Häussinger D, Gerok W
Infusionsther Klin Ernahr. 1984 Oct;11(5):245-53.
Hepatocytes from different subacinar localizations differ not only in their enzyme equipment, but have also different functions in intermediary metabolism. Gluconeogenesis, amino acid breakdown, urea synthesis and oxidative metabolism occur predominantly periportal, whereas glycolysis, glutamine synthesis and drug metabolism are predominantly perivenous. This metabolic zonation is rather dynamic and is influenced by hormones, oxygen-tension, substrate concentrations, circadian rhythms and development. There are metabolic interactions between differently localized hepatocyte populations: the product of one population may serve as the substrate for another. Hepatocyte heterogeneity in ammonia and glutamine metabolism provides new aspects on the pathogenesis of hyperammonemia in severe liver disease. Glutamine is degraded in the periportal area of the acinus, whereas there is a simultaneous resynthesis of glutamine in the perivenous area, resulting in an intercellular glutamine cycle. This provides an effective means for almost complete detoxication of ammonia by urea synthesis. The rate of hepatic bicarbonate elimination is regulated by the intercellular glutamine cycle pointing to the important role of the liver in maintaining pH homeostasis. Such a device also explains the development of an alkalosis in severe liver disease as a consequence of a diminished bicarbonate removal by the liver.
来自不同腺泡亚区定位的肝细胞不仅在酶装备上存在差异,而且在中间代谢中也具有不同功能。糖异生、氨基酸分解、尿素合成和氧化代谢主要发生在门静脉周围,而糖酵解、谷氨酰胺合成和药物代谢主要发生在肝静脉周围。这种代谢分区相当动态,并受激素、氧张力、底物浓度、昼夜节律和发育的影响。不同定位的肝细胞群体之间存在代谢相互作用:一个群体的产物可能作为另一个群体的底物。肝细胞在氨和谷氨酰胺代谢方面的异质性为严重肝病中高氨血症的发病机制提供了新的视角。谷氨酰胺在腺泡的门静脉周围区域降解,而在肝静脉周围区域同时存在谷氨酰胺的重新合成,从而形成细胞间谷氨酰胺循环。这为通过尿素合成几乎完全解毒氨提供了一种有效手段。肝脏碳酸氢盐的清除率受细胞间谷氨酰胺循环的调节,这表明肝脏在维持pH稳态中起着重要作用。这样一种机制也解释了严重肝病中由于肝脏碳酸氢盐清除减少而导致碱中毒的发生。