Pathogenesis of liver fibrosis: role of oxidative stress

Mol Aspects Med. 2000 Jun;21(3):49-98. doi: 10.1016/s0098-2997(00)00004-2.


In the liver, the progressive accumulation of connective tissue, a complex and dynamic process termed fibrosis, represents a very frequent event following a repeated or chronic insult of sufficient intensity to trigger a "wound healing"-like reaction. The fibrotic process recognises the involvement of various cells and different factors in bringing about an excessive fibrogenesis with disruption of intercellular contacts and interactions and of extracellular matrix composition. However, Kupffer cells, together with recruited mononuclear cells, and hepatic stellate cells are by far the key-players in liver fibrosis. Their cross-talk is triggered and favoured by a series of chemical mediators, with a prominent role played by the transforming growth factor beta. Both expression and synthesis of this inflammatory and pro-fibrogenic cytokine are mainly modulated through redox-sensitive reactions. Further, involvement of reactive oxygen species and lipid peroxidation products can be clearly demonstrated in other fundamental events of hepatic fibrogenesis, like activation and effects of stellate cells, expression of metalloproteinases and of their specific inhibitors. The important outcome of such findings as regards the pathogenesis of liver fibrosis derives from the observation of a consistent and marked oxidative stress condition in many if not all chronic disease processes affecting hepatic tissue. Hence, reactive oxidant species likely contribute to both onset and progression of fibrosis as induced by alcohol, viruses, iron or copper overload, cholestasis, hepatic blood congestion.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Extracellular Matrix / metabolism
  • Extracellular Matrix / pathology
  • Gene Expression Regulation
  • Liver / metabolism*
  • Liver / pathology*
  • Liver / physiopathology
  • Liver / virology
  • Liver Cirrhosis / etiology
  • Liver Cirrhosis / metabolism*
  • Liver Cirrhosis / pathology*
  • Liver Cirrhosis / virology
  • Oxidation-Reduction
  • Oxidative Stress*
  • Reactive Oxygen Species / metabolism
  • Transforming Growth Factor beta / metabolism


  • Reactive Oxygen Species
  • Transforming Growth Factor beta