing safe and accurate noninvasive technique for detecting progression or regression of hepatic fibrosis in patients with chronic liver disease (Fallowfield JA et al., 2006). The past few years have seen remarkable progress in the field of liver fibrosis, including understanding the crosstalk between innate immunity and inflammatory cells & pathways regulating fibrosis regression. This article will review recent advances in this field as well as imaging and diagnostic test of liver fibrosis.