liver pathology

肝脏病理
  • 文章类型: Journal Article
    有人建议饮酒可以预防帕金森氏病(PD)。在这里,我们评估了100名死亡年龄在51至93岁之间的受试者的大脑和肝脏的死后组织样本。这些受试者中有20%患有痴呆症。我们使用标准化评估策略来评估脑和肝脏病理(LP)。我们的队列包括没有受试者,温和,中度,和严重的LP引起的饮酒。我们注意到肝脏脂肪变性和大脑中α-突触核蛋白(αS)之间的分类数据存在显着负相关,肝脏脂肪变性和纤维化的程度与大脑中αS的程度之间存在显着负相关。观察到的阿尔茨海默氏II型星形胶质细胞与大脑中的αS病理之间存在显着负相关。LP和过度磷酸化τ(HPτ)之间没有发现关联。LP的程度与HPτ的程度之间没有显着相关性,大脑中的淀粉样β蛋白(Aβ)或反式DNA结合蛋白43(TDP43)。在HPτ的程度之间观察到显着的相关性,Aβ,αS,和TDP43在大脑和肝脏脂肪变性之间,炎症,和纤维化。患有严重LP的受试者表现出更高的阿尔茨海默氏症II型星形胶质细胞频率,或温和,LP.评估的蛋白质改变在患有阿尔茨海默氏症II型星形胶质细胞的受试者中并不更普遍或更严重。在所有情况下,痴呆症归因于蛋白质改变的组合,即,轻度LP患者中有30%观察到痴呆和痴呆的混合性,而重度LP患者中有13%观察到。总之,我们的结果与最近两项荟萃分析的结果一致,这些荟萃分析提示有饮酒史的受试者很少发生α-突触核蛋白病.
    It has been suggested that alcohol consumption protects against Parkinson\'s disease (PD). Here we assessed postmortem tissue samples from the brains and livers of 100 subjects with ages at death ranging from 51 to 93. Twenty percent of these subjects were demented. We used standardized assessment strategies to assess both the brain and liver pathologies (LP). Our cohort included subjects with none, mild, moderate, and severe LP caused by alcohol consumption. We noted a significant negative correlation of categorical data between liver steatosis and α-synuclein (αS) in the brain and a significant negative correlation between the extent of liver steatosis and fibrosis and the extent of αS in the brain. There was a significant negative association between the observation of Alzheimer\'s type II astrocytes and αS pathology in the brain. No association was noted between LP and hyperphosphorylated τ (HPτ). No significant correlation could be seen between the extent of LP and the extent of HPτ, amyloid β protein (Aβ) or transactive DNA binding protein 43 (TDP43) in the brain. There were significant correlations observed between the extent of HPτ, Aβ, αS, and TDP43 in the brain and between liver steatosis, inflammation, and fibrosis. Subjects with severe LP displayed a higher frequency of Alzheimer\'s type II astrocytes compared to those with no, or mild, LP. The assessed protein alterations were not more prevalent or severe in subjects with Alzheimer\'s type II astrocytes in the brain. In all cases, dementia was attributed to a combination of altered proteins, i.e., mixed dementia and dementia was observed in 30% of those with mild LP when compared with 13% of those with severe LP. In summary, our results are in line with the outcome obtained by the two recent meta-analyses suggesting that subjects with a history of alcohol consumption seldom develop an α-synucleinopathy.
