Antifibrotic therapy in chronic liver disease Don C. Rockey  Clinical Gastroenterology and Hepatology  Volume 3, Issue 2, Pages 95-107 (February 2005) DOI: 10.1016/S1542-3565(04)00445-8 Copyright © 2005 American Gastroenterological Association Terms and Conditions

Figure 1 Stellate cell activation. The current consensus is that the key pathogenic feature underlying liver fibrosis and cirrhosis is activation of hepatic stellate cells. This process is complex, both in terms of the events that induce activation and the effects of activation. Multiple and varied stimuli participate in the induction and maintenance of activation, including, but not limited to, cytokines, peptides, and the extracellular matrix itself. Key phenotypic features of activation include production of extracellular matrix (ECM), loss of retinoids, proliferation, up-regulation of smooth muscle proteins, secretion of peptides and cytokines (which have autocrine effects), and up-regulation of various cytokine and peptide receptors. Clinical Gastroenterology and Hepatology 2005 3, 95-107DOI: (10.1016/S1542-3565(04)00445-8) Copyright © 2005 American Gastroenterological Association Terms and Conditions