Native collagen formation by liver parenchymal cells in culture

A Light Microscopic and Ultrastructural Study of Spindle-Shaped Hepatocellular Carcinoma

Spindle-cell hepatocellular carcinoma is an unusual morphologic variant of hepatocellular carcinoma with a typical sarcomatous appearance. The exact diagnosis of this tumor may be difficult when only small biopsies are available and in the absence of ultrastructural studies. We describe two cases of hepatocellular carcinoma: one was entirely composed of spindle-shaped cells, and the other was a typical hepatocellular carcinoma with only a small area of sarcomatous, fusiform cells. In the first case, ultrastructural studies demonstrated desmosomes and many Mallory bodies and confirmed the epithelial nature of the neoplasm. In the second case, no ultrastructural studies were available, but the presence of gradual transition from liver cell carcinoma to spindle-cell carcinoma excludede the diagnosis of carcino-sarcoma.

The stellate cell system (vitamin A-storing cell system)

Past, present, and future research into hepatic stellate cells (HSCs, also called vitamin A-storing cells, lipocytes, interstitial cells, fat-storing cells, or Ito cells) are summarized and discussed in this review. Kupffer discovered black-stained cells in the liver using the gold chloride method and named them stellate cells (Sternzellen in German) in 1876. Wake rediscovered the cells in 1971 using the same gold chloride method and various modern histological techniques including electron microscopy. Between their discovery and rediscovery, HSCs disappeared from the research history. Their identification, the establishment of cell isolation and culture methods, and the development of cellular and molecular biological techniques promoted HSC research after their rediscovery. In mammals, HSCs exist in the space between liver parenchymal cells (PCs) or hepatocytes and liver sinusoidal endothelial cells (LSECs) of the hepatic lobule, and store 50-80% of all vitamin A in the body as retinyl ester in lipid droplets in the cytoplasm. SCs also exist in extrahepatic organs such as pancreas, lung, and kidney. Hepatic (HSCs) and extrahepatic stellate cells (EHSCs) form the stellate cell (SC) system or SC family; the main storage site of vitamin A in the body is HSCs in the liver. In pathological conditions such as liver fibrosis, HSCs lose vitamin A, and synthesize a large amount of extracellular matrix (ECM) components including collagen, proteoglycan, glycosaminoglycan, and adhesive glycoproteins. The morphology of these cells also changes from the star-shaped HSCs to that of fibroblasts or myofibroblasts.

Hepatic stellate cell (vitamin A-storing cell) and its relative--past, present and future

HSCs (hepatic stellate cells) (also called vitamin A-storing cells, lipocytes, interstitial cells, fat-storing cells or Ito cells) exist in the space between parenchymal cells and liver sinusoidal endothelial cells of the hepatic lobule and store 50-80% of vitamin A in the whole body as retinyl palmitate in lipid droplets in the cytoplasm. In physiological conditions, these cells play pivotal roles in the regulation of vitamin A homoeostasis. In pathological conditions, such as hepatic fibrosis or liver cirrhosis, HSCs lose vitamin A and synthesize a large amount of extracellular matrix components including collagen, proteoglycan, glycosaminoglycan and adhesive glycoproteins. Morphology of these cells also changes from the star-shaped SCs (stellate cells) to that of fibroblasts or myofibroblasts. The hepatic SCs are now considered to be targets of therapy of hepatic fibrosis or liver cirrhosis. HSCs are activated by adhering to the parenchymal cells and lose stored vitamin A during hepatic regeneration. Vitamin A-storing cells exist in extrahepatic organs such as the pancreas, lungs, kidneys and intestines. Vitamin A-storing cells in the liver and extrahepatic organs form a cellular system. The research of the vitamin A-storing cells has developed and expanded vigorously. The past, present and future of the research of the vitamin A-storing cells (SCs) will be summarized and discussed in this review.

The Immunology of Fibrogenesis in Alcoholic Liver Disease

Context.—Alcoholic liver disease in humans frequently leads to cirrhosis. Experimental models of hepatic fibrogenesis are available, but extrapolation of those findings to human ethanol-induced liver injury is difficult. Hepatic ethanol-induced fibrosis in humans has often been studied in relatively small patient populations. During the past decade, several animal models and human studies have attributed fibrogenesis in the liver to the role played by hepatocytes, Kupffer cells, endothelial cells, and especially stellate cells.

