Importance of Connexin-43 based gap junction in cirrhosis and acute-on-chronic liver failure.

Schematic representation of the adaptive and protective inducible expression of cx43 in chronic and acute-on-chronic liver injuries. Upon hepatic insult, endogenous expression of Cx26 and Cx32 is reduced to alleviate the spread out of noxious injurious agents among the hepatocytes, whereas Cx43 expression is induced between hepatocytes and endothelial cells, to drain out the hepatic metabolites and endotoxin into the draining veins. It is assumed that in this way the inducible Cx43 expression during the hepatic injury exerts a protective effect and therefore, inhibition of Cx43 by a mimetic peptide accentuates the hepatic injury following bile duct ligation in mice.