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Vol. 35. Núm. S2.
Diagnóstico y seguimiento de la fibrosis hepática mediante marcadores séricos directos (ELF)
Páginas 3-9 (Diciembre 2012)
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Vol. 35. Núm. S2.
Diagnóstico y seguimiento de la fibrosis hepática mediante marcadores séricos directos (ELF)
Páginas 3-9 (Diciembre 2012)
Diagnóstico y seguimiento de la fibrosis hepática mediante marcadores séricos directos (ELF)
Acceso a texto completo
Fibrogénesis hepática: fisiopatología
Liver fibrogenesis: physiopathology
Visitas
22607
Gemma Odenaa,b, Ramón Batallera,b,c,d,
Autor para correspondencia
ramon_bataller@med.unc.edu

Autor para correspondencia.
a Department of Nutrition, University of North Carolina, Chapel Hill, United States
b Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
c Departments of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, United States
d Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)
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Bibliografía
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Resumen

La fibrogénesis hepática es consecuencia de una reparación tisular exagerada ante un daño hepático crónico. La fibrosis consiste en el depósito progresivo de MEC en el parénquima hepático, que se observa en la mayoría de enfermedades crónicas del hígado y que precede al desarrollo de cirrosis. En los últimos años diversos estudios han identificado las células estrelladas hepáticas activadas, los fibroblastos portales y los miofibroblastos de distinto origen como las principales células productoras de colágeno en el hígado dañado. Asimismo, se han identificado las principales citocinas y moléculas implicadas. La demostración de que es posible la reversibilidad de la fibrogénesis hepática avanzada ha estimulado la investigación de posibles terapias antifibrogénicas. No obstante, el único tratamiento claramente efectivo es la eliminación del agente causal. Este artículo resume los progresos en el estudio de la patogénesis de la fibrogénesis hepática y discute las posibles dianas terapéuticas para desarrollar fármacos antifibrogénicos.

Palabras clave:
Inflamación hepática
Citocinas
Células estrelladas hepáticas
Enfermedades crónicas hepáticas
Abstract

Liver fibrogenesis is the result of excessive tissue repair of chronic liver damage. This entity consists of the progressive extracellular matrix deposition in the liver parenchyma that is observed in most chronic liver diseases and which precedes the development of cirrhosis. In the last few years, several studies have identified activated stellate cells, portal fibroblasts, and myofibroblasts from distinct cell populations as the main collagen-producing cells in the damaged liver. Likewise, the main cytokines and molecules involved in liver fibrogenesis have been identified. The finding that advanced liver fibrogenesis can be reversed has stimulated research into possible antifibrogenic therapies. Nevertheless, the only effective treatment is elimination of the causal agent. The present article summarizes the progress made in the study of the pathogenesis of liver fibrogenesis and discusses the possible therapeutic targets for the development of antifibrogenic agents.

