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The Condition of Extracellular Matrix Components and the Intensity of Fibrous Formation in the Liver in Patients with Non-alcoholic Steatohepatitis and Chronic Kidney Disease

Khukhlina O, Antoniv A, Antofiychuk N, Danylyshyn T, Vivsyannuk V, Trefanenko I and Shuper V

The article summarizes the clinical study, which showed that in non-alcoholic steatohepatitis that develops on the background of obesity and chronic kidney disease I-III stage, the presence of fibrotic changes in the liver tissue was found, which according to the biochemical index of fibrosis, exceeds those in patients with non-alcoholic steatohepatitis without comorbidity with kidney pathology. In patients with non-alcoholic steatohepatitis, which was accompanied by obesity, a significant increase in the synthesis of collagen and glycosaminoglycan’s which was accompanied with an ineffective resorption of newly formed collagen due to inhibition of the collagenolytic activity of blood plasma, due to significant activation of proteinase inhibitors (α2-MG) was observed with a significant imbalance in the system of connective tissue metabolism. Under the conditions of the comorbidity of non-alcoholic steatohepatitis with chronic kidney disease I-III stage, collagen synthesis and resorption are activated, but the anabolism processes predominate, in spite of the compensatory activation of collagenolysis, a substantial hyper production of actinic-phase proteins, fibronectin, glycosaminoglycan’s, fibroblast growth factor and lead to progressive fibrosis of the liver and disturbance of its functions.