Gaudio Eugenio, Franchitto Antonio, Pannarale Luigi, Carpino Guido, Alpini Gianfranco, Francis Heather, Glaser Shannon, Alvaro Domenico, Onori Paolo
Department of Human Anatomy, University of Rome, La Sapienza, Rome, Italy.
World J Gastroenterol. 2006 Jun 14;12(22):3546-52. doi: 10.3748/wjg.v12.i22.3546.
The microvascular supply of the biliary tree, the peribiliary plexus (PBP), stems from the hepatic artery branches and flows into the hepatic sinusoids. A detailed three-dimensional study of the PBP has been performed by using the Scanning Electron Microscopy vascular corrosion casts (SEMvcc) technique. Considering that the PBP plays a fundamental role in supporting the secretory and absorptive functions of the biliary epithelium, their organization in either normalcy and pathology is explored. The normal liver shows the PBP arranged around extra- and intrahepatic biliary tree. In the small portal tract PBP was characterized by a single layer of capillaries which progressively continued with the extrahepatic PBP where it showed a more complex vascular network. After common duct ligation (BDL), progressive modifications of bile duct and PBP proliferation are observed. The PBP presents a three-dimensional network arranged around many bile ducts and appears as bundles of vessels, composed by capillaries of homogeneous diameter with a typical round mesh structure. The PBP network is easily distinguishable from the sinusoidal network which appears normal. Considering the enormous extension of the PBP during BDL, the possible role played by the Vascular Endothelial Growth Factor (VEGF) is evaluated. VEGF-A, VEGF-C and their related receptors appeared highly immunopositive in proliferating cholangiocytes of BDL rats. The administration of anti-VEGF-A or anti-VEGF-C antibodies to BDL rats as well as hepatic artery ligation induced a reduced bile duct mass. The administration of rVEGF-A to BDL hepatic artery ligated rats prevented the decrease of cholangiocyte proliferation and VEGF-A expression as compared to BDL control rats. These data suggest the role of arterial blood supply of the biliary tree in conditions of cholangiocyte proliferation, such as it occurs during chronic cholestasis. On the other hand, the role played by VEGF as a tool of cross-talk between cholangiocytes and PBP endothelial cells suggests that manipulation of VEGF release and function could represent a therapeutic strategy for human pathological conditions characterized by damage of hepatic artery or the biliary tree.
胆管树的微血管供应,即胆管周围丛(PBP),源自肝动脉分支,并流入肝血窦。利用扫描电子显微镜血管铸型(SEMvcc)技术对PBP进行了详细的三维研究。鉴于PBP在支持胆管上皮的分泌和吸收功能中起重要作用,对其在正常和病理状态下的组织结构进行了探索。正常肝脏中,PBP围绕肝内和肝外胆管树排列。在小门静脉区域,PBP的特征是单层毛细血管,其逐渐延续至肝外PBP,在肝外PBP处显示出更复杂的血管网络。胆总管结扎(BDL)后,观察到胆管的渐进性改变和PBP增殖。PBP呈现围绕许多胆管排列的三维网络,表现为血管束,由直径均匀的毛细血管组成,具有典型的圆形网状结构。PBP网络很容易与外观正常的血窦网络区分开来。考虑到BDL期间PBP的巨大扩展,评估了血管内皮生长因子(VEGF)可能发挥的作用。VEGF-A、VEGF-C及其相关受体在BDL大鼠增殖的胆管细胞中呈现高度免疫阳性。给BDL大鼠注射抗VEGF-A或抗VEGF-C抗体以及肝动脉结扎均导致胆管质量减轻。与BDL对照大鼠相比,给BDL肝动脉结扎大鼠注射rVEGF-A可防止胆管细胞增殖和VEGF-A表达的降低。这些数据表明胆管树的动脉血供应在胆管细胞增殖的情况下所起的作用,例如在慢性胆汁淤积期间发生的情况。另一方面,VEGF作为胆管细胞与PBP内皮细胞之间相互作用工具所起的作用表明,操纵VEGF的释放和功能可能代表一种针对以肝动脉或胆管树损伤为特征的人类病理状况的治疗策略。