Keywords:
Hepatic inflammation
Cytokines
Hepatic stellate cells
Chronic liver disease
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Bibliografía
[1.]
R. Bataller, D.A. Brenner.
Liver fibrosis.
J Clin Invest, 115 (2005), pp. 209-218
[2.]
D. Roulot, J.L. Costes, J.F. Buyck, U. Warzocha, N. Gambier, S. Czernichow, et al.
Transient elastography as a screening tool for liver fibrosis and cirrhosis in a community-based population aged over 45 years.
[3.]
M. Pinzani.
Liver fibrosis.
Springer Semin Immunopathol, 21 (1999), pp. 475-490
[4.]
S.L. Friedman.
Hepatic stellate cells: protean, multifunctional, and enigmatic cells of the liver.
Physiol Rev, 88 (2008), pp. 125-172
[5.]
R. Kalluri, E.G. Neilson.
Epithelial-mesenchymal transition and its implications for fibrosis.
J Clin Invest, 112 (2003), pp. 1776-1784
[6.]
J.J. Maher.
Interactions between hepatic stellate cells and the immune system.
Semin Liver Dis, 21 (2001), pp. 417-426
[7.]
G. Notas, T. Kisseleva, D. Brenner.
NK and NKT cells in liver injury and fibrosis.
Clin Immunol, 130 (2009), pp. 16-26
[8.]
J. Li, S.J. Qiu, W.M. She, F.P. Wang, H. Gao, L. Li, et al.
Significance of the balance between regulatory T (Treg) and T helper 17 (Th17) cells during hepatitis B virus related liver fibrosis.
[9.]
T. Santodomingo-Garzon, M.G. Swain.
Role of NKT cells in autoimmune liver disease.
Autoimmun Rev, 10 (2011), pp. 793-800
[10.]
A.M. Gressner, R. Weiskirchen, K. Breitkopf, S. Dooley.
Roles of TGF-beta in hepatic fibrosis.
Front Biosci, 7 (2002), pp. d793-d807
[11.]
F.W. Shek, R.C. Benyon.
How can transforming growth factor beta be targeted usefully to combat liver fibrosis?.
Eur J Gastroenterol Hepatol, 16 (2004), pp. 123-126
[12.]
H. Yoshiji, S. Kuriyama, J. Yoshii, Y. Ikenaka, R. Noguchi, T. Nakatani, et al.
Tissue inhibitor of metalloproteinases-1 attenuates spontaneous liver fibrosis resolution in the transgenic mouse.
Hepatology, 36 (2002), pp. 850-860
[13.]
H. Tsukamoto, S.C. Lu.
Current concepts in the pathogenesis of alcoholic liver injury.
FASEB J, 15 (2001), pp. 1335-1349
[14.]
I.R. Wanless, K. Shiota.
The pathogenesis of nonalcoholic steatohepatitis and other fatty liver diseases: a four-step model including the role of lipid release and hepatic venular obstruction in the progression to cirrhosis.
Semin Liver Dis, 24 (2004), pp. 99-106
[15.]
D.C. Rockey.
Hepatic fibrogenesis and hepatitis C.
Semin Gastrointest Dis, 11 (2000), pp. 69-83
[16.]
R. Bataller, Y.H. Paik, J.N. Lindquist, J.J. Lemasters, D.A. Brenner.
Hepatitis C virus core and nonstructural proteins induce fibrogenic effects in hepatic stellate cells.
Gastroenterology, 126 (2004), pp. 529-540
[17.]
G. Poli.
Pathogenesis of liver fibrosis: role of oxidative stress.
Mol Aspects Med, 21 (2000), pp. 49-98
[18.]
M.J. Arthur.
Reversibility of liver fibrosis and cirrhosis following treatment for hepatitis C.
Gastroenterology, 122 (2002), pp. 1525-1528
[19.]
A. Parés, J. Caballería, M. Bruguera, M. Torres, J. Rodes.
Histological course of alcoholic hepatitis. Influence of abstinence, sex and extent of hepatic damage.
J Hepatol, 2 (1986), pp. 33-42
[20.]
J.B. Dixon, P.S. Bhathal, N.R. Hughes, P.E. O’Brien.
Nonalcoholic fatty liver disease: Improvement in liver histological analysis with weight loss.
Hepatology, 39 (2004), pp. 1647-1654
[21.]
P. Hammel, A. Couvelard, D. O’Toole, A. Ratouis, A. Sauvanet, J.F. Flejou, et al.
Regression of liver fibrosis after biliary drainage in patients with chronic pancreatitis and stenosis of the common bile duct.
N Engl J Med, 344 (2001), pp. 418-423
[22.]
C. Camma, D. Di Bona, F. Schepis, E.J. Heathcote, S. Zeuzem, P.J. Pockros, et al.
Effect of peginterferon alfa-2a on liver histology in chronic hepatitis C: a meta-analysis of individual patient data.