Objective.—To determine the contribution of the main liver cell types to ethanol-induced fibrogenesis. For that purpose, we studied the expression of the following immunologic parameters: smooth muscle–specific α actin (SMSA), CD68, CD34, transforming growth factor β1, intercellular adhesion molecule 1, and collagen types 1 and 3. The Dako LSAB+ kit (peroxidase method) was used.

Design.—We recently studied a large cohort of patients with alcoholic liver disease in France. In this cohort, we found 87 cases in which liver biopsies revealed only pericentral injury with nonpathologic portal areas. We compared cases in which the portal areas were nonpathologic with 324 patients in whom staging ranged from F0 to F3. Patients with cirrhosis (F4) were excluded from evaluation. To stage fibrosis, we used the METAVIR system. Furthermore, we selected 40 cases in which the biopsies measured at least 25 mm in length for further histochemical evaluation. Ten additional normal cases from our archives were used as controls. We divided this patient population into the following 5 groups of 10 patients each: group 1A, F0 with steatosis; group 1B, F0 without steatosis; group 2, F0 to F1, central injury; group 3, F3, fibrosis with multiple septa; and group 4, nonpathologic livers (controls).

Results.—Smooth muscle–specific α actin was expressed by stellate cells, pericentrally, with increasing severity and intensity in the advanced stage of fibrosis of group 3, less intense expression was noted in group 2, and expression was practically absent in group 1 and in nonpathologic controls. CD68 was the best marker for Kupffer cells and was expressed diffusely within the lobules in all groups. Its expression correlated directly with the degree of disease severity, progressing from stage I through stage III, but was absent in nonpathologic livers. CD34 was consistently expressed by endothelial cells in the periportal areas in all groups. The expression of collagen type 1 was intense in the bands of fibrosis or bridging, while type 3 expression was poor. Transforming growth factor β1 and intercellular adhesion molecule 1 were not expressed in any group.

Conclusions.—In this study, stellate cell activation (SMSA) was most intense pericentrally in the early stages and diffusely with progression to fibrosis and maximum intensity in stage III. Kupffer cell activation, as determined by CD68 expression, was intense and diffuse, while endothelial cells expressed CD34 periportally in a similar manner in all stages. Fibrogenesis in human ethanol injury is due to the activity of stellate cells, Kupffer cells, and to a lesser extent, to endothelial cells.

Ampelopsis brevipedunculata (Vitaceae) extract inhibits a progression of carbon tetrachloride-induced hepatic injury in the mice

Ampelopsis brevipedunculata (Maxim.) Trautv. (Vitaceae) has been used in Japanese herbal folk medicine to treat liver disease. The objective of this study is to evaluate the antihepatotoxic effect of A. brevipedunculata in the mice. An aqueous fraction was extracted by immersing the berries of the plant material in 40% ethanol for six months, followed by removing ethanol. Daily free access to the aqueous extract as drinking water greatly reduced the severity of hepatic injury, characterized by centrilobular necrosis, cytoplasmic vacuolation, cellular swelling, inflammation, and fibrosis in the mice receiving a nonlethal dose of carbon tetrachloride twice weekly during nine weeks. In addition, such a feeding regimen decreased the elevated levels of plasma glutamate oxaloacetate transaminase and glutamate pyruvate transaminase in the carbon tetrachloride-administered mice. These results suggest that the feeding regimen with A. brevipedunculata extract inhibited a progression of hepatic injury induced by carbon tetrachloride.

Effects of Ampelopsis brevipedunculata (Vitaceae) extract on hepatic M cell culture: function in collagen biosynthesis

A spirits-extracted fraction of berries of Ampelopsis brevipedunculata (Maxim.) Trautv. (Vitaceae) is used in Japanese folk medicine to treat liver disease. Since such an extract has been shown to inhibit formation of collagen fibers by rat hepatic M cells, it was felt that the extract acts as an inhibitor of hepatic fibrosis. Amino acid analysis of fibrous substances developing on M cell layers and of a cell lysate fraction indicated that an A. brevipedunculata extract inhibited collagen formation. Biosynthesis of non-collagenous proteins and collagen was evaluated by measuring the extent of [3H]tryptophan incorporation into a protein fraction and the rate of [3H]proline incorporation into a collagenase-digestible fraction, respectively. In contrast to the results of the analysis of the fibrous substances, the A. brevipedunculata extract failed to decrease synthesis of non-collagenous proteins and collagen unless cell proliferation was inhibited. There was no detectable level of collagenolytic activity in the M cell culture with the A. brevipedunculata extract. The decrease in accumulation of collagen, therefore, appeared to be a consequence of the proliferation-inhibitory effect of the A. brevipedunculata extract. Such inhibitory activity was found in a macromolecular fraction that contained abundant sugars but lacked proteins.