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  • 文章类型: Journal Article
    人抗白细胞介素21受体(IL-21R)单克隆抗体(mAb)ATR-107的毒性,在单剂量静脉内(IV)给药后,在CD-1小鼠和食蟹猴中进行了评估,在为期13周的毒性研究中,每周IV和皮下(SC)给药后,以及Sprague-Dawley(SD)大鼠和食蟹猴。不良肝坏死,弥漫性桥接纤维化,低剂量IV组(10mg/kg)大鼠肝酶升高,但不是在50或250毫克/千克的静脉注射,尽管全身性ATR-107暴露重叠,但SC给药后未出现。在小鼠或食蟹猴中没有看到类似的发现。一系列调查性大鼠毒性研究表明,肝脏发现仅发生在至少3周剂量给药后,仅发生在产生抗药物抗体(ADAs)的大鼠中,发病率与较高的ADAs滴度相关。然而,ADAs的存在并不总是导致肝损伤。在裸大鼠中没有发现肝脏,ATR-107暴露率高,没有ADAs。这些发现表明,随着ADAs的形成,适应性免疫反应对于ATR-107相关肝脏的发展是必要的。并且在反复施用人治疗性mAb后,在ADAs发育的大鼠中可能发生肝损伤。
    The toxicity of ATR-107, a human anti-interleukin-21 receptor (IL-21R) monoclonal antibody (mAb), was evaluated in CD-1 mice and cynomolgus monkeys after single-dose intravenous (IV) administration, and in Sprague-Dawley (SD) rats and cynomolgus monkeys after weekly IV and subcutaneous (SC) administration in 13-week toxicity studies that included recovery. Adverse liver necrosis, diffuse bridging fibrosis, and higher liver enzymes occurred in rats in the low-dose IV group (10 mg/kg), but not at 50 or 250 mg/kg IV, and not following SC administration despite overlapping systemic ATR-107 exposures. Similar findings were not seen in mice or cynomolgus monkeys. A series of investigative rat toxicity studies showed liver findings only occurred after administration of at least 3 weekly doses, only occurred in rats that developed anti-drug antibodies (ADAs), and the incidence was associated with higher ADAs titers. However, the presence of ADAs did not always result in liver injury. Liver findings did not occur in nude rats, which had high ATR-107 exposures and no ADAs. These findings suggest an adaptive immune response with formation of ADAs was necessary for development of ATR-107-related liver findings, and that liver injury can occur in rats secondary to development of ADAs following repeated administration of a human therapeutic mAb.
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  • 文章类型: Journal Article
    背景:ABCB4基因相关胆汁淤积性肝病具有广泛的临床和遗传变异。基因型与临床表型之间的相关性尚不清楚。回顾性分析23例ABCB4基因相关性胆汁淤积性肝病患者的临床及病理特点。下一代测序用于鉴定遗传原因。
    结果:纳入的23例患者(15名儿童和8名成人)被诊断为进行性家族性肝内胆汁淤积3型(PFIC3),药物性肝损伤(DILI),肝硬化胆汁淤积,肝硬化,轻度肝纤维化.19例患者接受肝脏病理检查,表现出纤维化,小胆管增生,CK7(+),Cu(+),胆管缺失,和肝硬化。鉴定了30种ABCB4变体,包括18种新颖的变体。
    结论:ABCB4基因相关胆汁淤积性肝病具有广泛的临床和遗传变异。双等位基因ABCB4突变携带者倾向于严重的PFIC3,主要发生在儿童中;而ABCB4非双等位基因变异可导致较温和的ICP,LACP,DILI或重叠,主要是成年人。因此,ABCB4基因型与表型有特定的相关性,但也有例外。非双等位基因无效突变可导致严重的疾病。这种遗传表型的潜在机制需要进一步研究。
    BACKGROUND: ABCB4 gene-related cholestatic liver diseases have a wide spectrum of clinical and genetic variations. The correlation between genotype and clinical phenotype still unclear. This study retrospectively analyzed the clinical and pathological characteristics of 23 patients with ABCB4 gene-related cholestatic liver diseases. Next-generation sequencing was used to identify the genetic causes.
    RESULTS: The 23 included patients (15 children and 8 adults) were diagnosed as progressive familial intrahepatic cholestasis type 3 (PFIC3), drug-induced liver injury (DILI), cirrhosis cholestasis, cirrhosis, and mild liver fibrosis. Nineteen patients underwent liver pathological examination of the liver, exhibiting fibrosis, small bile duct hyperplasia, CK7(+), Cu(+), bile duct deletion, and cirrhosis. Thirty ABCB4 variants were identified, including 18 novel variants.
    CONCLUSIONS: ABCB4 gene-related cholestatic liver diseases have a wide spectrum of clinical and genetic variations. Biallelic ABCB4 mutation carriers tended to severe PFIC3, which mostly occurs in children; while ABCB4 non-biallelic variants can lead to milder ICP, LACP, DILI or overlapping, mostly in adults. Thus, the ABCB4 genotype has a specific correlation with the phenotype, but there are exceptions. Non-biallelic null mutations can cause severe diseases. The mechanisms underlying this genetic phenotype require further investigation.
