Progressive fibrosis in nonalcoholic steatohepatitis: association with altered regeneration and a ductular reaction

Michelle M Richardson, Julie R Jonsson, Elizabeth E Powell, Elizabeth M Brunt, Brent A Neuschwander-Tetri, Prithi S Bhathal, John Dixon, Martin D Weltman, Herbert Tilg, Alexander R Moschen, David M Purdie, Anthony J Demetris, Andrew D Clouston

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370 Citations (Scopus)

Abstract

Portal fibrosis and linkage is a key feature of progressive disease in nonalcoholic steatohepatitis (NASH), but not simple steatosis. It is underappreciated and poorly understood. Fatty liver has impaired regeneration that induces a secondary replicative pathway using bipotential, periportal, hepatic progenitor cells (HPCs). We propose that activation of this pathway, with increased cell injury in NASH, also induces a periportal ductular reaction (DR) that could produce a profibrogenic stimulus
Original languageEnglish
Pages (from-to)80 - 90
Number of pages11
JournalGastroenterology
Volume133
Issue number1
Publication statusPublished - 2007

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