Targeting the renin–angiotensin system in liver fibrosis

Excerpt

Liver fibrosis is the progressive accumulation of extracellular matrix (ECM) in the liver as a result of a persistent liver injury. If fibrogenesis persists, the accumulation of ECM disrupts the liver architecture leading to cirrhosis, the most advanced stage of liver disease, and portal hypertension, with the subsequent development of complications of cirrhosis. Two important components determine the increased portal pressure, first a structural component, which is mainly the accumulation of ECM that disturbs normal blood flow in the liver, and second, a dynamic component, which is the result of a high intrahepatic contractility and swelling, resulting from the activation of hepatic stellate and liver myofibroblasts and an increased liver inflammation [1]. …