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  • 文章类型: Journal Article
    对肝硬化门脉高压症的门脉静脉(OPV)闭塞的影响知之甚少。探讨其在胆汁性肝硬化门脉高压中的作用及其机制。我们使用二维(2D)组织病理学评估了胆道闭锁患者肝脏外植体的OPV(BA,n=63),原发性胆汁性胆管炎(PBC,n=18),和乙型肝炎相关的肝硬化(Hep-B肝硬化,n=35)。然后,在胆管结扎(BDL)或四氯化碳(CCl4)给药后,在两个平行模型中通过X射线相衬CT测量大鼠的三维(3D)OPV,代表胆汁性肝硬化和坏死后肝硬化,分别。还在两个模型中测量了门静脉压力。最后,研究了增生性胆管对OPV的影响。我们发现OPV在胆汁性肝硬化患者中明显更常见,包括BA(78.57±16.45%)和PBC(60.00±17.15%),比Hep-B肝硬化患者(29.43±14.94%,p<0.001)。OPV发生较早,Kasai手术(KP)的配对肝活检证明,即使在BA患者中成功进行KP后也是不可逆的。OPV在BDL模型中也比在CCl4模型中明显更频繁,如2D和3D定量分析所示。BDL模型的门静脉压力明显高于CCl4模型。随着胆管的增生,门静脉小静脉被压缩并不可逆地闭塞,有助于早期和更高的门静脉压力在胆汁性肝硬化。OPV,作为前正弦分量,在胆汁性肝硬化门脉高压的发病机制中起着关键作用。增殖的胆管和胆管逐渐占据最初归于门脉的“领土”并压缩门脉。这可能导致胆汁性肝硬化的OPV。©2024英国和爱尔兰病理学会。
    The effects of the obliteration of portal venules (OPV) in cirrhotic portal hypertension are poorly understood. To investigate its contribution to portal hypertension in biliary cirrhosis and its underlying mechanism, we evaluated OPV using two-dimensional (2D) histopathology in liver explants from patients with biliary atresia (BA, n = 63), primary biliary cholangitis (PBC, n = 18), and hepatitis B-related cirrhosis (Hep-B-cirrhosis, n = 35). Then, three-dimensional (3D) OPV was measured by X-ray phase-contrast CT in two parallel models in rats following bile duct ligation (BDL) or carbon tetrachloride (CCl4) administration, representing biliary cirrhosis and post-necrotic cirrhosis, respectively. The portal pressure was also measured in the two models. Finally, the effects of proliferative bile ducts on OPV were investigated. We found that OPV was significantly more frequent in patients with biliary cirrhosis, including BA (78.57 ± 16.45%) and PBC (60.00 ± 17.15%), than that in Hep-B-cirrhotic patients (29.43 ± 14.94%, p < 0.001). OPV occurred earlier, evidenced by the paired liver biopsy at a Kasai procedure (KP), and was irreversible even after a successful KP in the patients with BA. OPV was also significantly more frequent in the BDL models than in the CCl4 models, as shown by 2D and 3D quantitative analysis. Portal pressure was significantly higher in the BDL model than that in the CCl4 model. With the proliferation of bile ducts, portal venules were compressed and irreversibly occluded, contributing to the earlier and higher portal pressure in biliary cirrhosis. OPV, as a pre-sinusoidal component, plays a key role in the pathogenesis of portal hypertension in biliary cirrhosis. The proliferated bile ducts and ductules gradually take up the \'territory\' originally attributed to portal venules and compress the portal venules, which may lead to OPV in biliary cirrhosis. © 2024 The Pathological Society of Great Britain and Ireland.
