Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, 410008, China.
Department of Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
Inflammation. 2023 Oct;46(5):1602-1611. doi: 10.1007/s10753-023-01854-x. Epub 2023 Jul 25.
Liver injury is a common pathological basis for various liver diseases. Chronic liver injury is often an important initiating factor in liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Currently, hepatitis A and E infections are the most common causes of acute liver injury worldwide, whereas drug toxicity (paracetamol overdose) in the USA and part of Western Europe. In recent years, chronic liver injury has become a common disease that harms human health. Meanwhile, the main causes of chronic liver injury are viral hepatitis (B, C) and long-term alcohol consumption worldwide. During the process of liver injury, massive inflammatory cytokines are stimulated by these hazardous factors, leading to a systemic inflammatory response syndrome, followed by a compensatory anti-inflammatory response, which causes immune cell dysfunction and sepsis, subsequent multi-organ failure. Cytokine release and immune cell infiltration-mediated aseptic inflammation are the most important features of the pathobiology of liver failure. From this perspective, diminishing the onset and progression of liver inflammation is of clinical importance in the treatment of liver injury. Although many studies have hinted at the critical role of nerves in regulating inflammation, there largely remains undetermined how hepatic nerves mediate immune inflammation and how the inflammatory factors released by these nerves are involved in the process of liver injury. Therefore, the purpose of this article is to summarize previous studies in the field related to hepatic nerve and inflammation as well as future perspectives on the aforementioned questions. Our findings were presented in three aspects: types of nerve distribution in the liver, how these nerves regulate immunity, and the role of liver nerves in hepatitis and liver failure.
肝损伤是各种肝病的常见病理基础。慢性肝损伤通常是肝纤维化、肝硬化和肝细胞癌(HCC)的重要起始因素。目前,全球范围内甲型和戊型肝炎感染是急性肝损伤的最常见原因,而美国和部分西欧国家则是药物毒性(扑热息痛过量)。近年来,慢性肝损伤已成为危害人类健康的常见病。同时,慢性肝损伤的主要原因是全球范围内的病毒性肝炎(B、C)和长期饮酒。在肝损伤过程中,这些危险因子会刺激大量炎症细胞因子,导致全身炎症反应综合征,随后是代偿性抗炎反应,导致免疫细胞功能障碍和败血症,随后是多器官衰竭。细胞因子释放和免疫细胞浸润介导的无菌性炎症是肝衰竭病理生物学的最重要特征。从这个角度来看,减少肝炎症的发生和进展对于肝损伤的治疗具有重要的临床意义。尽管许多研究已经暗示了神经在调节炎症中的关键作用,但肝神经如何调节免疫炎症以及这些神经释放的炎症因子如何参与肝损伤过程仍很大程度上尚未确定。因此,本文的目的是总结与肝神经和炎症相关的先前研究以及对上述问题的未来展望。我们的发现从三个方面呈现:肝脏中的神经分布类型、这些神经如何调节免疫以及肝神经在肝炎和肝衰竭中的作用。