Elpek Gülsüm Özlem
Gülsüm Özlem Elpek, Department of Pathology, Akdeniz University Medical School, 07070 Antalya, Turkey.
World J Hepatol. 2015 Mar 27;7(3):377-91. doi: 10.4254/wjh.v7.i3.377.
Recent data indicate that hepatic angiogenesis, regardless of the etiology, takes place in chronic liver diseases (CLDs) that are characterized by inflammation and progressive fibrosis. Because anti-angiogenic therapy has been found to be efficient in the prevention of fibrosis in experimental models of CLDs, it is suggested that blocking angiogenesis could be a promising therapeutic option in patients with advanced fibrosis. Consequently, efforts are being directed to revealing the mechanisms involved in angiogenesis during the progression of liver fibrosis. Literature evidences indicate that hepatic angiogenesis and fibrosis are closely related in both clinical and experimental conditions. Hypoxia is a major inducer of angiogenesis together with inflammation and hepatic stellate cells. These profibrogenic cells stand at the intersection between inflammation, angiogenesis and fibrosis and play also a pivotal role in angiogenesis. This review mainly focuses to give a clear view on the relevant features that communicate angiogenesis with progression of fibrosis in CLDs towards the-end point of cirrhosis that may be translated into future therapies. The pathogenesis of hepatic angiogenesis associated with portal hypertension, viral hepatitis, non-alcoholic fatty liver disease and alcoholic liver disease are also discussed to emphasize the various mechanisms involved in angiogenesis during liver fibrogenesis.
近期数据表明，无论病因如何，肝血管生成均发生于以炎症和进行性纤维化为特征的慢性肝病（CLD）中。由于在CLD实验模型中发现抗血管生成疗法在预防纤维化方面有效，因此有人提出，阻断血管生成可能是晚期纤维化患者一种有前景的治疗选择。因此，目前正致力于揭示肝纤维化进展过程中血管生成所涉及的机制。文献证据表明，在临床和实验条件下，肝血管生成与纤维化密切相关。缺氧与炎症和肝星状细胞一样，是血管生成的主要诱导因素。这些促纤维化细胞处于炎症、血管生成和纤维化的交叉点，在血管生成中也起着关键作用。本综述主要致力于清晰阐述在CLD中使血管生成与纤维化进展相关联直至肝硬化终点的相关特征，这些特征可能转化为未来的治疗方法。还讨论了与门静脉高压、病毒性肝炎、非酒精性脂肪性肝病和酒精性肝病相关的肝血管生成的发病机制，以强调肝纤维化形成过程中血管生成所涉及的各种机制。
