He YH, Pan JX, Xu LM, Gu T, Chen YW. Ductular reaction in non-alcoholic fatty liver disease: When Macbeth is perverted. World J Hepatol 2023; 15(6): 725-740 [PMID: 37397935 DOI: 10.4254/wjh.v15.i6.725]
Corresponding Author of This Article
Yuan-Wen Chen, MD, PhD, Chief Physician, Director, Department of Gastroenterology and Department of Geriatrics, Huadong Hospital Affiliated to Fudan University, No. 221 West Yan’an Road, Shanghai 200040, China. chenywhdgi@fudan.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yang-Huan He, Yuan-Wen Chen, Department of Gastroenterology and Department of Geriatrics, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
Jia-Xing Pan, Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
Lei-Ming Xu, Department of Gastroenterology, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200092, China
Ting Gu, Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
Author contributions: Chen YW conceived the Review; He YH and Pan JX wrote the first draft of the manuscript and prepared the figures; He YH, Pan JX, Xu LM, and Gu T collected the data for the article; all authors made substantial contributions to the discussion of data.
Supported bythe National Natural Science Foundation of China, No. 81970511&82270620.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Wen Chen, MD, PhD, Chief Physician, Director, Department of Gastroenterology and Department of Geriatrics, Huadong Hospital Affiliated to Fudan University, No. 221 West Yan’an Road, Shanghai 200040, China. chenywhdgi@fudan.edu.cn
Received: February 27, 2023 Peer-review started: February 27, 2023 First decision: March 28, 2023 Revised: April 3, 2023 Accepted: April 24, 2023 Article in press: April 24, 2023 Published online: June 27, 2023 Processing time: 118 Days and 8.8 Hours
Abstract
Non-alcoholic fatty liver disease (NAFLD) or metabolic (dysfunction)-associated fatty liver disease is the leading cause of chronic liver diseases defined as a disease spectrum comprising hepatic steatosis, non-alcoholic steatohepatitis (NASH), liver fibrosis, cirrhosis, and hepatic carcinoma. NASH, characterized by hepatocyte injury, steatosis, inflammation, and fibrosis, is associated with NAFLD prognosis. Ductular reaction (DR) is a common compensatory reaction associated with liver injury, which involves the hepatic progenitor cells (HPCs), hepatic stellate cells, myofibroblasts, inflammatory cells (such as macrophages), and their secreted substances. Recently, several studies have shown that the extent of DR parallels the stage of NASH and fibrosis. This review summarizes previous research on the correlation between DR and NASH, the potential interplay mechanism driving HPC differentiation, and NASH progression.
Core Tip: This is the first review focusing on recent advances in the relationship of hepatic cells with ductular reaction (DR), in fatty liver-related steatohepatitis and fibrosis. Recent advances in DR, a common compensatory reaction in liver injury, shed light on the effects of hepatic progenitor cells, hepatic stellate cells, myofibroblasts, inflammatory cells, and their secreted substance. In particular, hepatic progenitor cell differentiation was thoroughly discussed in developing steatohepatitis and fibrosis. This review summarizes the correlation between DR and steatohepatitis and fibrosis, the advanced stages of non-alcoholic fatty liver disease, or metabolic (dysfunction) related fatty liver disease.