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  • 文章类型: Case Reports
    我们报告了2例由于SARS-Cov2相关的继发性硬化性胆管炎(SSC)引起的原位肝移植(OLTX),这是长期人工呼吸和重症监护中的体膜氧合。在这些条件下,SSC是一种以退行性胆管疾病为特征的迅速进展的胆道疾病,胆管丢失,导管和实质胆汁淤积,胆道纤维化,最后是肝硬化.胆管周围丛的灌注和氧合减少,严重并发感染,和继发性药物毒性作用似乎在该疾病的发病机理中起着至关重要的作用。SARS-Cov2对内皮细胞的直接细胞病变作用,随后在肝脏血管床的所有部分中发生血栓形成和纤维化闭塞,可能会增强病毒相关的肝病,尤其是SSC。
    We report on two cases of orthotopic liver transplantation (OLTX) due to SARS-Cov2-associated secondary sclerosing cholangitis (SSC) following long-term artificial respiration and extra-corporal membrane oxygenation in intensive care. Under these conditions, SSC is a rapidly progredient biliary disease featuring degenerative cholangiopathy, loss of bile ducts, ductular and parenchymal cholestasis, biliary fibrosis, and finally cirrhosis. Reduced perfusion and oxygenation of the peribiliary plexus, severe concurrent infections, and secondary medico-toxic effects appear to play a crucial role in the pathogenesis of the disease. A direct cytopathic effect of SARS-Cov2 on endothelial cells followed by thrombosis and fibrosing obliteration in all parts of the vascular bed of the liver may enhance the virus-associated liver disease and particularly SSC.
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  • 文章类型: Journal Article
    肝病仍然是全世界死亡的主要原因之一。尽管肝病的患病率很高,诊断的可能性,预后,和治疗非酒精性和酒精性肝病仍然有许多局限性,需要开发新的方法和途径。在实验室研究中,各种模型被用来重建肝脏的病理状况,包括细胞培养,球体,类器官,微流体系统,组织切片。我们回顾了体内最常用的,在体外,以及用于研究非酒精性脂肪肝和酒精性肝病的离体模型,中毒性肝损伤,和纤维化,描述了他们的优势,局限性,和使用前景。非常重视每个模型中病理状况的发展机制,以及重建所有这些病理的发病机制的各种关键方面的可能性的评估。目前对于选择用于研究肝脏病理学的最适当的模型没有共识。某一有效研究模型的选择取决于实验的具体目的和目标。
    Liver pathologies remain one of the leading causes of mortality worldwide. Despite a high prevalence of liver diseases, the possibilities of diagnosing, prognosing, and treating non-alcoholic and alcoholic liver diseases still have a number of limitations and require the development of new methods and approaches. In laboratory studies, various models are used to reconstitute the pathological conditions of the liver, including cell cultures, spheroids, organoids, microfluidic systems, tissue slices. We reviewed the most commonly used in vivo, in vitro, and ex vivo models for studying non-alcoholic fatty liver disease and alcoholic liver disease, toxic liver injury, and fibrosis, described their advantages, limitations, and prospects for use. Great emphasis was placed on the mechanisms of development of pathological conditions in each model, as well as the assessment of the possibility of reconstructing various key aspects of pathogenesis for all these pathologies. There is currently no consensus on the choice of the most adequate model for studying liver pathology. The choice of a certain effective research model is determined by the specific purpose and objectives of the experiment.
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  • 文章类型: Case Reports
    肝脏孤立性坏死结节(SNN)是肝脏病理学中罕见且良性的发现。通常,它表现为单个无症状的病变,主要位于肝脏右叶的包膜下区域。不幸的是,很容易将这种良性病变误认为是原发性或继发性肿瘤病变,使其成为肝脏恶性肿瘤的潜在诊断陷阱。SNN的诊断可能难以确定,因为成像发现经常缺乏特异性。这显示了组织形态学检查的重要性,以准确识别该病变,排除任何可能的恶性肿瘤.我们在这里报告一个35岁的女性,有宫颈鳞状细胞癌的病史,她的肝脏上出现了一个孤立的结节,在图像中被错误地诊断为肝脏中的转移性病变。本文的目的是强调使用特殊染色和免疫组织化学染色来诊断SNN并排除任何肝脏坏死转移的重要性。我们证明,在坏死核心中没有网状网应该促使考虑肝脏中的坏死转移,而不是孤立的坏死结节。
    Solitary necrotic nodule (SNN) of the liver is an uncommon and benign finding in liver pathology. Typically, it appears as a single and asymptomatic lesion, primarily located at the subcapsular region of the right lobe of the liver. Unfortunately, it is easy to mistake this benign lesion for a primary or secondary neoplastic lesion, making it a potential diagnosis pitfall for liver malignancies. The diagnosis of SNN can be difficult to determine as the imaging findings frequently lack specificity. This brings out the importance of histomorphological examination to accurately identify this lesion, and to rule out any possible malignancies. We report here the case of a 35-year-old woman with a history of squamous cell carcinoma of the cervix, who presented a solitary nodule on her liver that was falsely diagnosed as a metastatic lesion in the liver at imagery. The aim of this article is to highlight the importance of using special stains and immunohistochemical staining for diagnosing SNN and excluding any necrotic metastases of the liver. We demonstrated that the absence of a reticulin meshwork in the necrotic core should prompt consideration of a necrotic metastasis in the liver, rather than a solitary necrotic nodule.
