Fibrosis

Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton and Vidya Acharya  

Introduction

Liver Cirrhosis (fibrosis)

Heart inferior wall fibrosis

Fibrosis (a pathological feature of many chronic inflammatory diseases) refers to scarring and hardening of tissues and organs. It is defined by the accumulation of excess extracellular matrix components (particularly collagen). When very progressive, the fibrotic process eventually leads to organ malfunction and death. Fibrosis can effect most tissues in the body..

Fibrogenesis is becoming increasingly recognised as a major cause of morbidity and death, with a dearth of treatment strategies available to target the pathogenesis of fibrosis.

Main Types of Fibrosis

Fibrosis after a burn

Fibrosis in “Frozen Shoulder”

Myocardial fibrosis

Fibrosis, the excessive accumulation of fibrous connective tissue, can lead to permanent scarring, organ malfunction and, ultimately, death. This can be seen in as seen in end-stage liver disease, kidney disease, idiopathic pulmonary fibrosis, liver cirrhosis and heart failure (cardiac fibrosis). Fibrosis is also a. feature in the following conditions.

1. Many chronic autoimmune disorders (eg scleroderma, rheumatoid arthritis, Crohn’s disease, myelofibrosis and systemic lupus erythematosus).
2. Pulmonary fibrosis, as: Replacement fibrosis (as occurs in response to lung damage caused by infarction or an infection); focal fibrosis, as occurs in a response to irritation by inhaled substances that are inhaled eg Silicosis or asbestos; diffuse parenchymal lung disease (DPLD).
3. Soft tissue injuries eg Skeletal muscle injuries: With minor injuries the muscles are able to regenerate completely and recover their usual capabilities. However, in severe injuries, the injured muscle cannot recover to a functional level because of the formation of fibrous scar tissue. Fibrosis of the joints can lead to stiffness and pain in the joints. Fibrosis of the tendons can lead to eg Dupuytren's contracture. Fibrosis of the shoulder capsule may lead to adhesive capsulitis (frozen shoulder).
4. Fibrosis is a feature of cancers (characterized by extracellular matrix deposition, remodeling, and cross-linking). The fibrosis enhances tumor cell growth, survival and migration and also a stiff ECM induces angiogenesis, hypoxia and compromises anti-tumor immunity
5. Fibrosis is a feature of chronic graft rejection and the pathogenesis of many progressive myopathies eg Dysregulated muscle repair with persistent fibrosis rather than correct regeneration plays a major role in the decline and reduced life expectancy associated with severe muscular dystrophies, like Duchenne muscular dystrophy

Physiotherapy

Physiotherapy plays a role in eg minimising fibrotic changes, influencing scar tissue strength, living a better quality of life with fibrosis. See links for Physiotherapy specifics.