Zhu Chengzhan, Dong Bingzi, Sun Leqi, Wang Yixiu, Chen Shuhai
Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland).
Shandong Key Laboratory of Digital Medicine and Computer Assisted Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland).
Med Sci Monit. 2020 Dec 14;26:e929129. doi: 10.12659/MSM.929129.
Liver regeneration (LR) is a set of complicated mechanisms between cells and molecules in which the processes of initiation, maintenance, and termination of liver repair are regulated. Although LR has been studied extensively, there are still numerous challenges in gaining its full understanding. Cells for LR have a wide range of sources and the feature of plasticity, and regeneration patterns are not the same under different conditions. Many patients undergoing partial hepatectomy develop cirrhosis or steatosis. The changes of LR in these cases are not clear. Many types of cells participate in LR. Hepatocytes, biliary epithelial cells, hepatic progenitor cells, and human liver stem cells can serve as the cell sources for LR. However, different types and degrees of damage trigger the response from the most suitable cells. Exploring the cell sources of LR is of great significance for accelerating recovery of liver function under different pathological patterns and developing a cell therapy strategy to cope with the shortage of donors for liver transplantation. In clinical practice, the background of the liver influences regeneration. Fibrosis and steatosis create different LR microenvironments and signal molecule interaction patterns. In addition, factors such as partial hepatectomy, aging, platelets, nerves, hormones, bile acids, and gut microbiota are widely involved in this process. Understanding the influencing factors of LR has practical value for individualized treatment of patients with liver diseases. In this review, we have summarized recent studies and proposed our views. We discuss cell sources and the influential factors on LR to help in solving clinical problems.
肝再生(LR)是细胞与分子之间的一系列复杂机制,其中肝脏修复的起始、维持和终止过程受到调控。尽管对肝再生已进行了广泛研究,但要全面了解它仍面临诸多挑战。肝再生的细胞来源广泛且具有可塑性,不同条件下的再生模式也不尽相同。许多接受部分肝切除术的患者会发展为肝硬化或脂肪变性。这些情况下肝再生的变化尚不清楚。多种类型的细胞参与肝再生。肝细胞、胆管上皮细胞、肝祖细胞和人肝干细胞都可作为肝再生的细胞来源。然而,不同类型和程度的损伤会触发最合适细胞的反应。探索肝再生的细胞来源对于加速不同病理模式下肝功能的恢复以及制定应对肝移植供体短缺的细胞治疗策略具有重要意义。在临床实践中,肝脏的背景会影响再生。纤维化和脂肪变性会创造不同的肝再生微环境和信号分子相互作用模式。此外,部分肝切除术、衰老、血小板、神经、激素、胆汁酸和肠道微生物群等因素也广泛参与这一过程。了解肝再生的影响因素对肝病患者的个体化治疗具有实际价值。在本综述中,我们总结了近期的研究并提出了我们的观点。我们讨论了肝再生的细胞来源及其影响因素,以帮助解决临床问题。