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  • 文章类型: Journal Article
    最近,我们对糖尿病小鼠肝脏中的铁变性表型进行了表征,并揭示了核因子(红系衍生的2)相关因子2(Nrf2)失活是肝损伤的组成部分。这里,我们的目的是调查萝卜硫素,Nrf2活化剂和抗氧化剂,预防糖尿病诱导的肝脏铁死亡及其相关机制。将雄性C57BL/6小鼠分为四组:对照组(载体处理),糖尿病(链脲佐菌素诱导的;40毫克/千克,从第1天到第5天),糖尿病萝卜硫素治疗组(第1天至第42天2.5mg/kg)和非糖尿病萝卜硫素治疗组(第1天至第42天2.5mg/kg)。结果表明,糖尿病诱导的Nrf2失活及其下游抗铁分子的表达降低,对抗氧化防御至关重要(过氧化氢酶,超氧化物歧化酶,硫氧还蛋白还原酶),铁代谢(铁蛋白重链(FTH1),铁蛋白1),谷胱甘肽(GSH)合成(胱氨酸-谷氨酸反转运系统,胱抑素,谷氨酸-半胱氨酸连接酶亚单位,谷氨酸-半胱氨酸连接酶修饰亚基,谷胱甘肽合成酶),GSH回收-谷胱甘肽还原酶(GR)被萝卜硫烷处理逆转/增加。此外,我们发现糖尿病肝脏的铁细胞表型与铁细胞吞噬增加和FTH1免疫阳性降低相关.通过GSH水平的增加进一步证明了萝卜硫烷的抗铁作用,不稳定铁和脂质过氧化物的积累减少(4-羟基-2-壬烯醛,脂褐素),减少铁细胞吞噬和肝损伤(纤维化减少,丙氨酸氨基转移酶,和天冬氨酸氨基转移酶)。最后,萝卜硫烷显著降低了糖尿病诱导的血清葡萄糖和甘油三酯水平升高。尽管这项研究仅限于使用一种实验性糖尿病模型,获得的结果首次证明萝卜硫烷通过激活Nrf2信号通路在体内预防糖尿病诱导的肝铁蛋白死亡。这表明萝卜硫烷是一种有前途的植物药物,可用于预防/减轻糖尿病相关病理中铁死亡。
    Recently, we characterized the ferroptotic phenotype in the liver of diabetic mice and revealed nuclear factor (erythroid-derived-2)-related factor 2 (Nrf2) inactivation as an integral part of hepatic injury. Here, we aim to investigate whether sulforaphane, an Nrf2 activator and antioxidant, prevents diabetes-induced hepatic ferroptosis and the mechanisms involved. Male C57BL/6 mice were divided into four groups: control (vehicle-treated), diabetic (streptozotocin-induced; 40 mg/kg, from Days 1 to 5), diabetic sulforaphane-treated (2.5 mg/kg from Days 1 to 42) and non-diabetic sulforaphane-treated group (2.5 mg/kg from Days 1 to 42). Results showed that diabetes-induced inactivation of Nrf2 and decreased expression of its downstream antiferroptotic molecules critical for antioxidative defense (catalase, superoxide dismutases, thioredoxin reductase), iron metabolism (ferritin heavy chain (FTH1), ferroportin 1), glutathione (GSH) synthesis (cystine-glutamate antiporter system, cystathionase, glutamate-cysteine ligase catalitic subunit, glutamate-cysteine ligase modifier subunit, glutathione synthetase), and GSH recycling - glutathione reductase (GR) were reversed/increased by sulforaphane treatment. In addition, we found that the ferroptotic phenotype in diabetic liver is associated with increased ferritinophagy and decreased FTH1 immunopositivity. The antiferroptotic effect of sulforaphane was further evidenced through the increased level of GSH, decreased accumulation of labile iron and lipid peroxides (4-hydroxy-2-nonenal, lipofuscin), decreased ferritinophagy and liver damage (decreased fibrosis, alanine aminotransferase, and aspartate aminotransferase). Finally, diabetes-induced increase in serum glucose and triglyceride level was significantly reduced by sulforaphane. Regardless of the fact that this study is limited by the use of one model of experimentally induced diabetes, the results obtained demonstrate for the first time that sulforaphane prevents diabetes-induced hepatic ferroptosis in vivo through the activation of Nrf2 signaling pathways. This nominates sulforaphane as a promising phytopharmaceutical for the prevention/alleviation of ferroptosis in diabetes-related pathologies.
