Yamashiro M, Kouda W, Kono N, Tsuneyama K, Matsui O, Nakanuma Y
Second Department of Pathology, Kanazawa University School of Medicine, Japan.
Virchows Arch. 1998 Nov;433(5):471-9. doi: 10.1007/s004280050276.
There is evidence that mast cells are involved in a number of pathophysiological processes. The significance of mast cells in hepatic fibrosis was examined in 28 patients with histologically normal livers, 34 with acute liver diseases, 51 with chronic liver diseases, and 59 with cholestatic biliary diseases, using immunostaining of the mast cell-specific proteinase, tryptase. Mast cells that were positive for tryptase and for chymase were significantly increased in frequency in fibrotic portal tracts and fibrous septa, particularly in cholestatic/biliary diseases. Mast cells were also increased in frequency around the fibrotic septal and intrahepatic large bile ducts and peribiliary glands of biliary diseases. However, they were less common or even rare in the sclerotic bile ducts and in scarred portal or septal fibrosis. More than half of these more numerous mast cells were positive for histamine, and some were also positive for basic fibroblast growth factor. These two substances were detectable by immunoelectron microscopic in the cytoplasmic granules of mast cells. In contrast, mast cell numbers were not significantly increased in acute viral or drug-induced hepatitis, or in zones 2 and 3 of the hepatic acinus with respect to pericellular and perivenular fibrosis in chronic liver diseases. These findings suggest that mast cells increase in number in cholestatic/biliary diseases, and to a lesser degree in chronic liver diseases, and are involved in the active fibrous enlargement of portal tract and fibrous septa formation and also in the fibrosis of the intrahepatic bile ducts as they display fibrosis-promoting factors such as tryptase, fibroblast growth factor and histamine.
有证据表明肥大细胞参与了多种病理生理过程。利用肥大细胞特异性蛋白酶（类胰蛋白酶）的免疫染色，对28例肝脏组织学正常的患者、34例急性肝病患者、51例慢性肝病患者和59例胆汁淤积性胆道疾病患者进行研究，以探讨肥大细胞在肝纤维化中的意义。在纤维化的门静脉区和纤维间隔中，尤其是在胆汁淤积性/胆道疾病中，类胰蛋白酶和糜蛋白酶呈阳性的肥大细胞频率显著增加。在胆道疾病的纤维化间隔和肝内大胆管及胆管周围腺体周围，肥大细胞的频率也增加。然而，在硬化的胆管以及瘢痕化的门静脉或间隔纤维化中，它们较少见甚至罕见。这些数量较多的肥大细胞中，超过一半组胺呈阳性，一些还对碱性成纤维细胞生长因子呈阳性。通过免疫电子显微镜可在肥大细胞的细胞质颗粒中检测到这两种物质。相比之下，在急性病毒性或药物性肝炎中，肥大细胞数量没有显著增加，在慢性肝病中，相对于细胞周围和静脉周围纤维化，肝腺泡2区和3区的肥大细胞数量也没有显著增加。这些发现表明，肥大细胞在胆汁淤积性/胆道疾病中数量增加，在慢性肝病中增加程度较小，并且通过释放诸如类胰蛋白酶、成纤维细胞生长因子和组胺等促纤维化因子，参与门静脉区的活动性纤维性增大和纤维间隔形成以及肝内胆管纤维化。
