A 50-year-old alcoholic man develops ascites, jaundice, and spider angiomata. Liver biopsy shows bridging fibrosis, regenerative nodules surrounded by fibrous septa, and loss of normal hepatic architecture. Which cell type is primarily responsible for fibrogenesis in the liver?
- A Kupffer cells
- B Hepatocytes
- C Hepatic stellate cells (Ito cells) ✓
- D Portal fibroblasts exclusively
Correct answer: C. Hepatic stellate cells (Ito cells)
Explanation
Hepatic stellate cells (HSCs), also known as Ito cells or perisinusoidal cells, are the principal effectors of hepatic fibrosis. Upon liver injury, HSCs are activated by TGF-β1 (from Kupffer cells and injured hepatocytes), transdifferentiate into myofibroblasts, and synthesize type I and III collagen. This activation is the central event in progression from steatosis/hepatitis to cirrhosis. Kupffer cells orchestrate inflammation and HSC activation but are not the primary fibrosis producers.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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