【摘要】 慢性乙型肝炎(CHB)肝纤维化是HBV感染所导致的肝组织损伤和修复过程,严重者发展成肝硬化,目前仍未有特效治疗药物。本文归纳了CHB肝纤维化发生发展过程中涉及的主要机制靶点如肝星状细胞活化、炎症、肠肝轴等,以及与纤维化相关的信号转导通路。靶向这些靶点可能对抗纤维化治疗有一定作用。目前抗HBV治疗联合或序贯中药抗纤维化治疗可使一部分患者的肝纤维化/肝硬化得以延缓甚至逆转,但逆转晚期肝纤维化/肝硬化仍面临很大的挑战,且联合或序贯治疗的时机仍无共识。探索与CHB肝纤维化/肝硬化高度相关的治疗靶标,结合靶向多种纤维化进展途径的化合物的组合疗法将成为未来研究的重点。更多还原

【Abstract】 Chronic hepatitis B(CHB) liver fibrosis is the process of liver tissue damage and repair caused by hepatitis B virus(HBV) infection and may develop into liver cirrhosis in severe cases, and there are still no specific drugs for the treatment of this disease. This article summarizes the main targets involved in the development and progression of CHB liver fibrosis, such as hepatic stellate cell activation, inflammation, and gut-liver axis, as well as the signal transduction pathways associated with fibrosis, and targeting these targets may have a certain anti-fibrogenic effect. At present, anti-HBV therapy combined with or followed by anti-fibrotic therapy can delay or even reverse liver fibrosis/cirrhosis in some patients; however, the reversal of advanced liver fibrosis/cirrhosis still faces great challenges, and there is still no consensus on the timing of combined or sequential therapy. It is believed that identification of therapeutic targets highly associated with CHB liver fibrosis/cirrhosis and combination therapy with compounds targeting multiple pathways associated with liver fibrosis will become the focus of future research.更多还原