Section of Hepatobiliary Surgery and Liver Transplantation, Surgical Research Laboratory, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, Michigan.
Semin Thromb Hemost. 2018 Mar;44(2):114-125. doi: 10.1055/s-0037-1604091. Epub 2017 Sep 12.
Platelets are key players in thrombosis and hemostasis. Alterations in platelet count and function are common in liver disease, and may contribute to bleeding or thrombotic complications in liver diseases and during liver surgery. In addition to their hemostatic function, platelets may modulate liver diseases by mechanisms that are incompletely understood. Here, we present clinical evidence for a role of platelets in the progression of chronic and acute liver diseases, including cirrhosis, acute liver failure, and hepatocellular carcinoma. We also present clinical evidence that platelets promote liver regeneration following partial liver resection. Subsequently, we summarize studies in experimental animal models that support these clinical observations, and also highlight studies that are in contrast with clinical observations. The combined results of clinical and experimental studies suggest that platelets may be a therapeutic target in the treatment of liver injury and repair, but the gaps in our understanding of mechanisms involved in platelet-mediated modulation of liver diseases call for caution in clinical application of these findings.
血小板是血栓形成和止血的关键因素。血小板计数和功能的改变在肝病中很常见,可能导致肝脏疾病和肝脏手术期间的出血或血栓并发症。除了止血功能外,血小板还可能通过尚未完全了解的机制调节肝脏疾病。在这里,我们提出了血小板在慢性和急性肝病(包括肝硬化、急性肝衰竭和肝细胞癌)进展中的作用的临床证据。我们还提出了临床证据表明,血小板可促进部分肝切除术后的肝再生。随后,我们总结了支持这些临床观察的实验动物模型研究,并强调了与临床观察相矛盾的研究。临床和实验研究的综合结果表明,血小板可能是治疗肝损伤和修复的一个治疗靶点,但我们对血小板介导的肝脏疾病调节机制的理解存在差距,因此在临床应用这些发现时需要谨慎。