IGF1 and Cirrhosis: In models of cirrhosis, IGF-1 exerts anti-fibrotic effects that include reduced activation of hepatic stellate cells (HSCs), upregulation of matrix metalloproteases (MMPs), downregulation of tissue inhibitors of MMPs (TIM-1 and TIM-2), downregulation of profibrogenic molecules including transforming growth factor beta-1 (TGFß1), and induction of cytoprotective factors including hepatocyte growth factor (HGF) [44,46,47].