Herbst H, Schuppan D, Milani S
Institut für Pathologie, Klinikum Benjamin Franklin, Freie Universität Berlin.
Verh Dtsch Ges Pathol. 1995;79:15-27.
Fibrosis, a consequence of most chronic liver diseases, may be conceived as the result of a disturbed balance between fibrogenesis and fibrolysis. We have studied several genes activated during the course of these processes in rat and human liver by immunohistology and in situ hybridization using tissue sections and cultured lipocytes. Activated lipocytes and portal fibroblasts proved to be the principal sources of extracellular matrix proteins and of the fibrogenic growth factor TGF-beta 1. The expression patterns of matrix-metalloproteinases (MMP)-1, -2, -3, and tissue inhibitors of metalloproteinases (TIMP)-1 and -2 genes suggest particularly reduced degradation of collagen type I. Increased fibrogenesis and inadequate fibrolysis may thus explain the accumulation of qualitatively altered extracellular matrix enriched in collagen type I as observed in fibrotic liver. Expression of PDGF-A by epithelial liver cells and of PDGF receptors by activated lipocytes points to paracrine regulatory loops stimulating the proliferation of cells potentially contributing to fibrosis. Continuous parenchymal damage may thus disrupt the balance between fibrogenesis and fibrolysis, resulting in fibrosis.
纤维化是大多数慢性肝病的结果,可被视为纤维生成与纤维溶解之间平衡失调的结果。我们通过免疫组织化学以及使用组织切片和培养的脂肪细胞进行原位杂交,研究了大鼠和人肝脏在这些过程中激活的几种基因。活化的脂肪细胞和门周成纤维细胞被证明是细胞外基质蛋白和促纤维化生长因子转化生长因子-β1的主要来源。基质金属蛋白酶(MMP)-1、-2、-3以及金属蛋白酶组织抑制剂(TIMP)-1和-2基因的表达模式表明,I型胶原的降解尤其减少。因此,纤维生成增加和纤维溶解不足可能解释了在纤维化肝脏中观察到的富含I型胶原的定性改变的细胞外基质的积累。肝上皮细胞表达血小板衍生生长因子-A(PDGF-A),活化的脂肪细胞表达PDGF受体,这表明存在旁分泌调节环,刺激可能促成纤维化的细胞增殖。因此,持续的实质损伤可能破坏纤维生成与纤维溶解之间的平衡,导致纤维化。