Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jun 27, 2023; 15(6): 725-740
Published online Jun 27, 2023. doi: 10.4254/wjh.v15.i6.725
Ductular reaction in non-alcoholic fatty liver disease: When Macbeth is perverted
Yang-Huan He, Jia-Xing Pan, Lei-Ming Xu, Ting Gu, Yuan-Wen Chen
Yang-Huan He, Yuan-Wen Chen, Department of Gastroenterology and Department of Geriatrics, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
Jia-Xing Pan, Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
Lei-Ming Xu, Department of Gastroenterology, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200092, China
Ting Gu, Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
Author contributions: Chen YW conceived the Review; He YH and Pan JX wrote the first draft of the manuscript and prepared the figures; He YH, Pan JX, Xu LM, and Gu T collected the data for the article; all authors made substantial contributions to the discussion of data.
Supported by the National Natural Science Foundation of China, No. 81970511&82270620.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Wen Chen, MD, PhD, Chief Physician, Director, Department of Gastroenterology and Department of Geriatrics, Huadong Hospital Affiliated to Fudan University, No. 221 West Yan’an Road, Shanghai 200040, China. chenywhdgi@fudan.edu.cn
Received: February 27, 2023
Peer-review started: February 27, 2023
First decision: March 28, 2023
Revised: April 3, 2023
Accepted: April 24, 2023
Article in press: April 24, 2023
Published online: June 27, 2023
Core Tip

Core Tip: This is the first review focusing on recent advances in the relationship of hepatic cells with ductular reaction (DR), in fatty liver-related steatohepatitis and fibrosis. Recent advances in DR, a common compensatory reaction in liver injury, shed light on the effects of hepatic progenitor cells, hepatic stellate cells, myofibroblasts, inflammatory cells, and their secreted substance. In particular, hepatic progenitor cell differentiation was thoroughly discussed in developing steatohepatitis and fibrosis. This review summarizes the correlation between DR and steatohepatitis and fibrosis, the advanced stages of non-alcoholic fatty liver disease, or metabolic (dysfunction) related fatty liver disease.