Hepatology, 39 (2004), pp. 333-342
[23.]
T. Kisseleva, M. Cong, Y. Paik, D. Scholten, C. Jiang, C. Benner, et al.
Myofibroblasts revert to an inactive phenotype during regression of liver fibrosis.
Proc Natl Acad Sci USA., 109 (2012), pp. 9448-9453
[24.]
J.S. Troeger, I. Mederacke, G.Y. Gwak, D.H. Dapito, X. Mu, C.C. Hsu, et al.
Deactivation of hepatic stellate cells during liver fibrosis resolution in mice.
Gastroenterology, 143 (2012), pp. 1073
[25.]
J.F. Dufour, R. DeLellis, M.M. Kaplan.
Reversibility of hepatic fibrosis in autoimmune hepatitis.
Ann Intern Med, 127 (1997), pp. 981-985
[26.]
J.M. Mato, J. Cámara, J. Fernández de Paz, L. Caballería, S. Coll, A. Caballero, et al.
S-adenosylmethionine in alcoholic liver cirrhosis: a randomized, placebo-controlled, double-blind, multicenter clinical trial.
J Hepatol, 30 (1999), pp. 1081-1089
[27.]
C.S. Lieber, D.G. Weiss, R. Groszmann, F. Paronetto, S. Schenker, Veterans Affairs Cooperative Study 391 Group.
I. Veterans Affairs Cooperative Study of polyenylphosphatidylcholine in alcoholic liver disease: effects on drinking behavior by nurse/physician teams.
Alcohol Clin Exp Res, 27 (2003), pp. 1757-1764
[28.]
R. Bataller, P. Sancho-Bru, P. Ginés, D.A. Brenner.
Liver fibrogenesis: a new role for the renin-angiotensin system.
Antioxid Redox Signal, 7 (2005), pp. 1346-1355
[29.]
J. Colmenero, R. Bataller, P. Sancho-Bru, M. Domínguez, M. Moreno, X. Forns, et al.
Effects of losartan on hepatic expression of nonphagocytic NADPH oxidase and fibrogenic genes in patients with chronic hepatitis C.
Am J Physiol Gastrointest Liver Physiol, 297 (2009), pp. G726-G734
[30.]
M.Y. Kim, M.Y. Cho, S.K. Baik, P.H. Jeong, K.T. Suk, Y.O. Jang, et al.
Beneficial effects of candesartan, an angiotensin-blocking agent, on compensated alcoholic liver fibrosis - a randomized open-label controlled study.
[31.]
J.J. Cho, B. Hocher, H. Herbst, J.D. Jia, M. Ruehl, E.G. Hahn, et al.
An oral endothelin-A receptor antagonist blocks collagen synthesis and deposition in advanced rat liver fibrosis.
Gastroenterology, 118 (2000), pp. 1169-1178
[32.]
M. Moreno, J.F. Chaves, P. Sancho-Bru, F. Ramalho, L.N. Ramalho, M.L. Mansego, et al.
Ghrelin attenuates hepatocellular injury and liver fibrogenesis in rodents and influences fibrosis progression in humans.
Hepatology, 51 (2010), pp. 974-985
[33.]
F. Teixeira-Clerc, B. Julien, P. Grenard, J. Tran Van Nhieu, V. Deveaux, L. Li, et al.
CB1 cannabinoid receptor antagonism: a new strategy for the treatment of liver fibrosis.
Nat. Med, 12 (2006), pp. 671-676
[34.]
J. Muñoz-Luque, J. Ros, G. Fernández-Varo, S. Tugues, M. Morales-Ruiz, C.E. Álvarez, et al.
Regression of fibrosis after chronic stimulation of cannabinoid CB2 receptor in cirrhotic rats.
J Pharmacol Exp Ther, 324 (2008), pp. 475-483
[35.]
A.M. Di Bisceglie, M.L. Shiffman, G.T. Everson, K.L. Lindsay, J.E. Everhart, E.C. Wright, et al.
Prolonged therapy of advanced chronic hepatitis C with low-dose peginterferon.
N Engl J Med, 359 (2008), pp. 2429-2441
[36.]
R. Belfort, S.A. Harrison, K. Brown, C. Darland, J. Finch, J. Hardies, et al.
A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis.
N Engl J Med, 355 (2006), pp. 2297-2307
[37.]
H. Hyogo, S. Tazuma, K. Arihiro, K. Iwamoto, Y. Nabeshima, M. Inoue, et al.
Efficacy of atorvastatin for the treatment of nonalcoholic steatohepatitis with dyslipidemia.
Metabolism, 57 (2008), pp. 1711-1718
[38.]
T.R. Morgan, D.G. Weiss, B. Nemchausky, E.R. Schiff, B. Anand, F. Simon, et al.
Colchicine treatment of alcoholic cirrhosis: a randomized, placebo-controlled clinical trial of patient survival.
Gastroenterology, 128 (2005), pp. 882-890
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