Journey from fatty liver to steatohepatitis to fibrosis and then cirrhosis.

Outside liver cells, or in-between liver cells and sinusoidal Capillaries (blood vessels), there are nasty group of cells called STELLATE OR ITO CELLS, usually they are friendly, not making any trouble for us. Usually, they store fats and Vitamin A. But when they are irritated by chronic inflammatory system, then they start producing collagen and they start damaging the whole liver architecture even blood vessels. These cells are extremely important especially in pathological conditions. When liver has inflammation for long time, inflammatory mediators stimulate these ITO cells. These ITO cells lose their fats, they become very aggressive and dangerous.  When there is hepatitis for long time (chronic hepatitis) ITO cells then converted into Myofibroblasts, they start secreting lot of collagen, liver will be generalized fibrotic. FIBROSIS will develop later. Capillaries system will get fibrosed and blood flow will alter. Liver will become fibrotic and nodular, we call it CIRRHOSIS.