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肝脏的神经支配与非酒精性脂肪性肝病。

Hepatic Innervations and Nonalcoholic Fatty Liver Disease.

机构信息

Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.

Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India.

出版信息

Semin Liver Dis. 2023 May;43(2):149-162. doi: 10.1055/s-0043-57237. Epub 2023 May 8.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disorder. Increased sympathetic (noradrenergic) nerve tone has a complex role in the etiopathomechanism of NAFLD, affecting the development/progression of steatosis, inflammation, fibrosis, and liver hemodynamical alterations. Also, lipid sensing by vagal afferent fibers is an important player in the development of hepatic steatosis. Moreover, disorganization and progressive degeneration of liver sympathetic nerves were recently described in human and experimental NAFLD. These structural alterations likely come along with impaired liver sympathetic nerve functionality and lack of adequate hepatic noradrenergic signaling. Here, we first overview the anatomy and physiology of liver nerves. Then, we discuss the nerve impairments in NAFLD and their pathophysiological consequences in hepatic metabolism, inflammation, fibrosis, and hemodynamics. We conclude that further studies considering the spatial-temporal dynamics of structural and functional changes in the hepatic nervous system may lead to more targeted pharmacotherapeutic advances in NAFLD.

摘要

非酒精性脂肪性肝病(NAFLD)是最常见的慢性肝脏疾病。交感神经(去甲肾上腺素能)张力增加在 NAFLD 的病因发病机制中具有复杂的作用,影响脂肪变性、炎症、纤维化和肝脏血流动力学改变的发展/进展。此外,迷走传入纤维对脂质的感知也是肝脂肪变性发展的重要因素。此外,最近在人类和实验性 NAFLD 中描述了肝交感神经的结构紊乱和进行性退化。这些结构改变可能伴随着肝交感神经功能受损和去甲肾上腺素能信号不足。在这里,我们首先概述了肝脏神经的解剖和生理学。然后,我们讨论了 NAFLD 中的神经损伤及其对肝脏代谢、炎症、纤维化和血液动力学的病理生理后果。我们得出结论,进一步的研究考虑肝脏神经系统结构和功能变化的时空动态,可能会导致 NAFLD 的更有针对性的药物治疗进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9033/10348844/e3055b5c2fee/10-1055-s-0043-57237-i2200081-1.jpg

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