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  • DOI:
    文章类型: Journal Article
    October 11, 2023 marked the 90th anniversary of the birth of the outstanding Russian virologist, academician of the Russian Academy of Sciences Nikolai Veniaminovich Kaverin. N.V. Kaverin was born in Leningrad into the famous literary family of Veniamin Aleksandrovich Kaverin and Lydia Nikolaevna Tynyanova. In 1951 he graduated from school with a gold medal and entered the 1st Moscow Medical Institute named after. THEM. Sechenov. During his senior years, Kaverin already worked at the Research Institute of Virology named after. DI. Ivanovsky RAMS, and in 1960, upon completion of graduate school, defended his Ph.D. thesis.
    11 октября 2023 г. исполнилось 90 лет со дня рождения выдающегося российского вирусолога, академика РАН Николая Вениаминовича Каверина. Н.В. Каверин родился в Ленинграде в известной литературной семье Вениамина Александровича Каверина и Лидии Николаевны Тыняновой. В 1951 г. окончил школу с золотой медалью и поступил в 1-й Московской медицинский институт им. И.М. Сеченова. На старших курсах Каверин уже работал в НИИ вирусологии им. Д.И. Ивановского РАМН, а в 1960 г., по окончании аспирантуры, защитил кандидатскую диссертацию.
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  • 文章类型: Journal Article
    导管反应和纤维化是许多肝脏疾病的标志,包括原发性硬化性胆管炎,原发性胆汁性胆管炎,胆道闭锁,和代谢功能障碍相关的脂肪变性肝病/代谢功能障碍相关的脂肪性肝炎。肝纤维化是通常由肌成纤维细胞过度的胶原沉积引起的细胞外基质的积累。导管反应是肝损伤期间胆管(由胆管细胞组成)的增殖。许多其他肝细胞,包括肝星状细胞,肝细胞,肝祖细胞,间充质干细胞通过直接或间接与肌成纤维细胞和胆管细胞相互作用而促进导管反应和纤维化。这篇综述总结了许多肝脏疾病中导管反应和纤维化之间的细胞联系的最新发现。
    Ductular reaction and fibrosis are hallmarks of many liver diseases including primary sclerosing cholangitis, primary biliary cholangitis, biliary atresia, alcoholic liver disease, and metabolic dysfunction-associated steatotic liver disease/metabolic dysfunction-associated steatohepatitis. Liver fibrosis is the accumulation of extracellular matrix often caused by excess collagen deposition by myofibroblasts. Ductular reaction is the proliferation of bile ducts (which are composed of cholangiocytes) during liver injury. Many other cells including hepatic stellate cells, hepatocytes, hepatic progenitor cells, mesenchymal stem cells, and immune cells contribute to ductular reaction and fibrosis by either directly or indirectly interacting with myofibroblasts and cholangiocytes. This review summarizes the recent findings in cellular links between ductular reaction and fibrosis in numerous liver diseases.
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