Pathogenesis of Liver Fibrosis and Its TCM Therapeutic Perspectives

Abstract

Liver fibrosis is a pathological process of abnormal tissue proliferation in the liver caused by various pathogenic factors, which will further develop into cirrhosis or even hepatocellular carcinoma if liver injury is not intervened in time. As a diffuse progressive liver disease, its clinical manifestations are mostly excessive deposition of collagen-rich extracellular matrix resulting in scar formation due to liver injury. Hepatic fibrosis can be caused by hepatitis B and C, fatty liver, alcohol, and rare diseases such as hemochromatosis. As the metabolic center of the body, the liver regulates various vital activities. During the development of fibrosis, it is influenced by many other factors in addition to the central event of hepatic stellate cell activation. Currently, with the increasing understanding of TCM, the advantages of TCM with multiple components, pathways, and targets have been demonstrated. In this review, we will describe the factors influencing liver fibrosis, focusing on the effects of cells, intestinal flora, iron death, signaling pathways, autophagy and angiogenesis on liver fibrosis, and the therapeutic effects of herbal medicine on liver fibrosis.

Targeted inhibition of autophagy in hepatic stellate cells by hydroxychloroquine: An effective therapeutic approach for the treatment of liver fibrosis

“…The balance of ECM is regulated by matrix metalloproteinases (MMP) and tissue inhibitor of metalloproteinases (TIMP). 3,4 The increase of autophagy can accelerate the metabolism of lipid droplets (LDs) in aHSC, which provides the energy for the activation of HSC and lead to liver fibrosis. [5][6][7] However, the autophagy in different liver cells has completely opposite effects on liver fibrosis.…”

Isorhamnetin Exerts Antifibrotic Effects by Attenuating Platelet-Derived Growth Factor-BB-induced HSC-T6 Cells Activation via Suppressing PI3K-AKT Signaling Pathway

“…It also exerts hepatoprotective effects by inhibiting the autophagy of hepatocytes and increasing apoptosis [ 14 ] . Nan et al [ 15 ] and Yang et al [ 16 ] have reported that isorhamnetin could weaken CCl4-induced hepatic fibrosis by reducing TGF-β mediated Smad signaling. However, it is unclear whether isorhamnetin can reduce hepatic fibrosis in the PDGF-BB-induced HSC-T6.…”

Convergent application of traditional Chinese medicine and gut microbiota in ameliorate of cirrhosis: a data mining and Mendelian randomization study

“…The clinical application of dialectical principles is fundamental to TCM therapy. According to studies, TCM is an effective way to halt cirrhosis progression and improve prognosis (Dong et al, 2015;Nan et al, 2022). TCM treatment of hepatitis B cirrhosis has gradually become a new trend.…”