Okamoto Naomasa, Akimoto Naotaka, Hidaka Nobuto, Shoji Shuneki, Sumida Hiroshi
Hiroshima University and Miyazaki University, Hiroshima, Japan.
Congenit Anom (Kyoto). 2010 Sep;50(3):141-58. doi: 10.1111/j.1741-4520.2010.00286.x. Epub 2010 Jun 29.
The formal genesis of the great arteries continues to be controversial due to the lack of consensus of septation of the developing outflow tract. In order to make it clear how the great arteries are generated, we have re-examined our previous papers which emphasized the formation of the aorta and pulmonary trunk, concept of the aorticopulmonary septum, formation of the leaflets of semilunar valves, morphogenesis of the crista supraventricularis, programmed cell death and rotation of the outflow tract. In the present paper, we compare outcomes gained from the re-examination of our previous papers with prevalent interpretations of the arterial trunk. We obtained conclusions as follows: (i) The elongation of the fourth and sixth aortic arch arteries, which sprout from the wall of the aortic sac at the expense of the distal truncus, contributes to the formation of the aorta and pulmonary trunk; (ii) Smooth muscle cells of the tunica media of the arterial trunks do not arise from the transformation of the myocardial cells of the truncus wall (not 'arterialization'); (iii) Truncus swellings are divided into two parts: distal and proximal. The former contributes to the separation of the orifices of arterial trunks ('aorticopulmonary septum'). The latter contributes to the formation of the leaflets of the semilunar valves of the aorta and pulmonary trunk; (iv) The origin of the myocardial cells of the crista supraventricularis is a wall of the conus originated from secondary/anterior heart fields; and (v) There has been no acceptable proof that rotation and counterclockwise rotation are involved.
由于在发育中的流出道分隔方面缺乏共识，大动脉的正式起源仍然存在争议。为了弄清楚大动脉是如何形成的，我们重新审视了我们之前强调主动脉和肺动脉干形成、主动脉肺动脉隔的概念、半月瓣小叶的形成、室上嵴的形态发生、程序性细胞死亡以及流出道旋转的论文。在本文中，我们将对之前论文重新审视所得到的结果与对动脉干的普遍解释进行比较。我们得出了以下结论：（i）从主动脉囊壁发出、以远端动脉干为代价的第四和第六主动脉弓动脉的伸长，有助于主动脉和肺动脉干的形成；（ii）动脉干中膜的平滑肌细胞并非来自动脉干壁心肌细胞的转化（并非“动脉化”）；（iii）动脉干膨大部分分为两部分：远端和近端。前者有助于动脉干口的分离（“主动脉肺动脉隔”）。后者有助于主动脉和肺动脉干半月瓣小叶的形成；（iv）室上嵴心肌细胞的起源是源自次级/前心区的圆锥壁；以及（v）没有可接受的证据表明存在旋转和逆时针旋转。
