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La fibrosis hepática es un proceso dinámico y regulado que se desencadena en respuesta a la lesión hepatocelular crónica provocada por diversas causas. La fuente principal de ese tejido fibroso son las células mesenquimales estrelladas del hígado (CEH), que se ubican en el espacio perisinusoidal de Disse entre los hepatocitos y las células endoteliales.
En condiciones fisiológicas, las CEH quiescentes desempeñan un papel fundamental al regular la homeostasis de los retinoides y la remodelación de la matriz extracelular (MEC) tanto por medio de su capacidad de sintetizar los componentes de ésta, como por su habilidad para producir diferentes metaloproteinasas degradantes de la MEC y sus inhibidores. Sin embargo, durante la fibrogénesis hepática, las CEH se activan diferenciándose en células parecidas a los miofibroblastos con capacidad proliferativa, fibrogénica y contráctil para desempeñar un papel primordial en la configuración de la fibrosis hepática y en el control del flujo sanguíneo del hígado.
En esta revisión se comentarán la morfología básica y las funciones de las CEH en condiciones normales y durante su activación en la fibrosis.
Hepatic fibrosis is a dynamic and sophisticatedly regulated wound healing response to chronic hepatocellular injury. This fibrotic process results from the accumulation of extracellular matrix (ECM) including collagen, proteoglycan, and adhesive glycoproteins which are principally produced by hepatic stellate cells (HSC), a mesenchymal cell type located between parenchymal cell plates and sinusoidal endothelial cells in the space of Disse.
In physiological conditions, quiescent HSCs play important roles in the regulation of retinoid homeostasis and ECM remodeling by producing ECM components as well as metalloproteases and its inhibitor.
However during hepatic fibrogenesis, HSCs are known to be activated or «transdifferentiated» to myofibroblast-like cells which play a pivotal role in ECM remodeling and hepatic blood flow regulation. Activation of HSC is now well established as the key process involved in the development of hepatic fibrosis.
Both basic morphology and functions of HSCs in normal conditions and its role in pathological fibrosis will be discussed in this review.
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