The evolution of cirrhosis

摘要: Fibrosis is part of the innate wound healing response that occurs in injured tissues. Within the liver, fibrosis is characterized by the deposition of extracellular matrix. Current evidence indicates that net deposition of matrix is the result of a balance between synthesis and degradation and constitutes a dynamic process. The progression of fibrosis to cirrhosis has a number of sequelae. First, it will distort hepatic architecture and vasculature; second, it will have a deleterious effect on hepatic function; and third, it will increase the propensity for neoplastic transformation. Therefore, the evolution of fibrosis to cirrhosis represents a change in the morphology, haemodynamics and function of the liver. This chapter will focus on the mechanisms of progression and whether this process is potentially reversible.