Fibrotic Scarring: Causes, Consequences, and Treatment Options
Fibrotic scarring is excessive deposition of collagen‑rich connective tissue after injury or chronic inflammation. While part of normal healing, it can become pathological.
Common Causes
- Surgery, trauma, burns
- Chronic infections (TB, schistosomiasis)
- Radiation therapy
- Autoimmune diseases (scleroderma, RA‑ILD)
- Metabolic disorders (NASH → cirrhosis, diabetic nephropathy)
Organ‑Specific Complications
- Liver: Cirrhosis → portal hypertension, liver failure
- Lungs: Pulmonary fibrosis → restrictive lung disease
- Kidneys: Glomerulosclerosis → CKD
- Heart: Myocardial fibrosis → diastolic dysfunction, arrhythmia
- Reproductive tract: Asherman’s syndrome, tubal occlusion → infertility
Treatment Approaches
- Treat underlying cause (antivirals, immunosuppressants, metabolic control).
- Anti‑fibrotics: Pirfenidone, nintedanib (IPF); antifibrotic research ongoing for other organs.
- Corticosteroids/immunosuppressants for inflammatory fibrosis.
- Surgical: Resection, transplantation (end‑stage).
- Supportive: Symptom management, rehabilitation.
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