Embrionary way to create a fatty liver in portal hypertension.

Maria-Angeles Aller, Natalia Arias, Isabel Peral, Sara García-Higarza, Jorge-Luis Arias, Jaime Arias
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Abstract

Portal hypertension in the rat by triple partial portal vein ligation produces an array of splanchnic and systemic disorders, including hepatic steatosis. In the current review these alterations are considered components of a systemic inflammatory response that would develop through three overlapping phenotypes: The neurogenic, the immune and the endocrine. These three inflammatory phenotypes could resemble the functions expressed during embryonic development of mammals. In turn, the inflammatory phenotypes would be represented in the embryo by two functional axes, that is, a coelomic-amniotic axis and a trophoblastic yolk-sac or vitelline axis. In this sense, the inflammatory response developed after triple partial portal vein ligation in the rat would integrate both functional embryonic axes on the liver interstitial space of Disse. If so, this fact would favor the successive development of steatosis, steatohepatitis and fibrosis. Firstly, these recapitulated embryonic functions would produce the evolution of liver steatosis. In this way, this fat liver could represent a yolk-sac-like in portal hypertensive rats. After that, the systemic recapitulation of these embryonic functions in experimental prehepatic portal hypertension would consequently induce a gastrulation-like response in which a hepatic wound healing reaction or fibrosis occur. In conclusion, studying the mechanisms involved in embryonic development could provide key results for a better understanding of the nonalcoholic fatty liver disease etiopathogeny.

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门静脉高压症的胚胎性脂肪肝形成途径。
三段式部分门静脉结扎引起的大鼠门静脉高压可引起一系列内脏和全身疾病,包括肝脂肪变性。在目前的综述中,这些改变被认为是全身性炎症反应的组成部分,它将通过三种重叠的表型发展:神经源性、免疫和内分泌。这三种炎症表型可能类似于哺乳动物胚胎发育过程中表达的功能。反过来,炎症表型将在胚胎中通过两个功能轴表示,即体腔-羊膜轴和滋养层卵黄囊或卵黄轴。从这个意义上说,大鼠门静脉部分结扎后产生的炎症反应将两个功能胚胎轴整合到Disse肝间质间隙上。如果是这样,这一事实将有利于脂肪变性、脂肪性肝炎和纤维化的连续发展。首先,这些重述的胚胎功能会导致肝脏脂肪变性的进化。由此可见,门脉高压大鼠的脂肪肝可能呈黄囊样。在此之后,这些胚胎功能在实验性肝前门静脉高压症中的系统性重述将导致类似原肠胚形成的反应,其中肝伤口愈合反应或纤维化发生。总之,研究胚胎发育的相关机制可以为更好地了解非酒精性脂肪性肝病的发病机制提供关键结果。
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