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Liver inflammation and fibrosis
Yukinori Koyama, David A. Brenner
Yukinori Koyama, David A. Brenner
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Review Series

Liver inflammation and fibrosis

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Abstract

Chronic liver inflammation leads to fibrosis and cirrhosis, which is the 12th leading cause of death in the United States. Hepatocyte steatosis is a component of metabolic syndrome and insulin resistance. Hepatic steatosis may be benign or progress to hepatocyte injury and the initiation of inflammation, which activates immune cells. While Kupffer cells are the resident macrophage in the liver, inflammatory cells such as infiltrating macrophages, T lymphocytes, neutrophils, and DCs all contribute to liver inflammation. The inflammatory cells activate hepatic stellate cells, which are the major source of myofibroblasts in the liver. Here we review the initiation of inflammation in the liver, the liver inflammatory cells, and their crosstalk with myofibroblasts.

Authors

Yukinori Koyama, David A. Brenner

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Figure 1

An overview of lipid metabolism in hepatocytes.

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An overview of lipid metabolism in hepatocytes.
Hepatocytes become steat...
Hepatocytes become steatotic as a result of increased de novo lipogenesis, decreased β oxidation, and decreased VLDL secretion. Free fatty acids (FFAs) such as palmitate can induce the formation of both ceramide and lysophosphatidylcholine (LPC). LPC can activate proapoptotic signaling and lead to extracellular vesicle (EV) release. Palmitate-derived ceramide also induce EV release. HMGB1 and IL-33 are alarmins that are released from hepatocytes in the pathogenesis of chronic liver diseases, including nonalcoholic fatty liver disease. PPAR stimulation facilitates oxidation of lipids by upregulating acyl-CoA-oxidase and MCAD. Thus, PPARs are possible therapeutic targets in nonalcoholic steatohepatitis. FXR signaling facilitates secretion of bile acids and decreases hepatic lipid synthesis and enhances peripheral clearance of VLDL. AOX, acyl-CoA oxidase.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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