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By Julia Mayerle, Herbert Tilg

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Additional info for Clinical Update on Inflammatory Disorders of the Gastrointestinal Tract (Frontiers of Gastrointestinal Research, Vol. 26)

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Am J Physiol Gastrointest Liver Physiol 2004;287:G1175–G1181. 78 Silverstein MD, Loftus EV, Sandborn WJ, Tremaine WJ, Feagan BG, Nietert PJ, Harmsen WS, Zinsmeister AR: Clinical course and costs of care for Crohn’s disease: Markov model analysis of a population-based cohort. Gastroenterology 1999; 117:49–57. 79 Louis E, Collard A, Oger AF, Degroote E, Aboul Nasr El Yafi FA, Belaiche J: Behaviour of Crohn’s disease according to the Vienna classification: changing pattern over the course of the disease.

Indeed, fibrotic deposition related to recent disease and characterized by the presence of thin reticulin fibres, often in the presence of a diffuse inflammatory infiltrate, is likely fully reversible, whereas long-standing fibrosis – indicated by extensive collagen cross-linking by tissue transglutaminase, presence of elastin, dense acellular/paucicellular ECM and decreased expression and/or activity of specific metalloproteinases – is not [66–68]. Because advanced fibrosis is often hypocellular, it has been suggested that incomplete ECM degradation (irreversible fibrosis) develops when the appropriate cellular mediators (the source of MMPs) are no longer present [68].

89 Pinzani M, Rombouts K, Colagrande S: Fibrosis in chronic liver diseases: diagnosis and management. J Hepatol 2005;42 (suppl 1):S22–S36. 90 Iredale JP, Benyon RC, Pickering J, McCullen M, Northrop M, Pawley S, et al: Mechanisms of spontaneous resolution of rat liver fibrosis: hepatic stellate cell apoptosis and reduced hepatic expression of metalloproteinase inhibitors. J Clin Invest 1998;102: 538–549. 91 Wright MC, Issa R, Smart DE, Trim N, Murray GI, Primrose JN, et al: Gliotoxin stimulates the apoptosis of human and rat hepatic stellate cells and enhances the resolution of liver fibrosis in rats.

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