Coexpression of the collagen-binding stress protein HSP47 gene and the alpha 1(I) and alpha 1(III) collagen genes in carbon tetrachloride-induced rat liver fibrosis

HSP47 is a collagen-binding stress protein and is assumed to act as a collagen-specific molecular chaperone during the biosynthesis and secretion of procollagen in the living cell. The synthesis of HSP47 has been reported to correlate with that of collagen in several cell lines. We examined the expression of HSP47 mRNA during the progression of carbon tetrachloride (CCl4)-induced liver fibrosis in rats. Northern blot analysis revealed that the expression of HSP47 mRNA was markedly induced during the progression of fibrosis in parallel with alpha 1(I) and alpha 1(III) collagen mRNAs. By in situ hybridization, the distribution of HSP47 transcripts was similar to that of alpha 1(I) collagen and was observed only in cells lining collagen fibrils. These collagen-positive cells were confirmed to be Ito cells by immunohistochemistry for desmin. The absence of high levels of HSP47 mRNA in the liver of rats treated with only a single administration of CCl4 indicated that the induction of HSP47 mRNA was not due to the direct effect of CCl4 as a stressor, but was due to the progression of liver fibrosis. The function of HSP47 in liver fibrosis will also be discussed.

Simultaneous expression of type I procollagen mRNA and albumin in cirrhotic human liver

The gene expression of human type I procollagen was investigated in cirrhotic human liver by using in situ hybridization with nonradioactive DNA probes. Using in situ hybridization can provide direct evidence for the cell type capable for type I collagen synthesis in tissues. T-T dimerized DNA probes were used and DNAs hybridized in situ were detected immunohistochemically using specific antibodies against T-T dimer. The data demonstrated that type I collagen is synthesized in hepatocytes and stellate cells in pseudolobules and in fibroblasts in Glissons capsules in cirrhotic human livers. We indicated hepatocytes morphologically and functionally by using immunohistochemical localization of albumin, which was used as a marker of hepatocyte, since albumin is synthesized exclusively by hepatocytes.

Hepatic collagen synthesis in patients with alcoholic and nonalcoholic liver disease

To examine the synthesis of hepatic collagen in patients with alcoholic and nonalcoholic liver disease, liver biopsy specimens were incubated in vitro with 14C-proline, and the radioactivity of the newly synthesized protein-bound 14C-hydroxyproline was measured. Mean hepatic collagen synthesis was 0.82 +/- 0.19 pmole of 14C-hydroxyproline/g liver/2 h in control subjects without histological liver fibrosis. Hepatic collagen synthesis was increased in patients with alcoholic and nonalcoholic liver diseases, especially in those with alcoholic fibrosis, alcoholic cirrhosis and chronic active hepatitis. The raised collagen synthesis in alcoholic liver disease rapidly decreased after withdrawal of alcohol. When alcoholic liver disease were compared with nonalcoholic liver disease, there was no significant difference in hepatic collagen synthesis.

Localization of type III procollagen mRNA in areas of liver fibrosis by in situ hybridization

Localization of type III procollagen mRNA in human liver was studied by in situ hybridization using human alpha 1(III) procollagen cDNA. Frozen and paraformaldehyde-fixed sections of biopsied human liver from patients with chronic hepatitis and cirrhosis were examined using the digoxigenin-labeled cDNA probe. Localization of the type III procollagen mRNA was demonstrated not only in the cytoplasm of mesenchymal cells but also in a large number of hepatocytes, in proportion to the extent of fibrosis. These results suggest that hepatocytes play an important role in fibrogenesis in the liver.

Differential immunohistochemical localization of cytokeratins and collagen types I and III in experimentally-induced cirrhosis

Liver cirrhosis was induced in male Wistar rats by subcutaneous injection (1 ml of 30 g/l) of an aqueous solution of thioacetamide. Using the indirect immunoperoxidase technique, high molecular weight keratins were localized in bile ducts and ductules. Low molecular weight cytokeratins were present in regenerating hepatocytes in active cirrhosis; bile ducts were unstained. These results suggest that cytokeratin staining may be useful in distinguishing bile duct epithelium and hepatocytes in hepatobiliary diseases. Anticollagen type III antibody stained hepatocytes and thin connective tissue fibres, while anticollagen type I antibody stained thicker fibres and some sinusoidal cells but not hepatocytes. Collagens were usually undetectable in normal liver cells. It is suggested, therefore, that hepatocytes may play a major role in collagen type III production which precedes the deposition of collagen type I. By contrast, collagen type I may be produced by fibroblasts and some cells along sinusoids (e.g. perisinusoidal fat-storing cells) after liver injury.

