Liver fibrosis: latest advances in treatment

Liver fibrosis is a self-repair response of the liver, triggered by various chronic liver injuries, and can progress to cirrhosis and liver cancer. Globally, the prevalence of liver fibrosis is continuously increasing, posing a serious threat to public health. The pathophysiological process of liver fibrosis is very complex, involving interactions between multiple cells and cytokines, but the key lies in the excessive deposition of extracellular matrix (ECM) caused by the activation of hepatic stellate cells (HSCs). Currently, apart from liver transplantation, there are no targeted therapeutic methods. However, as understanding deepens continuously and the exploration of the pathophysiology of liver fibrosis has advanced, a series of anti-fibrotic therapies targeting different mechanisms have also made significant progress. Various treatment methods, including stem cells, nano-drug delivery systems (NDDS), natural products, traditional Chinese medicine formulas, and thyroid hormone receptor agonists, have shown significant anti-fibrotic effects by regulating key signaling pathways, inhibiting the stimulation of HSCs, promoting liver self-repair, and modulating immune responses. This review focuses on summarizing these anti-liver fibrosis methods, in-depth analysis of their mechanisms of action, and further discusses the challenges they face in clinical application.