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Fibrogenese – Zirrhose

Fibrogenic cirrhosis

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Zusammenfassung

Die Leberfibrose ist definiert als exzessive Ablagerung von extrazellulärer Matrix. Sie ist die Hauptkomplikation einer chronischen Leberschädigung. Ihr Endstadium, die Leberzirrhose, ist mit hoher Morbidität und Mortalität vergesellschaftet. Für die Akkumulation von extrazellulärer Matrix sind unterschiedliche Zelltypen verantwortlich, die einen myofibroblastenähnlichen Phänotyp annehmen: im Disse-Raum lokalisierte hepatische Sternzellen, portale Fibroblasten und Myofibroblasten aus den periportalen und perizentralen Gebieten, möglicherweise auch Myofibroblasten aus dem Knochenmark. Unterschiede zwischen den Zelltypen hinsichtlich myofibroblastischer Differenzierung, Aktivierung und „Deaktivierung“ wurden zwar beschrieben, doch sind weitere Daten erforderlich insbesondere im Hinblick auf biologische und biochemische Charakterisierung, Interaktionen mit inflammatorischen Zellen und Zytokinzusammensetzung, die zu ihrer Aktivierung oder ihrem Zelltod führt.

Abstract

Liver fibrosis is defined as an excessive deposition of extracellular matrix. It is the main complication in chronic liver damage and its endpoint, liver cirrhosis, is responsible for impressive morbidity and mortality. The accumulation of extracellular matrix proteins in liver fibrosis and cirrhosis is due to different cell types which acquire a myofibroblastic phenotype – the hepatic stellate cells, located in the space of Disse, portal fibroblasts as well as myofibroblasts of the portal and pericentral area and bone marrow derived myofibroblasts. Differences have been reported between the two cell populations with respect to myofibroblastic differentiation, activation and “deactivation”, proliferation and apoptosis. However, in most cases additional confirmation may be required. Thus, the biological and biochemical characterization of these cells, their interactions with inflammatory cells and the cytokine environment leading to their activation or cell death are essential to understand the mechanisms underlying the progressive development of excessive scarring in the liver as well as the ability of the liver to repair tissue and regenerate.

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Danksagung

Diese Arbeit wurde unterstützt von der Deutschen Forschungsgemeinschaft (SFB 402, Projekt C6) und vom Kompetenznetz Hepatitis (Projekt 11.2).

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  1. Klinik für Innere Medizin, Abteilung für Gastroenterologie und Endokrinologie, Georg-August-Universität Göttingen, Robert- Koch- Straße 40, 37075, Göttingen, Deutschland

    B. Saile &  G. Ramadori

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  1. B. Saile
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  2. G. Ramadori
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Correspondence to G. Ramadori.

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Saile, B., Ramadori, G. Fibrogenese – Zirrhose. Gastroenterologe 2, 228–237 (2007). https://doi.org/10.1007/s11377-007-0092-7

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