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肝硬化的发病机制。

Pathogenesis of liver cirrhosis.

作者信息

Zhou Wen-Ce, Zhang Quan-Bao, Qiao Liang

机构信息

Wen-Ce Zhou, Department of General Surgery II, the First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China.

出版信息

World J Gastroenterol. 2014 Jun 21;20(23):7312-24. doi: 10.3748/wjg.v20.i23.7312.

Abstract

Liver cirrhosis is the final pathological result of various chronic liver diseases, and fibrosis is the precursor of cirrhosis. Many types of cells, cytokines and miRNAs are involved in the initiation and progression of liver fibrosis and cirrhosis. Activation of hepatic stellate cells (HSCs) is a pivotal event in fibrosis. Defenestration and capillarization of liver sinusoidal endothelial cells are major contributing factors to hepatic dysfunction in liver cirrhosis. Activated Kupffer cells destroy hepatocytes and stimulate the activation of HSCs. Repeated cycles of apoptosis and regeneration of hepatocytes contribute to pathogenesis of cirrhosis. At the molecular level, many cytokines are involved in mediation of signaling pathways that regulate activation of HSCs and fibrogenesis. Recently, miRNAs as a post-transcriptional regulator have been found to play a key role in fibrosis and cirrhosis. Robust animal models of liver fibrosis and cirrhosis, as well as the recently identified critical cellular and molecular factors involved in the development of liver fibrosis and cirrhosis will facilitate the development of more effective therapeutic approaches for these conditions.

摘要

肝硬化是各种慢性肝病的最终病理结果,而纤维化是肝硬化的前驱病变。多种类型的细胞、细胞因子和微小RNA(miRNA)参与了肝纤维化和肝硬化的起始和进展过程。肝星状细胞(HSC)的激活是纤维化过程中的关键事件。肝窦内皮细胞的窗孔减少和毛细血管化是肝硬化肝功能障碍的主要促成因素。活化的库普弗细胞会破坏肝细胞并刺激HSC的激活。肝细胞反复的凋亡和再生循环促成了肝硬化的发病机制。在分子水平上,许多细胞因子参与调节HSC激活和纤维化形成的信号通路的介导。最近,作为转录后调节因子的miRNA已被发现在纤维化和肝硬化中起关键作用。强大的肝纤维化和肝硬化动物模型,以及最近确定的参与肝纤维化和肝硬化发展的关键细胞和分子因素,将有助于开发针对这些病症的更有效治疗方法。

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