Latry P, Bioulac-Sage P, Echinard E, Gin H, Boussarie L, Grimaud J A, Balabaud C
Hum Pathol. 1987 Aug;18(8):775-80. doi: 10.1016/s0046-8177(87)80050-3.
A direct correlation exists between collagenization of Disse's space and the presence of diabetic microangiopathy in type I diabetes. To confirm and extend this finding, we studied four liver biopsy samples from two patients with type I diabetes (one with retinopathy) and two patients with type II diabetes (no retinopathy). All had normal or subnormal results on liver function tests and normal liver architecture. Levels of collagen types I, III, and IV, laminin, and fibronectin, as determined by immunocytochemical techniques, appeared increased in all patients. Liver biopsy samples were perfusion fixed for electron microscopy of sinusoids and sinusoidal cells. Numerous and thick collagen bundles could be seen in Disse's space, as could the increase of basement membrane-like material underlying the endothelial cells, perisinusoidal cells, and sinusoidal membrane of hepatocytes. Perisinusoidal cells were active and had abundant rough endoplasmic reticula and thick processes. This preliminary study indicates that collagenization of Disse's space is not specific to a certain type of diabetes. The increase of basement membrane-like material raises the question of whether liver sinusoids are truly different from other capillaries as far as diabetic microangiopathy is concerned.
狄氏间隙的胶原化与Ⅰ型糖尿病患者糖尿病微血管病变的存在之间存在直接相关性。为了证实并扩展这一发现，我们研究了来自两名Ⅰ型糖尿病患者（其中一名患有视网膜病变）和两名Ⅱ型糖尿病患者（无视网膜病变）的四份肝活检样本。所有患者的肝功能检查结果均正常或低于正常水平，肝脏结构正常。通过免疫细胞化学技术测定，所有患者的Ⅰ型、Ⅲ型和Ⅳ型胶原、层粘连蛋白和纤连蛋白水平均有所升高。肝活检样本进行灌注固定，用于肝血窦和肝血窦细胞的电子显微镜检查。在狄氏间隙可见大量粗大的胶原束，在内皮细胞、肝血窦周细胞和肝细胞肝血窦膜下方的基底膜样物质也增多。肝血窦周细胞活跃，有丰富的粗面内质网和粗大的突起。这项初步研究表明，狄氏间隙的胶原化并非某种特定类型糖尿病所特有。基底膜样物质的增加引发了一个问题，即就糖尿病微血管病变而言，肝血窦与其他毛细血管是否真的不同。
