Isaza-Restrepo Andres, Martin-Saavedra Juan S, Velez-Leal Juan L, Vargas-Barato Felipe, Riveros-Dueñas Rafael
Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia.
Department of Clinical Surgery, Hospital Universitario Mayor - Méderi, Bogotá, Colombia.
Front Physiol. 2018 Jun 15;9:738. doi: 10.3389/fphys.2018.00738. eCollection 2018.
Despite its complexity, the peritoneum is usually underestimated in classical medical texts simply as the surrounding tissue (serous membrane) of the gut. Novel findings on physiology and morphology of the peritoneum and mesothelial cell exist but they are usually focused or limited to Continuous Ambulatory Peritoneal Dialysis research and practice. This review aims to expose, describe and analyze the most recent evidence on the peritoneum's morphology, embryology and physiology. A literature review was performed on Pubmed and MEDLINE. With no limit of publication date, original papers and literature reviews about the peritoneum, the peritoneal cavity, peritoneal fluid, and mesothelial cells were included ( = 72). Peritoneum develops in close relationship to the gut from an early period in embryogenesis. Analyzing together the development of the primitive gut and the surrounding mesothelium helps understanding that the peritoneal cavity, the mesenteries and other structures can be considered parts of the peritoneum. However, some authors consider that structures like the mesenteries are different to the peritoneum. The mesothelial cell has a complex ultrastructural organization with intercellular junctions and apical microvilli. This complexity is further proven by the large array of functions like selective fluid and cell transport; physiological protective barrier; immune induction, modulation, and inhibition; tissue repair and scarring; preventing adhesion and tumoral dissemination; cellular migration; and the epithelial-mesenchymal transition capacity. Recent evidence on the anatomy, histology, and physiology of the peritoneum, shows that this structure is more complex than a simple serous membrane. These results call for a new conceptualization of peritoneum, and highlight the need of adequate research for identifying clinical relevance of this knowledge.
尽管腹膜结构复杂，但在经典医学文献中，它通常仅被简单地视为肠道的周围组织（浆膜）。关于腹膜和间皮细胞的生理学和形态学有一些新发现，但这些发现通常集中或局限于持续性非卧床腹膜透析的研究与实践。本综述旨在揭示、描述和分析有关腹膜形态学、胚胎学和生理学的最新证据。我们在PubMed和MEDLINE上进行了文献综述。不限出版日期，纳入了关于腹膜、腹膜腔、腹膜液和间皮细胞的原始论文和文献综述（n = 72）。在胚胎发育早期，腹膜就与肠道紧密相关地发育。综合分析原始肠道和周围间皮的发育有助于理解腹膜腔、肠系膜和其他结构可被视为腹膜的一部分。然而，一些作者认为肠系膜等结构与腹膜不同。间皮细胞具有复杂的超微结构组织，包括细胞间连接和顶端微绒毛。这种复杂性还通过一系列功能进一步得到证明，如选择性液体和细胞转运、生理保护屏障、免疫诱导、调节和抑制、组织修复和瘢痕形成、防止粘连和肿瘤播散、细胞迁移以及上皮-间质转化能力。关于腹膜解剖学、组织学和生理学的最新证据表明，这种结构比简单的浆膜更为复杂。这些结果呼吁对腹膜进行新的概念化，并强调需要进行充分的研究以确定这些知识的临床相关性。
