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Activated hepatic stellate cells (<jats:styled-content style=\"fixed-case\">HSC<\/jats:styled-content>) are known to contribute to liver fibrosis, but currently there are no effective therapies for the treatment of established liver fibrosis. Activation of the acidic sphingomyelinase (<jats:styled-content style=\"fixed-case\">ASM<\/jats:styled-content>) has been shown to be involved in <jats:styled-content style=\"fixed-case\">HSC<\/jats:styled-content> activation. In the present study we investigated whether treatment with the <jats:styled-content style=\"fixed-case\">ASM<\/jats:styled-content> inhibitor, amitriptyline (<jats:styled-content style=\"fixed-case\">TCA<\/jats:styled-content>), could prevent and\/or reverse fibrosis induced in mice by carbon tetrachloride (<jats:styled-content style=\"fixed-case\"><jats:roman>CCl<jats:sub>4<\/jats:sub><\/jats:roman><\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Mice were treated with <jats:styled-content style=\"fixed-case\"><jats:roman>CCl<jats:sub>4<\/jats:sub><\/jats:roman><\/jats:styled-content> for 8\u2009weeks to induce fibrosis. Concurrently, mice received drinking water with or without 180\u2009mg\/L <jats:styled-content style=\"fixed-case\">TCA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mice receiving <jats:styled-content style=\"fixed-case\">TCA<\/jats:styled-content> in the water had decreased hepatic collagen deposition and reduced liver <jats:styled-content style=\"fixed-case\">mRNA<\/jats:styled-content> expression of the fibrogenic mediators, transforming growth factor (<jats:styled-content style=\"fixed-case\">TGF<\/jats:styled-content>)\u2010\u03b21, tissue inhibitor of matrix metalloproteinase\u20101, collagen and tumor necrosis factor\u2010\u03b1. <jats:styled-content style=\"fixed-case\">TCA<\/jats:styled-content> treatment also reduced <jats:styled-content style=\"fixed-case\">HSC<\/jats:styled-content> activation determined by \u03b1\u2010smooth muscle actin staining. In a separate set of experiments, mice were treated with <jats:styled-content style=\"fixed-case\"><jats:roman>CCl<jats:sub>4<\/jats:sub><\/jats:roman><\/jats:styled-content> for 5\u2009weeks prior to treatment with <jats:styled-content style=\"fixed-case\">TCA<\/jats:styled-content>, to test whether <jats:styled-content style=\"fixed-case\">TCA<\/jats:styled-content> had any effect on established fibrosis. Remarkably, in mice with established fibrosis, treatment with <jats:styled-content style=\"fixed-case\">TCA<\/jats:styled-content> significantly reduced collagen deposition, <jats:styled-content style=\"fixed-case\">HSC<\/jats:styled-content> activation, and prevented portal hypertension and improved hepatic architecture. Treatment of isolated <jats:styled-content style=\"fixed-case\">HSC<\/jats:styled-content>\u2005<jats:italic>in vitro<\/jats:italic> with <jats:styled-content style=\"fixed-case\">TCA<\/jats:styled-content> completely inhibited <jats:styled-content style=\"fixed-case\">TGF<\/jats:styled-content>\u2010\u03b21\u2010induced collagen expression and platelet\u2010derived growth factor\u2010\u03b2\u2010\u03b2\u2010induced proliferation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The data suggest that <jats:styled-content style=\"fixed-case\">ASM<\/jats:styled-content> is a critical signaling component in <jats:styled-content style=\"fixed-case\">HSC<\/jats:styled-content> for the development of liver fibrosis and represents an important therapeutic target.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.12352","type":"journal-article","created":{"date-parts":[[2014,5,5]],"date-time":"2014-05-05T02:10:58Z","timestamp":1399255858000},"page":"305-314","source":"Crossref","is-referenced-by-count":23,"title":["Inhibition of acidic sphingomyelinase reduces established hepatic fibrosis in mice"],"prefix":"10.1111","volume":"45","author":[{"suffix":"III","given":"Ralph C.","family":"Quillin","sequence":"first","affiliation":[{"name":"Department of Surgery Laboratory Medicine University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory C.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Surgery Laboratory Medicine University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Nojima","sequence":"additional","affiliation":[{"name":"Department of 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