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Reversal of Cirrhosis

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Complications of Cirrhosis

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Abstract

Cirrhosis is a major cause of morbidity and mortality worldwide. In contrast with the traditional view that cirrhosis is irreversible, clinical and experimental studies suggest that the removal of the causative agent can lead to reversibility of early stages of cirrhosis. Patients with advanced fibrosis or cirrhosis may also benefit from targeted therapies that favor fibrosis resolution and restoration of a normal liver architecture. Cirrhosis is a dynamic process characterized by the accumulation of extracellular matrix proteins that distort the hepatic architecture by forming a fibrous scar and the subsequent development of nodules of regenerating hepatocytes. Regression of advanced liver fibrosis is associated with reabsorption of fibrous scar and the disappearance of collagen-producing myofibroblasts. To develop therapies that favor cirrhosis resolution, it is essential to identify the main molecular mechanisms that mediate the removal of the fibrosis scar. Key players in this process are hepatic stellate cells, macrophages, metalloproteinases, and their inhibitors. This chapter summarizes the current evidence that cirrhosis is potentially reversible, the mechanisms leading to fibrosis progression and resolution and the potential targeted therapies for patients with advanced fibrosis.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Departments of Medicine and Nutrition, University of North Carolina, Chapel Hill, NC, USA

    Gemma Odena & Eva Stein

  2. Departments of Medicine and Nutrition, University of North Carolina, 7340-A Medical Biomolecular Research Building, 27599, Chapel Hill, NC, USA

    Assoc. Prof. Ramon Bataller MD, PhD

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  1. Gemma Odena
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  2. Eva Stein
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  3. Assoc. Prof. Ramon Bataller MD, PhD
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Correspondence to Ramon Bataller MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Transplant, Mayo Clinic, Jacksonville, Florida, USA

    Andrew P. Keaveny

  2. Institut de Malalties Digestives i Metaboliques, University of Barcelona, Barcelona, Spain

    Andrés Cárdenas

Abbreviations

ECM

Extracellular matrix proteins

HCV

Hepatitis C infection

HSC

Hepatic stellate cells

MMPs

Metalloproteinases

NASH

Nonalcoholic steatohepatitis

NF-κB

Nuclear factor kappa B

PDGF

Platelet-derived growth factor

ROS

Reactive oxygen species

TIMPs

Tissue inhibitors of metalloproteinases

TGFβ1

Transforming growth factor beta 1

VEGF

Vascular endothelial growth factor

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© 2015 Springer International Publishing Switzerland

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Odena, G., Stein, E., Bataller, R. (2015). Reversal of Cirrhosis. In: Keaveny, A., Cárdenas, A. (eds) Complications of Cirrhosis. Springer, Cham. https://doi.org/10.1007/978-3-319-13614-1_8

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  • DOI: https://doi.org/10.1007/978-3-319-13614-1_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-13613-4

  • Online ISBN: 978-3-319-13614-1

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