La fibrosi epatica: aggiornamenti su fisiopatologia, diagnosi e prognosi

Hepatic fibrosis: update on pathophysiology, diagnosis and prognosis. Hepatic fibrosis, char- acterized by the excessive accumulation of connective tissue within the liver parenchyma, represents a critical pathological milestone in the progression of various chronic liver diseases. Over the past twenty years, this field of research has wit- nessed remarkable growth, fuelled by the increasing recognition of hepatic fibrosis as a central determinant of liver disease progres- sion. The investigation of the pathophysiological mechanisms underlying the deposition of connective tissue within the liver induced by chronic injury, its quantification in vivo, and the development of therapies aimed at slowing, halting, or even reversing this process have increasingly assumed a pivotal role. This prominence stems from the established correlation between the severity of hepatic fibrosis and the development of liver cirrhosis and its associated complications. Collagen deposition in chronic liver diseases involves diverse hepatic and extrahepatic cell populations and various mediators. Depending on the pathogenic insult, distinct morphological patterns in extracellular matrix deposition can be discerned. Nevertheless, the common outcome of all chronic liver diseases with sustained injury is the development of liver cirrhosis. This review delves into the multifaceted aspects of hepatic fibrosis, encompass- ing its pathophysiology, the influence of diverse aetiologies, the invasive and non-invasive quantification methods, and the prognostic implications associated with varying stages of fibrosis.