Hepatic Fibrosis -- Role of Hepatic Stellate Cell Activation

Scott L. Friedman, MD

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In This Article

Future Prospects

Continued progress can be anticipated in the molecular regulation of fibrosis and its treatment. Rapid advances in gene therapy, tissue-specific targeting, and high-throughput small-molecule screening of cytokine inhibitors are likely to benefit diagnosis and therapy of hepatic fibrosis. Methods have been developed for stellate cell-specific targeting in animal models,[95] which could lead to successful targeting to minimize toxicity of antifibrotics and for use as novel diagnostics. New insights into regulation of growth and apoptosis may have direct implications for stellate cell behavior in liver injury. Sequencing of the human genome and use of microarrays may yield genetic polymorphisms that predict the rate of fibrosis prospectively, as well as patterns of multigene expression that have clinical or therapeutic implications. Additionally there is tremendous interest in herbal and natural antifibrotic remedies, particularly in the Far East, where many such compounds are undergoing clinical trials. Future therapies may emerge from these latter efforts as well.

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