| Symptoms
& History
Physical
Findings
Stop
& Think
Lab
and X-Ray
Differential
Diagnosis
The
Disease
Treatment
Conclusions
Quiz
& Evaluation |
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Progressive
fibrosis is central to the process of cirrhosis.
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Hepatic
stelate cells (Ito cells), are the principal source of the collagen
in cirrhosis. These little fellows are normally involved with vatimin
A storage and found in the Space of Disse.
-
Stellate
cells transform into myofibroblasts during the inflammatory
process and begin to elaborate collagen.
-
Chronic inflammation leads to
production of TNF, TGF-beta and intelukin-1, all stimulants of collagen
deposition.
-
Cytokine production by Kupffer
cells and endothelial cells add to the stimulus.
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Disruption of extracellular
matrix.
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Direct stimulation of stelate
cells by inflammatory toxins.
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