Exploring hepatic stellate cell-driven fibrosis: therapeutic advances and future perspectives

Background and purpose: Liver fibrosis, a progressive liver disease arising from viral or metabolic causes, poses a major global health challenge due to its potential progression to cirrhosis and hepatocellular carcinoma. Due to the complex aetiology and epidemiology of liver fibrosis, most therapi...

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Main Authors: Alka Singh, Ansab Akhtar, Prashant Shukla
Format: Article
Language:English
Published: International Association of Physical Chemists (IAPC) 2025-08-01
Series:ADMET and DMPK
Subjects:
Online Access:https://pub.iapchem.org/ojs/index.php/admet/article/view/2874
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author Alka Singh
Ansab Akhtar
Prashant Shukla
author_facet Alka Singh
Ansab Akhtar
Prashant Shukla
author_sort Alka Singh
collection DOAJ
description Background and purpose: Liver fibrosis, a progressive liver disease arising from viral or metabolic causes, poses a major global health challenge due to its potential progression to cirrhosis and hepatocellular carcinoma. Due to the complex aetiology and epidemiology of liver fibrosis, most therapies fail in the clinic, and very few drugs have been approved by the US FDA. Approach: This review highlights the patho­physiological features of liver fibrosis, with a focus on novel targets in hepatic stellate cells (HSCs), key players in the fibrogenesis process, to develop successful therapeutic approaches using both pharma­cological agents and active targeting strategies. The review also examines current therapeutic strategies targeting liver fibrosis, both in preclinical lab setups and clinical trials. Furthermore, various receptors involved in HSC-mediated liver fibrosis and active drug delivery targeting strategies are reviewed to enhance therapeutic outcomes. This article also integrates existing knowledge to identify research gaps and guide future investigations and clinical translation in liver fibrosis treatment. In addition, novel pathways pertaining to liver fibrosis, such as the RSPO3-LGR4/5-β-catenin cascade, the CD47/YAP/TEAD4 signalling axis, and HAb18G/CD147, are briefly elaborated in the context of therapeutic approaches for arresting HSC activation. Single-cell RNA sequencing of HSCs is presented to provide a clearer picture of liver fibrosis. Conclusion: The review highlights critical research gaps in liver fibrosis therapy and promising active tar­geting strategies and pharmacological interventions to improve therapeutic outcomes. Overall, this review provides a robust foundation for scientists and clinicians to advance active targeting of the disease pathology and to develop new pharmaceutical formulations that are pharmacologically safer and more efficacious.
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spelling doaj-art-5ae7d601faa945a6a564132cfccaccc12025-08-20T04:01:01ZengInternational Association of Physical Chemists (IAPC)ADMET and DMPK1848-77182025-08-0113410.5599/admet.2874Exploring hepatic stellate cell-driven fibrosis: therapeutic advances and future perspectivesAlka Singh0https://orcid.org/0009-0005-8145-7794Ansab Akhtar1https://orcid.org/0000-0002-4839-4454Prashant Shukla2https://orcid.org/0000-0003-1286-4183Department of Pharmaceutical Sciences, School of Health Sciences and Technology, UPES, Dehradun, IndiaLouisiana State University, Health Sciences Center, New Orleans, United StatesDepartment of Pharmaceutical Sciences, School of Health Sciences and Technology, UPES, Dehradun, India Background and purpose: Liver fibrosis, a progressive liver disease arising from viral or metabolic causes, poses a major global health challenge due to its potential progression to cirrhosis and hepatocellular carcinoma. Due to the complex aetiology and epidemiology of liver fibrosis, most therapies fail in the clinic, and very few drugs have been approved by the US FDA. Approach: This review highlights the patho­physiological features of liver fibrosis, with a focus on novel targets in hepatic stellate cells (HSCs), key players in the fibrogenesis process, to develop successful therapeutic approaches using both pharma­cological agents and active targeting strategies. The review also examines current therapeutic strategies targeting liver fibrosis, both in preclinical lab setups and clinical trials. Furthermore, various receptors involved in HSC-mediated liver fibrosis and active drug delivery targeting strategies are reviewed to enhance therapeutic outcomes. This article also integrates existing knowledge to identify research gaps and guide future investigations and clinical translation in liver fibrosis treatment. In addition, novel pathways pertaining to liver fibrosis, such as the RSPO3-LGR4/5-β-catenin cascade, the CD47/YAP/TEAD4 signalling axis, and HAb18G/CD147, are briefly elaborated in the context of therapeutic approaches for arresting HSC activation. Single-cell RNA sequencing of HSCs is presented to provide a clearer picture of liver fibrosis. Conclusion: The review highlights critical research gaps in liver fibrosis therapy and promising active tar­geting strategies and pharmacological interventions to improve therapeutic outcomes. Overall, this review provides a robust foundation for scientists and clinicians to advance active targeting of the disease pathology and to develop new pharmaceutical formulations that are pharmacologically safer and more efficacious. https://pub.iapchem.org/ojs/index.php/admet/article/view/2874Retinoid receptorsnon-alcoholic fatty liver diseaseresmetiromliposomesactive targetingclinical trials
spellingShingle Alka Singh
Ansab Akhtar
Prashant Shukla
Exploring hepatic stellate cell-driven fibrosis: therapeutic advances and future perspectives
ADMET and DMPK
Retinoid receptors
non-alcoholic fatty liver disease
resmetirom
liposomes
active targeting
clinical trials
title Exploring hepatic stellate cell-driven fibrosis: therapeutic advances and future perspectives
title_full Exploring hepatic stellate cell-driven fibrosis: therapeutic advances and future perspectives
title_fullStr Exploring hepatic stellate cell-driven fibrosis: therapeutic advances and future perspectives
title_full_unstemmed Exploring hepatic stellate cell-driven fibrosis: therapeutic advances and future perspectives
title_short Exploring hepatic stellate cell-driven fibrosis: therapeutic advances and future perspectives
title_sort exploring hepatic stellate cell driven fibrosis therapeutic advances and future perspectives
topic Retinoid receptors
non-alcoholic fatty liver disease
resmetirom
liposomes
active targeting
clinical trials
url https://pub.iapchem.org/ojs/index.php/admet/article/view/2874
work_keys_str_mv AT alkasingh exploringhepaticstellatecelldrivenfibrosistherapeuticadvancesandfutureperspectives
AT ansabakhtar exploringhepaticstellatecelldrivenfibrosistherapeuticadvancesandfutureperspectives
AT prashantshukla exploringhepaticstellatecelldrivenfibrosistherapeuticadvancesandfutureperspectives