Mekanisme yang Diinduksi oleh Hipoksia dalam Fibrosis Hepar: Tinjauan Sistematis
DOI:
https://doi.org/10.59923/healthcare.v1i1.737Keywords:
Hipoksia, Fibrosis Hepar, Sel Stelata Hepar, Hypoxia-Inducible FactorAbstract
Fibrosis hepar merupakan respons patologis terhadap cedera hepar kronik yang dapat berkembang menjadi sirosis dan kegagalan hepar. Berbagai bukti ilmiah menunjukkan bahwa hipoksia pada mikro-lingkungan hepar berperan penting dalam proses fibrogenesis. Tinjauan sistematis ini bertujuan untuk mengkaji mekanisme yang diinduksi oleh hipoksia dalam perkembangan dan progresi fibrosis hepar. Pencarian literatur dilakukan secara sistematis menggunakan basis data PubMed dan Google Scholar terhadap artikel yang diterbitkan pada periode 2014-2024. Proses penelusuran dan seleksi artikel mengikuti pedoman Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) dengan menggunakan kerangka PECOT. Studi orisinal yang membahas peran hipoksia dalam mekanisme fibrosis hepar disertakan dan dianalisis secara kualitatif menggunakan pendekatan naratif. Sebanyak 18 studi memenuhi kriteria inklusi. Hasil tinjauan menunjukkan bahwa hipoksia berkontribusi terhadap fibrosis hepar melalui aktivasi sel stelata hepatik, regulasi jalur hypoxia-inducible factor (HIF), pembentukan positive feedback loop HIF-1α, gangguan mikrosirkulasi, serta remodeling matriks ekstraseluler yang dipicu hipoksia. Interaksi mekanisme tersebut membentuk siklus patologis yang bersifat self-sustaining dan mempercepat progresi fibrosis. Hipoksia juga berperan dalam mempertahankan dan mempercepat progresi fibrosis pada penyakit hepar kronik. Dapat disimpulkan bahwa hipoksia merupakan faktor patogenetik penting dalam fibrosis hepar melalui berbagai mekanisme seluler dan molekuler. Pemahaman mengenai peran hipoksia diharapkan dapat menjadi dasar dalam pengembangan strategi pencegahan dan terapi untuk memperlambat progresi fibrosis hepar.
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