Gabrielli G B, Corrocher R
Istituto di Patologia Medica, Università di Verona, Italia.
Dig Dis. 1991;9(5):303-16. doi: 10.1159/000171314.
Hepatic fibrosis is characterized by a progressive increase in extracellular matrix in the liver, formed by collagens, proteoglycans and glycoproteins, qualitatively similar but quantitatively different from that in normal liver. A great number of matrix-related substances have been investigated in serum in order to identify reliable serum markers of liver fibroplasia. Among the various cleavage products of collagen precursor, the NPIIIP collagen is at present considered the most reliable serum marker of active fibrogenesis in liver, useful in monitoring the progression of fibrosis and in assessing the therapeutic efficacy of antifibrotic drugs. Lam-P1 and type IV collagen are now regarded as putative markers of basement membrane formation and sinusoids capillarization, an important pathological process in fibrosing disease, related to the impairment of hepatic circulation. Other serum-measured matrix-related substances, e.g. enzymes involved in collagen metabolism, fibronectin and proteoglycans, have not proved to reflect liver fibroplasia reliably. In spite of the availability of useful serum markers, the assessment of hepatic fibrosis is still based on liver biopsy.
肝纤维化的特征是肝脏细胞外基质进行性增加，该基质由胶原蛋白、蛋白聚糖和糖蛋白构成，在性质上与正常肝脏相似，但数量不同。为了确定可靠的肝纤维化血清标志物，人们对大量与基质相关的物质进行了血清学研究。在胶原蛋白前体的各种裂解产物中，NPIIIP胶原蛋白目前被认为是肝脏中活跃纤维生成最可靠的血清标志物，有助于监测纤维化的进展以及评估抗纤维化药物的治疗效果。Lam-P1和IV型胶原蛋白现在被视为基底膜形成和肝血窦毛细血管化的推定标志物，肝血窦毛细血管化是纤维化疾病中的一个重要病理过程，与肝循环受损有关。其他血清检测的与基质相关的物质，如参与胶原蛋白代谢的酶、纤连蛋白和蛋白聚糖，尚未被证明能可靠地反映肝纤维化。尽管有有用的血清标志物，但肝纤维化的评估仍基于肝活检。
