Shimazaki Y, Hara F
First Department of Internal Medicine, Nippon Medical School.
Nihon Ika Daigaku Zasshi. 1991 Aug;58(4):74-83.
Histopathological changes in alcoholic liver disease are characterized by Mallory body, fatty liver, and peculiar fibrosis such as pericentral fibrosis, pericellular fibrosis, stellate fibrosis originating from Glisson's sheath, and swelling of the liver cells. However, the mechanism of fibrosis remains unknown. The author tried to demonstrate, by the immunohistochemical method, fibronectin (FN), collagen type I, III, IV (IC, IIIC, IVC), factor XIIIa, and factor VIII related antigen (VIII RAg), all of which are related to the process of wound healing, in order to clarify the mechanism of fibrosis in alcoholic liver disease. With the progress of fibrosis, FN was demonstrated in the sinusoidal wall, as well as the portal areas and around the central veins. IC and IIIC were positive in the fibrotic area extending into the lobules and pericellular fibrosis. IVC was similar to FN and was positive in the sinusoidal wall. Scattered XIIIa positivity was recognized in the fibrotic areas, especially in the foci of active fibrosis. VIII RAg was positive in the capillary vessels invading the lobules through the limiting plates. The distribution of these proteins in the fibrotic area in alcoholic liver disease closely resembled that in the wound healing process. It is concluded that fibrosis occurring in the periportal area is essentially the same as in the wound healing process and the mechanism of fibrosis in alcoholic liver disease is thought to be active fibroplasia.
酒精性肝病的组织病理学变化特征为出现马洛里小体、脂肪肝以及特殊的纤维化，如中央周围纤维化、细胞周围纤维化、源自肝门管的星状纤维化，还有肝细胞肿胀。然而，纤维化的机制仍不清楚。作者试图通过免疫组织化学方法来证实纤连蛋白（FN）、Ⅰ型、Ⅲ型、Ⅳ型胶原（IC、IIIC、IVC）、ⅩⅢa因子和Ⅷ因子相关抗原（ⅧRAg），所有这些都与伤口愈合过程相关，以阐明酒精性肝病中纤维化的机制。随着纤维化的进展，FN在肝血窦壁、门静脉区以及中央静脉周围均有表达。IC和IIIC在延伸至小叶内的纤维化区域及细胞周围纤维化中呈阳性。IVC与FN相似，在肝血窦壁呈阳性。在纤维化区域，尤其是活跃纤维化灶中可发现散在的ⅩⅢa阳性。ⅧRAg在通过界板侵入小叶的毛细血管中呈阳性。这些蛋白质在酒精性肝病纤维化区域的分布与伤口愈合过程中的分布非常相似。结论是，门周区域发生的纤维化与伤口愈合过程基本相同，酒精性肝病中纤维化的机制被认为是活跃的纤维组织增生。