Ultrastructure of cholinergic innervation in the cirrhotic liver in guinea pigs. Neurohistochemical and ultrastructural study

Hepatic cirrhosis was induced in guinea pigs by ligation of the common bile duct and innervation of the liver was studied by fluorescence histochemistry (glyoxylic acid method), acetylcholinesterase (AChE) neurohistochemistry (modified Karnovsky and Roots method), and transmission electron microscopy. In control animals the adrenergic terminals showed connections with endothelial cells, hepatocytes and fat-storing cells, but no cholinergic terminals were evident. Cirrhosis was present 6 weeks after the bile duct ligation and marked fibrosis, accompanied by bile duct proliferation, was evident in the portal areas. Numerous AChE-positive nerve fibers traversed the collagenous bundles in the fibrotic areas, and cholinergic terminals formed close contacts with fibroblasts. Each axon terminal was found to contain numerous small coreless vesicles and AChE-reaction products were confirmed in the space between a nerve terminal and a fibroblast. In contrast, fluorescence adrenergic nerve fibers and their terminals remained unchanged. This study demonstrates that parasympathetic cholinergic innervation participates in some stages in the development of hepatic cirrhosis.

Pathological studies on three cases of cancer treated with polysaccharides from human-type Mycobacterium tuberculosis. Antitumor activity through collagen fiber proliferation

Three cases of cancer treated with SSM (Special Substance, Maruyama: a polysaccharide extract from Mycobacterium tuberculosis) for a long period were studied pathologically following biopsies and autopsies. The most significant antitumor activity resulting from SSM treatment was found to be collagenation from stromal cells and the cancer cells themselves. Another significant finding was that collagenation was promoted by macrophages which had been stimulated non-specifically. However, it was apparent that SSM-A or B had to be used efficiently and quickly in order to prevent invasion or metastasis of cancer. Collagenation due to SSM treatment was more marked in metastatic cancer lesions in the liver than those in the lung. In a case of breast cancer reported in a previous investigation of SSM treatment, remarkable calcification was found in a metastatic cancer lesion which had become confined through collagenation, thus preventing cancer cell metastasis. The collagenation of cancerous lesions through SSM treatment resembled the healing of caseous tuberculosis lesions through a similar mechanism.

Production of collagen fibrils in adrenocortical adenoma with Cushing's syndrome

The production of collagen fibrils, especially collagen type III, was studied with regard to eight adrenocortical adenomas with Cushing's syndrome. Anti-type III procollagen amino-terminal peptide serum (procollagen III) was employed for the PAP method. In areas of clear-type cells, the parenchymal cells were negative for procollagen III, but the stroma exhibited an intense reactivity and were arranged in an alveolar fashion. On the other hand, it was obvious that not only interstitial cells or spindle-shaped cells but also the parenchymal cells synthesized procollagen III in areas of compact-type cells, and the stroma showed a strongly positive reaction to it.

Dynamics of collagen accumulation and activity of collagen-degrading enzymes in the liver of rats with carbon tetrachloride-induced hepatic fibrosis

Liver fibrosis in rats was induced by repeated subcutaneous injections of carbon tetrachloride. Total collagen, soluble and insoluble collagen fractions as well as type I and type III collagen content in the liver were subsequently measured over a 3-18 week period. Liver collagen was found to increase exponentially during this time. Insoluble collagen accumulated more rapidly than soluble forms, and the accumulation of type III collagen was relatively greater than type I collagen. Changes in specific liver enzymes were also observed. Collagenase, collagenolytic cathepsin and collagen peptidase activities all increased. Levels of collagen-degrading enzymes increased rapidly during the first weeks of fibrosis-induction, and were followed by a more gradual increase during the remainder of the study.

