Page 12 - EJMO-9-3

Eurasian Journal of Medicine

and Oncology

REVIEW ARTICLE
Liver fibrosis: Clinical assessment, pathogenesis,

and anti-fibrotic therapy

Xin Liu 1† , Chongmiao Yang 1† , Yanyan Liu 1† , Xiaowen Lin 1 , Wei Su 2 ,
Jian Sun * , and Xiaoguang Zhao *
1
2
1 Zhuhai People’s Hospital (The Affiliated Hospital of Beijing Institute of Technology, Zhuhai Clinical
Medical College of Jinan University), Zhuhai, Guangdong, China
2 Translational Medicine Research Center, Medical Pathology Center, Chongqing University Three
Gorges Hospital, School of Medicine Chongqing University, Chongqing University, Chongqing,
China

Abstract

Liver fibrosis represents a prevalent pathological change that occurs during the
progression of chronic liver disease, which is characterized by excessive reparative
responses following hepatic tissue injury. Advances in diagnostic and imaging
technologies have facilitated a deeper understanding of liver function and
metabolic changes, which are crucial for early and accurate diagnosis of liver fibrosis.
Furthermore, elucidating the signaling pathways involved in liver fibrogenesis
provides valuable insights into its pathogenesis and progression, guiding clinical
† These authors contributed equally
to this work. management and treatment strategies for patients with liver fibrosis. This review
critically evaluates various clinical and experimental therapies aimed at mitigating
*Corresponding authors:
Xiaoguang Zhao or reversing liver fibrosis. Specific targeted nanocarrier drug delivery systems and
(zhaoxiaoguang@ext.jnu.edu.cn) traditional herbal medicines hold promise in enhancing anti-fibrotic efficacy and
Jian Sun inhibiting disease progression.
(sunjian@cqu.edu.cn)
Citation: Liu X, Yang C, Liu Y, et al.
Liver fibrosis: Clinical assessment, Keywords: Liver fibrosis; Hepatic stellate cells; Non-invasive assessment; Anti-fibrotic
pathogenesis, and anti-fibrotic therapy; Traditional Chinese medicine
therapy. Eurasian J Med Oncol.
2025;9(3):4-18.
doi: 10.36922/ejmo.8125
Received: December 22, 2024 1. Introduction
Revised: February 25, 2025
Liver fibrosis is a common pathological repair response to chronic liver injuries and
Accepted: March 6, 2025 serves as the common endpoint in many chronic liver diseases. In recent years, it has
Published Online: March 26, 2025 been increasingly associated with poor prognosis and is likely to be the leading cause
of end-stage liver disease in the future. The activation of hepatic stellate cells (HSCs)
Copyright: © 2025 Author(s).
1,2
This is an Open-Access article is recognized as the most critical event in the pathogenesis of liver fibrosis. HSCs
distributed under the terms of the exist in two distinct morpho-physiological states, which are quiescent and activated.
3
Creative Commons Attribution In the quiescent state, HSCs are located around hepatic sinusoids and store lipid
License, permitting distribution,
and reproduction in any medium, droplets. However, in response to liver injury, they become activated and transform into
provided the original work is myofibroblast-like cells that secrete large amounts of extracellular matrix (ECM). The
4,5
properly cited. proliferation, migration, and contraction of these myofibroblasts, along with excessive
6
Publisher’s Note: AccScience ECM accumulation, further aggravate the fibrotic progression. Kupffer cells, the resident
Publishing remains neutral with monocytes, and macrophages of the liver serve as critical antigen-presenting cells within
regard to jurisdictional claims in 7,8
published maps and institutional the human body. Upon stimulation by external factors, they can engulf antigens
affiliations and form antigen peptide-major histocompatibility complex class II complexes. These
Volume 9 Issue 3 (2025) 4 doi: 10.36922/ejmo.8125