The liver is central to health, providing numerous synthetic, metabolic, bioactivating, conjugating, and elimination functions (see table) that are essential to normal homeostasis. It orchestrates synthesis and metabolism of lipids, carbohydrates, and proteins; storage, metabolism, and activation of certain vitamins; and storage of minerals, glycogen, and triglycerides. It provides coagulant, anticoagulant, and essential acute phase proteins and can function as an on-demand site of extramedullary hematopoiesis.
The liver also contributes to digestion via synthesis and enterohepatic circulation of bile acids and influences the enteric biome (bile acids and IgA in bile) and systemic immunologic responses. It is central to the metabolism of endogenous and exogenous compounds, including a variety of xenobiotics, drugs, and toxins via bioactivation, biotransformation, detoxification, and elimination.
Housing the largest population of fixed macrophages in the body (Kupffer cells), the liver also orchestrates clearance of bloodborne toxicants, particulate and soluble debris, and bacteria and their toxins, many derived from the digestive canal.