Structural change of adrenocortical adenoma in Cushing's syndrome

Eight adrenocortical adenomata from patients with Cushing's syndrome were examined by light and electron microscopy. Light microscopically, the reticulin fibers were markedly prominent in areas of the compact-type cells and ran tangentially to the adenoma cells or parenchymal cells. Electron microscopically, adrenocortical adenoma was composed of parenchymal cells, interstitial cells, and endothelial cells. In areas of the clear-type cells, the parenchymal cells were arranged in long columns and covered by the sinusoidal wall. In areas of the compact-type cells, the sinusoid was well-developed and meandering. The dilated intercellular space was conspicuous and filled with filamentous substance and collagen fibrils. The parenchymal cells appeared to produce the filamentous substance and collagen fibrils, and underwent fragmentation. Interstitial cells and fragmented cytoplasm of the parenchymal cells were found in the intercellular and perisinusoidal space. It was likely that the fragmented cytoplasm flowed into the sinusoid. Experimental study using cell culture methods revealed these phenomena, especially a production of collagen fibrils.

Inhibition of aging changes by lyophilized Streptococcus faecalis in diet

Effects of dietary Streptococcus faecalis (SF) on aging were evaluated using 1-week, 6-month, and 27-month-old Wistar and SHR rats. SF was lyophilized and added to commercial pellets at 1%. SF inhibited hypertension in aging SHR. SF inhibited aging-related changes in a wide variety of tissues. These changes were a disarray of hepatic cords, portal fibrosis; calcification of cartilage matrix, dominance of chondroitin sulfate B, and keratosulfate over chondroitin sulfates A and C; aortic endothelial damage, segmental thickening, calcification, and chondroid cells in the intima; atrophy of epidermis and appendages, and increase in amorphous dermal matrix; waxy degeneration and atrophy of psoas muscles; increase in lipoperoxides in the serum, liver, and brain; and reduction of cyclic AMP and GMP in the serum. Histological changes of the xyphoid cartilage, aorta, mesenteric artery, liver, dorsal skin, and psoas muscles in 27-month-old SF rats were much less severe than those in controls.

Collagen formation by the hepatocyte in primary monolayer culture and in vivo

Immunohistochemical techniques were used to confirm biochemical evidence that parenchymal cells isolated from adult rat liver and maintained in nonreplicating monolayer culture for 2 days synthesized type IV basement membrane collagen. On continued incubation in serum-free medium, the hepatocytes also synthesized the interstitial collagens, types I and III. Consistent with these results in culture, type IV collagen was localized to the hepatocytes in slices of pathologic rat liver. Hence collagen formation is a previously unrecognized function of the hepatocyte that may be important in the pathogenesis of liver fibrosis or cirrhosis.

Connective tissue components of the normal and fibrotic liver. I. Structure, local distribution and metabolism of connective tissue components in the normal liver and changes in chronic liver diseases

The first part of this review describes the chemistry, the occurrence and the metabolism of extracellular connective tissue components in the liver. The normal liver contains typical connective tissue proteins (collagens, structural glycoproteins and proteoglycans) not only in vessel walls, perivascular areas and in the capsule, but they occur also in small amounts in the parenchyma, mainly in the space of Disse along the sinusoidal walls. The "interstitial" collagens type I and III represent the major amount of collagen in the normal as well as in fibrotic liver, showing a relative increase of type III in fibrosis. Basement membrane collagens type IV and V as well as the cysteine-rich collagenous components "7 S collagen" and "short chain collagen" have been shown to occur in extracts prepared after limited pepsin digestion. In the normal liver, basement membrane collagen can hardly be detected within the parenchyma by immunofluorescence microscopy; increased occurrence, however, can be shown along the sinusoids even in early stages of chronic liver diseases. The glycoprotein fibronectin was shown to be distributed very similarly to collagens type I and III, whereas the basement membrane specific glycoprotein laminin is restricted to vessel walls and the epithelial layer of bile ductuli in the normal liver but is also found in the parenchyma in fibrosis. Occurrence of proteoglycans is increased in fibrosis: a change in the composition of glycosaminoglycans from mainly heparan sulfate in the normal to dermatan- and chondroitin sulfate in the fibrotic liver was observed. It is not yet clear which cell type is mainly responsible for increased connective tissue synthesis in fibrosis. The occurrence of cells resembling smooth muscle cells ("myofibroblasts") in connective tissue septa of fibrotic livers and the fact that similar cells which actively synthesize collagen grow from explants of fibrotic livers may indicate the significance of this cell type in the process of liver fibrosis.

