A review of liver fibrosis and cirrhosis regression
Cirrhosis has traditionally been considered an irreversible process of end-stage liver disease. With new treatments for chronic liver disease, there is regression of fibrosis and cirrhosis, improvement in clinical parameters (i.e. liver function and hemodynamic markers, hepatic venous pressure gradi...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Pathologists & the Korean Society for Cytopathology
2023-07-01
|
| Series: | Journal of Pathology and Translational Medicine |
| Subjects: | |
| Online Access: | http://jpatholtm.org/upload/pdf/jptm-2023-05-24.pdf |
| _version_ | 1797778001233969152 |
|---|---|
| author | Michael J. Lee |
| author_facet | Michael J. Lee |
| author_sort | Michael J. Lee |
| collection | DOAJ |
| description | Cirrhosis has traditionally been considered an irreversible process of end-stage liver disease. With new treatments for chronic liver disease, there is regression of fibrosis and cirrhosis, improvement in clinical parameters (i.e. liver function and hemodynamic markers, hepatic venous pressure gradient), and survival rates, demonstrating that fibrosis and fibrolysis are a dynamic process moving in two directions. Microscopically, hepatocytes push into thinning fibrous septa with eventual perforation leaving behind delicate periportal spikes in the portal tracts and loss of portal veins. Obliterated portal veins during progressive fibrosis and cirrhosis due to parenchymal extinction, vascular remodeling and thrombosis often leave behind a bile duct and hepatic artery within the portal tract. Traditional staging classification systems focused on a linear, progressive process; however, the Beijing classification system incorporates both the bidirectional nature for the progression and regression of fibrosis. However, even with regression, vascular lesions/remodeling, parenchymal extinction and a cumulative mutational burden place patients at an increased risk for developing hepatocellular carcinoma and should continue to undergo active clinical surveillance. It is more appropriate to consider cirrhosis as another stage in the evolution of chronic liver disease as a bidirectional process rather than an end-stage, irreversible state. |
| first_indexed | 2024-03-12T23:12:01Z |
| format | Article |
| id | doaj.art-e9cc110bd561473b803da376fbfd1da1 |
| institution | Directory Open Access Journal |
| issn | 2383-7837 2383-7845 |
| language | English |
| last_indexed | 2024-03-12T23:12:01Z |
| publishDate | 2023-07-01 |
| publisher | Korean Society of Pathologists & the Korean Society for Cytopathology |
| record_format | Article |
| series | Journal of Pathology and Translational Medicine |
| spelling | doaj.art-e9cc110bd561473b803da376fbfd1da12023-07-18T01:48:35ZengKorean Society of Pathologists & the Korean Society for CytopathologyJournal of Pathology and Translational Medicine2383-78372383-78452023-07-0157418919510.4132/jptm.2023.05.2417071A review of liver fibrosis and cirrhosis regressionMichael J. LeeCirrhosis has traditionally been considered an irreversible process of end-stage liver disease. With new treatments for chronic liver disease, there is regression of fibrosis and cirrhosis, improvement in clinical parameters (i.e. liver function and hemodynamic markers, hepatic venous pressure gradient), and survival rates, demonstrating that fibrosis and fibrolysis are a dynamic process moving in two directions. Microscopically, hepatocytes push into thinning fibrous septa with eventual perforation leaving behind delicate periportal spikes in the portal tracts and loss of portal veins. Obliterated portal veins during progressive fibrosis and cirrhosis due to parenchymal extinction, vascular remodeling and thrombosis often leave behind a bile duct and hepatic artery within the portal tract. Traditional staging classification systems focused on a linear, progressive process; however, the Beijing classification system incorporates both the bidirectional nature for the progression and regression of fibrosis. However, even with regression, vascular lesions/remodeling, parenchymal extinction and a cumulative mutational burden place patients at an increased risk for developing hepatocellular carcinoma and should continue to undergo active clinical surveillance. It is more appropriate to consider cirrhosis as another stage in the evolution of chronic liver disease as a bidirectional process rather than an end-stage, irreversible state.http://jpatholtm.org/upload/pdf/jptm-2023-05-24.pdflivercirrhosisfibrosis |
| spellingShingle | Michael J. Lee A review of liver fibrosis and cirrhosis regression Journal of Pathology and Translational Medicine liver cirrhosis fibrosis |
| title | A review of liver fibrosis and cirrhosis regression |
| title_full | A review of liver fibrosis and cirrhosis regression |
| title_fullStr | A review of liver fibrosis and cirrhosis regression |
| title_full_unstemmed | A review of liver fibrosis and cirrhosis regression |
| title_short | A review of liver fibrosis and cirrhosis regression |
| title_sort | review of liver fibrosis and cirrhosis regression |
| topic | liver cirrhosis fibrosis |
| url | http://jpatholtm.org/upload/pdf/jptm-2023-05-24.pdf |
| work_keys_str_mv | AT michaeljlee areviewofliverfibrosisandcirrhosisregression AT michaeljlee reviewofliverfibrosisandcirrhosisregression |