Peeters Geert, Debbaut Charlotte, Friebel Adrian, Cornillie Pieter, De Vos Winnok H, Favere Kasper, Vander Elst Ingrid, Vandecasteele Tim, Johann Tim, Van Hoorebeke Luc, Monbaliu Diethard, Drasdo Dirk, Hoehme Stefan, Laleman Wim, Segers Patrick
IBiTech - bioMMeda, Department of Electronics and Information Systems, Ghent University, Gent, Belgium.
Interdisciplinary Centre for Bioinformatics (IZBI), University of Leipzig, Leipzig, Germany.
J Anat. 2018 Mar;232(3):485-496. doi: 10.1111/joa.12760. Epub 2017 Dec 4.
Cirrhosis represents the end-stage of any persistent chronically active liver disease. It is characterized by the complete replacement of normal liver tissue by fibrosis, regenerative nodules, and complete fibrotic vascularized septa. The resulting angioarchitectural distortion contributes to an increasing intrahepatic vascular resistance, impeding liver perfusion and leading to portal hypertension. To date, knowledge on the dynamically evolving pathological changes of the hepatic vasculature during cirrhogenesis remains limited. More specifically, detailed anatomical data on the vascular adaptations during disease development is lacking. To address this need, we studied the 3D architecture of the hepatic vasculature during induction of cirrhogenesis in a rat model. Cirrhosis was chemically induced with thioacetamide (TAA). At predefined time points, the hepatic vasculature was fixed and visualized using a combination of vascular corrosion casting and deep tissue microscopy. Three-dimensional reconstruction and data-fitting enabled cirrhogenic features to extracted at multiple scales, portraying the impact of cirrhosis on the hepatic vasculature. At the macrolevel, we noticed that regenerative nodules severely compressed pliant venous vessels from 12 weeks of TAA intoxication onwards. Especially hepatic veins were highly affected by this compression, with collapsed vessel segments severely reducing perfusion capabilities. At the microlevel, we discovered zone-specific sinusoidal degeneration, with sinusoids located near the surface being more affected than those in the middle of a liver lobe. Our data shed light on and quantify the evolving angioarchitecture during cirrhogenesis. These findings may prove helpful for future targeted invasive interventions.
肝硬化是任何持续性慢性活动性肝病的终末期。其特征是正常肝组织被纤维化、再生结节和完全纤维化的血管化间隔完全替代。由此产生的血管结构扭曲导致肝内血管阻力增加,阻碍肝脏灌注并导致门静脉高压。迄今为止,关于肝硬化发生过程中肝血管系统动态演变的病理变化的知识仍然有限。更具体地说,缺乏疾病发展过程中血管适应性的详细解剖学数据。为满足这一需求,我们在大鼠模型中研究了肝硬化发生诱导过程中肝血管系统的三维结构。用硫代乙酰胺(TAA)化学诱导肝硬化。在预定的时间点,使用血管铸型和深部组织显微镜相结合的方法固定并观察肝血管系统。三维重建和数据拟合能够在多个尺度上提取肝硬化特征,描绘肝硬化对肝血管系统的影响。在宏观层面,我们注意到从TAA中毒12周起,再生结节严重压迫柔软的静脉血管。尤其是肝静脉受这种压迫的影响很大,血管段塌陷严重降低了灌注能力。在微观层面,我们发现了区域特异性的窦状隙变性,位于肝脏表面附近的窦状隙比肝叶中部的窦状隙受影响更大。我们的数据揭示并量化了肝硬化发生过程中不断演变的血管结构。这些发现可能对未来有针对性的侵入性干预有所帮助。