Pathological study on gold impregnation of fat-storing cells in human liver

Examination of 51 human liver specimens with the modified Kupffer's gold impregnation method confirmed the presence and distribution of fat-storing cells in various kinds of diseased livers such as fatty liver, acute centrolobular necrosis, subacute massive necrosis and cirrhosis as well as in liver cell carcinoma. In normal liver, gold-reactive fat-storing cells were distributed in the central area or diffusely in lobules. In the liver with marked fatty change and obstructive jaundice, presence of fat-storing cells was able to be clarified by this method. In cases of acute hepatocellular necrosis, the necrotic areas contained a large number of fat-storing cells in contrast to adjacent areas. In cases of subacute massive hepatic necrosis and cirrhosis, the areas with abundant newly formed collagen fibers (type III collagen) contained many gold-reactive fat-storing cells. In the septa consisting of dense type I collagen fibers, by contraries, fat-storing cells were hardly visible. The features suggested that fat-storing cells are closely related to intralobular fibrogenesis. In one case of liver cell carcinoma, there were many gold-reactive fat-storing cells in tumour tissue.

Influence of extracellular proline on collagen synthesis in rat liver slices

The synthesis of collagen was measured in incubated rat liver slices. The concentration of proline in the medium was varied, but the specific radioactivity of proline was kept constant. The synthesis of total protein was found to be about 500-fold that of collagen. The incorporation into hydroxyproline--that is, the synthesis of collagen--and the total incorporation of proline into protein were dependent on the concentration of proline in the medium, by Michaelis-Menten kinetics, with an apparent Km of 0.40 mM for the synthesis of collagen and 0.43 mM for the synthesis of total protein.

The synthesis of total and specific glycosaminoglycans during development of experimental liver cirrhosis

During hepatic fibrogenesis induced by long-term administration of thioacetamide, the synthesis of chondroitin 4,6-sulfate and hyaluronic acid was strongly enhanced; the formation of heparan sulfate comprising at least 70% of total liver GAG synthesis and of a keratan-sulfate-like fraction was stimulated 1.7 fold. Formation of dermatan-sulfate in liver could not be detected.

Establishment and characterization of 5 human cell lines derived from a series of 50 primary intracranial tumors

A series of 50 human primary intracranial tumors were cultivated in vitro in an attempt to establish cell lines with the trypsinization technique. During the in vitro adaptation period, cultures were maintained at high cell density to avoid rapid over-growth by connective tissue. Five lines were established from 5 tumors including 4 malignant gliomas (SA4, SA44, SA45, SA101) and 1 meningeal sarcoma (SA39). These 5 lines were compared for the following investigations and criteria: light and electron microscopy, chromosomal patterns, saturation density, plating efficiency, doubling time, synthesis of collagen, S-100 and GFA proteins, response to d b-c AMP and tumorigenicity into nude mice. For one or more of the characteristics mentioned above each line was distinct from the others. None of the growth parameters that serve to define the abnormal state in vitro correlated consistently with cellular tumorigenicity in athymic nude mice. The nature of lines derived from gliomas remain uncertain and the collagen synthesis in vitro is not sufficient to affirm that these lines are mesenchymal rather than glial.

Liver collagen synthesis in murine schistosomiasis

Collagen synthesis was measured in liver slices obtained from mice with hepatosplenic schistosomiasis. Enlarged fibrotic livers from these mice contained 20 times more collagen than normal. This model of hepatic fibrosis results from an inflammatory granulomatous host response to Schistosoma mansoni ova in portal tracts, rather than from direct lover cell injury as with carbon tetrachloride-induced liver fibrosis. Collagen synthesis, as measured by the formation of labeled protein-bound hydroxyproline, occurred in granulomas isolated from fibrotic livers. Labeled collagen that cochromatographed with type I collagen was extracted with neutral salt solution from liver slices incubated with labeled proline. The free proline pool of the liver was doubled in infected mice; coordinately, liver slices from these animals showed maximal collagen production when the concentration of free proline in the medium was raised to 0.4 mM, the same level measured in the fibrotic livers. Under such conditions, collagen synthesis was at a rate equivalent to the formation of 5.4 nmol of protein-bound hydroxyproline per g liver in 6 h. In comparative incubations in medium containing 0.2 mM proline, fibrotic liver slices produced 16-fold more collagen than normal slices. The proline analogue, L-azetidine 2-carboxylic acid, effectively inhibited synthesis of labeled collagen by fibrotic liver slices. These studies show the synthesis of collagen in a reproducible animal model of the most prevalent form of human liver fibrosis. Difinitition of the controlling factors in this system is of interest for the general problem of fibrosis produced by immunological responses.