Current and future anti-fibrotic therapies for chronic liver disease.
Chronic injury results in a wound healing response that eventually leads to fibrosis. The response is generalized, with features common among multiple organ systems. In the liver, various different types of injury lead to fibrogenesis, implying a common pathogenesis. Although several specific therapies for patients who have different liver diseases have been successfully developed, including antiviral therapies for those who have hepatitis B and hepatitis C virus infection, specific and effective antifibrotic therapy remains elusive. Over the past 2 decades, great advances in the understanding of fibrosis have been made and multiple mechanisms underlying hepatic fibrogenesis uncovered. Elucidation of these mechanisms has been of fundamental importance in highlighting novel potential therapies. Preclinical studies have indicated several putative therapies that might abrogate fibrogenesis. This article emphasizes mechanisms underlying fibrogenesis and reviews available and future therapeutics.
Rockey
Don C
DC
Division of Digestive and Liver Diseases, Department of Internal Medicine, The University of Texas, Southwestern Medical Center, Dallas, TX 75390, USA. don.rockey@utsouthwestern.edu
D000804:Angiotensin II / Q000037:antagonists & inhibitors; D002908:Chronic Disease; D003078:Colchicine / Q000627:therapeutic use; D003094:Collagen / Q000037:antagonists & inhibitors / Q000096:biosynthesis; D005109:Extracellular Matrix / Q000378:metabolism; D055166:Hepatic Stellate Cells / Q000378:metabolism; D006801:Humans; D007371:Interferon-gamma / Q000627:therapeutic use; D008024:Ligands; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000473:pathology* / Q000503:physiopathology; D047495:PPAR gamma / Q000037:antagonists & inhibitors; D011728:Pyridones / Q000627:therapeutic use
D008024:Ligands; D047495:PPAR gamma; D011728:Pyridones; D000804:Angiotensin II; D007371:Interferon-gamma; D003094:Collagen; C093844:pirfenidone; D003078:Colchicine