Department of Hepatology and Gastroenterology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Liver Int. 2011 Feb;31(2):146-62. doi: 10.1111/j.1478-3231.2010.02369.x. Epub 2010 Nov 15.
Nowadays, liver cancer, cirrhosis and other liver-related diseases are the fifth most common cause of mortality in the UK. Furthermore, chronic liver diseases (CLDs) are one of the major causes of death, which are still increasing year-on-year. Therefore, knowledge about the pathophysiology of CLDs and its complications is of uttermost importance. The goal of this review is to clarify the role of angiogenesis in the disease progression of various liver diseases. Looking closer at the pathophysiology of portal hypertension (PH), fibrosis, cirrhosis, non-alcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC), we find that angiogenesis is a recurring factor in the disease progression. In PH, several factors involved in its pathogenesis, such as hypoxia, oxidative stress, inflammation and shear stress are potential mediators for the angiogenic response. The progression from fibrosis to cirrhosis, the end-point of CLDs, is distinguished by a prolonged inflammatory and fibrogenic process that leads to an abnormal angioarchitecture distinctive for cirrhosis. In several stages of NASH, a link might be made between the disease progression and hepatic microvasculature changes. HCC is one of the most vascular solid tumours in which angiogenesis plays an important role in its development, progression and metastasis. The close relationship between the progression of CLDs and angiogenesis emphasises the need for anti-angiogenic therapy as a tool for blocking or slowing down the disease progression. The fact that angiogenesis plays a pivotal role in CLDs gives rise to new opportunities for treating CLDs and its complications.
如今，肝癌、肝硬化和其他肝脏相关疾病是英国第五大致死原因。此外，慢性肝脏疾病（CLDs）是主要死亡原因之一，且其发病率仍在逐年上升。因此，了解 CLDs 的病理生理学及其并发症至关重要。本文旨在阐明血管生成在各种肝脏疾病进展中的作用。深入研究门静脉高压症（PH）、纤维化、肝硬化、非酒精性脂肪性肝炎（NASH）和肝细胞癌（HCC）的病理生理学，我们发现血管生成是疾病进展的一个反复出现的因素。在 PH 中，参与其发病机制的几个因素，如缺氧、氧化应激、炎症和切应力，可能是血管生成反应的潜在介质。从纤维化到肝硬化的进展，即 CLDs 的终点，以导致肝硬化特征性的异常血管生成的延长炎症和纤维发生过程为特征。在 NASH 的几个阶段，可能存在疾病进展与肝微血管变化之间的联系。HCC 是最具血管生成的实体肿瘤之一，血管生成在其发展、进展和转移中起重要作用。CLDs 的进展与血管生成之间的密切关系强调了抗血管生成治疗作为阻断或减缓疾病进展的工具的必要性。血管生成在 CLDs 中起着关键作用，这为治疗 CLDs 及其并发症提供了新的机会。
