Exploration of Drug Targets for Liver Fibrosis Based on Hepatic Stellate Cells and Extracellular Matrix Remodeling

A Special Issue of Biomolecules (ISSN 2218-273X) belonging to the section "Molecular Medicine".

Deadline for manuscript submissions: 28 February 2027 | Viewed by 1732

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Department of Pharmacology, University of Valencia, avda. Blasco Ibañez n.15, 46010 Valencia, Spain
Interests: antiretroviral therapy; hepatic diseases; liver fibrosis; mitochondria; autophagy; mitochondrial dysfunction and its role in pathogenesis; cellular mechanisms involved in the toxicity of antiretroviral drugs and HIV, with special focus on mitochondrial function; endoplasmic reticular stress and activation of survival programs (autophagy) and cellular death (apoptosis)
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Dear Colleagues,

Liver fibrosis (LF) is a pathological wound-healing response manifested through the excessive buildup of extracellular matrix (ECM) in the liver as a result of prolonged inflammation and injury. It is the common denominator of most types of chronic liver disease caused by different etiologies (alcohol consumption, viral hepatitis, and steatosis related to metabolic dysfunction being the most common). If it progresses, LF can lead to severe, irreversible damage called cirrhosis, causing liver failure, portal hypertension with its complications (ascites, jaundice, and bleeding), and the development of HCC (hepatocellular carcinoma). Activation of hepatic stellate cells (HSCs) into a myofibroblast phenotype represents a key event in LF, as these cells are the primary source of ECM. Of note, although improved management of the underlying diseases can halt progression and, to an extent, even reverse LF, there are currently no specific approved antifibrotic therapies. Recent research has focused on HSCs and, specifically, ECM remodeling as therapeutic targets.

Prof. Dr. Nadezda Apostolova
Guest Editor

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Keywords

  • liver fibrosis
  • collagen
  • hepatic stellate cells
  • senescence
  • animal models
  • extracellular matrix
  • hepatitis
  • cytokines
  • biomarkers
  • MASH
  • MASLD
  • cirrhosis
  • hepatocellular carcinoma

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Published Papers (2 papers)

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Review

28 pages, 3641 KB  
Review
Therapeutic Targets for Hepatic Fibrosis Driven by Hypoxia-Mediated Hepatic Stellate Cell Activation
by Wenteng Li, Tong Li and Jingwei Mao
Biomolecules 2026, 16(8), 1089; https://doi.org/10.3390/biom16081089 - 25 Jul 2026
Viewed by 547
Abstract
Hepatic fibrosis is a pathological process involving the systemic reconfiguration of the liver microenvironment under chronic liver injury. It is a pathological wound healing response characterized by the excessive deposition of extracellular matrix (ECM) driven by the activation of hepatic stellate cells (HSCs), [...] Read more.
Hepatic fibrosis is a pathological process involving the systemic reconfiguration of the liver microenvironment under chronic liver injury. It is a pathological wound healing response characterized by the excessive deposition of extracellular matrix (ECM) driven by the activation of hepatic stellate cells (HSCs), starting with the capillarization of liver sinusoidal endothelial cells (LSECs). This process can lead to liver structure destruction, portal hypertension, and even liver dysfunction, and is a major driving factor for death related to liver diseases. During this process, hypoxia initiates the transcriptional upregulation of effector molecules such as vascular endothelial growth factor (VEGF) and Lysyl oxidase (LOX) by stabilizing hypoxia-inducible factors (HIFs), inducing changes in LSEC phenotype and activation of HSCs, thus becoming a core driving factor. Activated HSCs not only exacerbate the capillarization of LSECs and tissue hypoxia but also strengthen the transcriptional activity of HIFs through autocrine/paracrine signaling, establishing a positive feedback loop linking hypoxia to HIFs and HSC activation, continuously driving the progression of liver fibrosis and significantly increasing the probability of chronic liver diseases evolving into cirrhosis and the risk of death. This review will analyze the mechanism of liver fibrosis driven by hypoxia, integrate the current treatment landscape, focus on exploring the therapeutic targets related to hypoxia-induced activation of hepatic stellate cells leading to liver fibrosis, and evaluate their translational potential. It is expected to provide information for future effective anti-fibrotic intervention strategies. Full article
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24 pages, 1799 KB  
Review
The Matrix Reloaded: The Hepatic Matrisome as a Therapeutic Opportunity to Fight Liver Fibrosis
by Cristina Benavides, Pepa Kecheva, Fernando Solano, Olga Martínez-Arroyo, Juan V. Esplugues, Ana Blas-García and Nadezda Apostolova
Biomolecules 2026, 16(6), 884; https://doi.org/10.3390/biom16060884 - 16 Jun 2026
Viewed by 746
Abstract
Liver fibrosis is the excessive accumulation of extracellular matrix (ECM) that occurs in most types of chronic liver diseases (CLDs) as a response to sustained liver injury. While the ECM comprises different proteins, collagen being the most abundant, the term matrisome refers to [...] Read more.
Liver fibrosis is the excessive accumulation of extracellular matrix (ECM) that occurs in most types of chronic liver diseases (CLDs) as a response to sustained liver injury. While the ECM comprises different proteins, collagen being the most abundant, the term matrisome refers to a plethora of ECM-related molecules, including collagen-associated proteins, growth factors, cytokines, enzymes and their endogenous inhibitors. The hepatic matrisome undergoes significant qualitative and quantitative changes during liver fibrosis. Despite intense research over recent years, our understanding of the matrisome in the liver—both in health and disease—and particularly of its function beyond its conventional structural role, remains poor. This review highlights how comprehending hepatic matrisome responses to liver injury can yield novel insights into disease progression and regression and could be exploited as a potential antifibrotic strategy. The antifibrotic potency of drugs that interfere with the matrisome at different levels has been demonstrated in preclinical studies, but translation to clinical trials remains still limited. So far, simtuzumab (LOXL2 inhibitor antibody), imatinib (small-molecule inhibitor against discoidin domain receptors—DDRs), bexotegrast (integrin inhibitor), GR-MD-02 (galectin 3 inhibitor), and BMS-986263 (siRNA-targeting HSP47) have been or are being evaluated in clinical trials related to CLD, and some of them have shown promising results. Full article
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