Liver fibrosis is the extreme accumulation of extracellular matrix protein such as collagen that that occurs in major types of chronic liver disease. Normally the advanced liver fibrosis that results in liver failure, inflamed liver, cirrhosis and portal hypertension and required liver transplantation. Portal fibroblasts, hepatic stellate cells and myofibroblasts have been identified as the main collagen producing cell in the inflamed liver. These cells are normally activated by the fibrogenic cytokines including angiotensin II, TGF-beta1, and leptin. The Reversibility of the advanced liver fibrosis has been recently recognized. Emerging antifibrotic therapies can inhibits the accumulation of fibrogenic cells and also prevent the deposition of the extracellular matrix proteins. However many therapeutic interventions are so much effective in the experimental models of the liver fibrosis but their safety and the efficiency are still unknown.
What is liver fibrosis?
Liver fibrosis is the excessive accumulation of scar tissue which results from ongoing inflamed liver and liver cell death that may occur in most of the types of chronic liver disease. The abnormal spherical areas of the cells from as dying cells are normally replaced by the regenerating cells. Regenerating cells usually causes the liver to become harder. The fibrosis is referred to the accumulation of tough.
Fibrosis of the liver
Any chronic or severe attack into the liver will cause inflammation that then leads to the generation of fibrous scar tissue on the liver and creating hepatic fibrosis. Fibrosis of the liver is therefore a scarring process, which will replace damaged hepatic cells. The extent of this fibrosis can vary and this process can described in several stages. Usually a normal liver is at a stage between F0 and F1. Then stage F2 denotes light fibrosis and the F3 is chronic or severe fibrosis. Liver cirrhosis is defined from the stage F4.
Fibrosis of the liver therefore disorganizes the architecture of the liver both functionally and anatomically. When fibrosis of the liver reaches into cirrhosis stage, then it is initially completely asymptomatic and this is the compensated stage of cirrhosis. It can be discovered fortuitously during the scheduled examination. The liver cirrhosis is then decompensates.
Which is secondary to liver fibrosis and this impedes venous normally circulation and causes the pressure into portal vain to rise.
This is the formation of liquid effusion into the abdominal cavity that can become infected.
Primitive cancer of the liver that is a final complication and it is also called hepatocellular carcinoma.
Liver fibrosis and chronic liver disease
Liver fibrosis is a scarring procedure that initiated in response to the chronic liver disease. Chronic liver disease may causes due to repeated and contentious liver inflammation. The major causes of chronic liver disease are viral hepatitis C and hepatitis B. Non-alcoholic fatty liver disease and alcoholic cirrhosis also causes chronic liver disease. The early symptoms of chronic liver disease are depended on the types of underlying daises. Weakness, jaundice and inflamed liver are major symptoms.
Causes of liver fibrosis
Chronic viral hepatitis B and hepatitis C are one of the most common causes of liver fibrosis. Liver fibrosis is a part of inflammation activities during the chronic viral hepatitis course. In the liver fibrosis stage, there is no lobular regeneration and distinguishes it from inflamed liver. When the liver fibrosis is advances to cause fibrotic separations between the portal areas and center vain liver fibrosis enter the final stage.
It is one of the major causes of liver fibrosis. Chronic hepatitis C infection may cause liver cirrhosis, liver cancer, liver failure and inflamed liver. Anti-viral therapies and vaccine are normally use as a treatment of hepatitis C.
NAFLD and NASH
NAFLD means non-alcoholic fatty liver disease. NAFLD normally refers to wide range of various stage of chronic liver disease that are usually associated with the obesity, steatosis or accumulation of fat by the liver, NASH or nonalcoholic steatohepatitis to liver fibrosis. Recent studies suggest that the nonalcoholic steatohepatitis results in liver fibrosis up to forty percent of patient.
Liver fibrosis stages
S0 means there is no liver fibrosis. S1 is a mild liver fibrosis that only seen at the portal area. On other hand S2 is the moderate stage of the liver fibrosis, between the portal areas without destruction of the lobular structure. Stage three or S3 means the severe liver fibrosis. In this stage there is fibrotic bridging between the portal and the center vain.
Different between liver fibrosis and cirrhosis
Cirrhosis is normally developed from the fibrosis. Although the cirrhosis and liver fibrosis are different they are closely related with each others. They are normally two distinguished pathological conditions. In fibrosis stages the amount of the collagen increase and ratio of the fibro connective tissue VS liver cellular tissue increase. In this stage the liver lobular structure are keep intact. Normally cirrhosis is consists of two pathological features including fibro-connective tissue hypertrophy and second is pseudo-lobule formation. In the stages of cirrhosis the liver primary structure is deformed.
Diagnosis of liver fibrosis
Right now the liver biopsy is one of the most common and accurate way to diagnose the liver fibrosis. Sometime some blood chemical measurements also can provide a important diagnostic marker for liver fibrosis. On the other hand chemical markers that can also be used to assess the liver fibrosis activity such as Laminin or LN, hyaluronic acid or HA, collagen IV and procollagen type III etc. they can also show thw activity of the liver fibrosis.
Liver fibrosis treatment
Vitamin D related ligands like calcitriol can put the break of fibrosis. This technique fist discover by evans lab. The Salk scientists first proposed that clinical trials of vitamin D are analog of the liver fibrosis. The synthetic vitamin D analog are better than the natural vitamin D. First the natural vitamin D that is found in little amount in some foods and also produces into body by the exposure to sunlight. Secondly excessive natural D may cause hypercalcemia or the excess calcium into the blood can lead to vomiting and nausea.