Cited by 837Liver physiology and pathologyTGF-β signaling in diseasesLiver Disease Diagnosis and Treatment

TGF-β in Hepatic Stellate Cell Activation and Liver Fibrogenesis—Updated 2019

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Dewidar, Bedair, Meyer, Christoph, Dooley, Steven, Meindl-Beinker, and Nadja·2019·Cells

Abstract

Liver fibrosis is an advanced liver disease condition, which could progress to cirrhosis and hepatocellular carcinoma. To date, there is no direct approved antifibrotic therapy, and current treatment is mainly the removal of the causative factor. Transforming growth factor (TGF)-β is a master profibrogenic cytokine and a promising target to treat fibrosis. However, TGF-β has broad biological functions and its inhibition induces non-desirable side effects, which override therapeutic benefits. Therefore, understanding the pleiotropic effects of TGF-β and its upstream and downstream regulatory mechanisms will help to design better TGF-β based therapeutics. Here, we summarize recent discoveries and milestones on the TGF-β signaling pathway related to liver fibrosis and hepatic stellate cell (HSC) activation, emphasizing research of the last five years. This comprises impact of TGF-β on liver fibrogenesis related biological processes, such as senescence, metabolism, reactive oxygen species generation, epigenetics, circadian rhythm, epithelial mesenchymal transition, and endothelial-mesenchymal transition. We also describe the influence of the microenvironment on the response of HSC to TGF-β. Finally, we discuss new approaches to target the TGF-β pathway, name current clinical trials, and explain promises and drawbacks that deserve to be adequately addressed.

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  • Tregs can paradoxically promote HSC activation through TGF-β-dependent signaling and IL-8 induction, facilitating fibrogenesis.

    “While Tregs secrete anti-inflammatory cytokines like IL-10, IL-35, and TGF-β (Dikiy and Rudensky 2023), they can paradoxically promote HSC activation through TGF-β-dependent signaling pathway and IL-8 induction, thereby facilitating fibrogenesis (Dewidar et al. 2019; Langhans et al. 2013; Zhu et al. 2015).”

    From The double-edged sword of regulatory T cells in MASLD: from inflammation control to fibrosis promotion (2026) · cites this paper as Dewidar et al. 2019

    Section 1.1 states that TGF-β signaling drives HSC activation and fibrogenesis. But the paper does not establish that Tregs cause this activation or induce IL-8; Section 10 instead describes Tregs as mediating an anti-inflammatory effect of TGF-β, distinct from its profibrogenic effects. The claim’s Treg-specific mechanism is therefore unsupported by this source. (LLM, conf=0.85)

    Experimental — accuracy not yet measured
  • TGF-β, despite immunoregulatory functions, is a potent pro-fibrotic cytokine in liver disease; under sustained injury, it promotes HSC activation and transdifferentiation into ECM-producing myofibroblasts.

    “Notably, TGF-β, despite its immunoregulatory functions, is also a potent pro-fibrotic cytokine in liver disease; under conditions of sustained hepatic injury, TGF-β promotes HSC activation and their transdifferentiation into ECM-producing myofibroblasts, thus driving fibrogenic progression (Dewidar et al. 2019; Tsuchida and Friedman 2017).”

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Sorted by citations

Authors
Dewidar, B., Meyer, C., Dooley, S., & Meindl-Beinker, A. N.
Affiliations
  • Tanta University (EG)
  • Heidelberg University (DE)
Corresponding author
Meindl-Beinker, and Nadja
Venue
Cells
Publisher
MDPI AG
Published
2019-11-11
Volume
8
Issue
11
Pages
1419
ISSN
2073-4409 (ISSN-L)
OpenAlex
W2986691533
Cited by
837
References
16
Citations by year
2026: 135 · 2025: 127 · 2024: 143 · 2023: 133 · 2022: 136 · 2021: 118 · 2020: 41 · 2019: 2 · 2018: 2
FWCI
9.74
Type
journal article
Language
en
Open access
Locations
  • Cells (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (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
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › TGF-β signaling in diseases
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
Keywords
TGF-beta signaling, hepatic stellate cell activation, liver fibrosis, fibrogenesis, antifibrotic therapy, cellular senescence, reactive oxygen species, epigenetics, circadian rhythm, epithelial-mesenchymal transition, endothelial-to-mesenchymal transition, tumor microenvironment, TGF-β inhibitors, hepatocellular carcinoma, liver cirrhosis
MeSH terms
Animals, Autophagy, Circadian Rhythm, Disease Susceptibility, Energy Metabolism, Gene Expression Regulation, Humans, Liver Cirrhosis, Signal Transduction, Biomarkers, Transforming Growth Factor beta, Cellular Senescence, Oxidative Stress, Epigenesis, Genetic, Hepatic Stellate Cells, Myofibroblasts, Cellular Microenvironment

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