Pleiotrophin signalling via the protein tyrosine phosphatase receptor zeta-1 (PTPRZ1) has been found to regulate the ductular reaction, which occurs during liver injury. Cell–cell adhesion, cell–matrix interactions and cell migration—all of which are involved in the ductular reaction—were shown to be negatively regulated by pleiotrophin–PTPRZ1 signalling. PTPRZ1 protein levels were shown to be increased in the ductular reaction of patients with polycystic liver disease, primary biliary cirrhosis and primary sclerosing cholangitis.