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Cited by 70Liver physiology and pathologyLiver Disease Diagnosis and TreatmentLiver Disease and Transplantation

Liver Fibrosis Leading to Cirrhosis: Basic Mechanisms and Clinical Perspectives

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Somnay, Kaumudi, Wadgaonkar, Priyanka, Sridhar, Nidhishri, Roshni, Prarath, Rao, Nachiketh, Wadgaonkar, Raj·2024·Biomedicines
DOI 10.3390/biomedicines12102229PMC PMC11505165
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Abstract

Liver fibrosis is the pathological deposition of extracellular matrix rich in fibrillar collagen within the hepatocytes in response to chronic liver injury due to various causes. As the condition advances, it can progress to cirrhosis, the late stages of which are irreversible. Multiple pathophysiological mechanisms and cell types are responsible for the progression of liver fibrosis and cirrhosis. Hepatic stellate cells and myofibroblast activation represent a key event in fibrosis. Capillarization of liver sinusoidal endothelial cells further contributes to extracellular matrix deposition and an increase in portal pressure. Macrophages and neutrophils produce inflammatory cytokines and participate in activating hepatic stellate cells. Although initially believed to be irreversible, early stages of fibrosis are now found to be reversible. Furthermore, advances in noninvasive imaging and serum studies have changed and improved how cirrhosis can be evaluated and monitored. Although there are currently no specific approved therapies to reverse liver fibrosis, management of underlying diseases has been found to halt the progression, and to an extent, even reverse liver fibrosis, preventing further liver injury and cirrhosis-related complications.

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  • Liver transplantation remains the only definitive cure for end-stage liver disease.

    “For patients with end-stage disease, liver transplantation remains the only definitive cure.”

    From From scaffold to function: A systematic review on dLECM-based hydrogels for liver tissue engineering — Fabrication, properties, and translational applications (2026) · cites this paper as [5]

    The Treatment/Management section (2.4; page unavailable) calls liver transplantation the final therapeutic option for patients with decompensated cirrhosis. That supports its role in end-stage disease, but the paper does not say it is the only definitive cure; it describes improved survival after transplantation rather than a cure. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Transplant waiting lists are growing faster than donor availability, and long-term outcomes are complicated by rejection and immunosuppression.

    “Yet, with transplant waiting lists growing faster than donor availability, and long-term outcomes still complicated by rejection and immunosuppression, it's clear we need better alternatives [[3], [4], [5]].”

    From From scaffold to function: A systematic review on dLECM-based hydrogels for liver tissue engineering — Fabrication, properties, and translational applications (2026) · cites this paper as [5]

    The Prognosis section (2.3; page unavailable) discusses prioritizing patients awaiting liver transplantation, and Treatment/Management (2.4; page unavailable) reports generally improved survival after transplantation. Neither addresses whether waiting lists are growing faster than donor availability or whether rejection and immunosuppression complicate long-term outcomes. Searches for donor shortage, rejection, and transplant immunosuppression found no passage establishing those claims. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Authors
Somnay, K., Wadgaonkar, P., Sridhar, N., Roshni, P., Rao, N., & Wadgaonkar, R.
Affiliations
  • NewYork–Presbyterian Hospital (US)
  • Montefiore Medical Center (US)
  • New York Hospital Queens (US)
  • State University of New York (US)
Corresponding author
Somnay, Kaumudi
ORCID
Venue
Biomedicines
Publisher
MDPI AG
Published
2024-09-30
Volume
12
Issue
10
Pages
2229
ISSN
2227-9059 (ISSN-L)
DOI
10.3390/biomedicines12102229
PMC
PMC11505165
OpenAlex
W4402993620
Cited by
70
References
4
Citations by year
2026: 49 · 2025: 21
FWCI
5.05
Type
journal article
Language
en
Open access
Licence
Locations
  • Biomedicines (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Health Sciences › Medicine › Hepatology › Liver physiology and pathology
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
Keywords
liver fibrosis, liver cirrhosis, extracellular matrix deposition, collagen deposition, hepatic stellate cells, myofibroblast activation, liver sinusoidal endothelial cells, capillarization, portal hypertension, macrophages, neutrophils, inflammatory cytokines, fibrosis reversibility, serum fibrosis biomarkers, cirrhosis management, chronic liver injury

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