纤维化和肝再生机制

IF 3 4区 医学 Q1 Medicine Translational gastroenterology and hepatology Pub Date : 2022-01-25 eCollection Date: 2022-01-01 DOI:10.21037/tgh.2020.02.21
Esmeralda Zuñiga-Aguilar, Odin Ramírez-Fernández
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引用次数: 0

摘要

肝硬化是由病毒、代谢或自身免疫引起的持续肝脏炎症活动的最后阶段。在过去的几年里,肝硬化被认为是一种独特的、静态的病症;最近,一些肝损伤程度不同的亚组患者在同一诊断下并存,这对自然病史产生了影响。肝脏生长因子(LGF)是一种强效的体内和体外有丝分裂剂,可通过肝细胞 DNA 合成诱导肝脏再生(HR)。LGF水平在肝硬化中的临床意义尚不明确,即使它在肝脏再生过程中发挥着重要作用,研究也表明它可能是急性肝衰竭和慢性肝炎中肝硬化严重程度的标志物。有研究认为,它可以预测暴发性肝功能不全患者的死亡率。肝功能衰竭是最神秘、最迷人的生物现象之一。在大肝切除术(>70%)或严重肝细胞损伤后,HR 能迅速恢复肝脏容量和肝功能,并在损伤停止后严格调节组织损伤反应,这是肝脏独有的特性。HR 是临床应用的基础,如广泛的肝切除术(>70% 的肝实质)、分段移植或活体移植、连续肝切除术、孤立的肝门栓塞或伴有原位肝横断术、急性肝衰竭时的临时人工支持以及可能的细胞治疗临床应用。
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Fibrosis and hepatic regeneration mechanism.

Liver cirrhosis is the final stage of continuous hepatic inflammatory activity derived by viral, metabolic or autoimmune origin. In the last years, cirrhosis was considered a unique and static condition; recently was accepted some patients subgroups with different liver injury degrees that coexist under the same diagnosis, with implications about the natural disease history. The liver growth factor (LGF) is a potent in vivo and in vitro mitogenic agent and an inducer of hepatic regeneration (HR) through the hepatocytes DNA synthesis. The clinical implications of the LGF levels in cirrhosis, are not clear and even with having a fundamental role in the liver regeneration processes, the studies suggest that it could be a cirrhosis severity marker, in acute liver failure and in chronic hepatitis. Its role as predictor of mortality in fulminant hepatic insufficiency patients has been suggested. HR is one of the most enigmatic and fascinating biological phenomena. The rapid volume and liver function restoration after a major hepatectomy (>70%) or severe hepatocellular damage and its strict regulation of tissue damage response after the cessation, is an exclusive property of the liver. HR is the clinical applications fundament, such as extensive hepatic resections (>70% of the liver parenchyma), segmental transplantation or living donor transplantation, sequential hepatectomies, isolated portal embolization or associated with in situ hepatic transection, temporary artificial support in acute liver failure and the possible cell therapy clinical applications.

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来源期刊
CiteScore
8.20
自引率
0.00%
发文量
1
期刊介绍: Translational Gastroenterology and Hepatology (Transl Gastroenterol Hepatol; TGH; Online ISSN 2415-1289) is an open-access, peer-reviewed online journal that focuses on cutting-edge findings in the field of translational research in gastroenterology and hepatology and provides current and practical information on diagnosis, prevention and clinical investigations of gastrointestinal, pancreas, gallbladder and hepatic diseases. Specific areas of interest include, but not limited to, multimodality therapy, biomarkers, imaging, biology, pathology, and technical advances related to gastrointestinal and hepatic diseases. Contributions pertinent to gastroenterology and hepatology are also included from related fields such as nutrition, surgery, public health, human genetics, basic sciences, education, sociology, and nursing.
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