南方医科大学学报

南方医科大学学报 ›› 2022, Vol. 42 ›› Issue (12): 1907-1910.doi: 10.12122/j.issn.1673-4254.2022.12.22

• • 上一篇    

肝脏血管认知更新与研究新思路

林 媛，刘志敏，董梦琦，周伟杰   

  1. 南方医科大学南方医院普通外科，广东 广州 510515
  • 出版日期:2022-12-20 发布日期:2023-01-12

An update of understanding of the hepatic vascular system and new research strategies

LIN Yuan, LIU Zhimin, DONG Mengqi, ZHOU Weijie   

  1. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
  • Online:2022-12-20 Published:2023-01-12

RichHTML

35

PDF

438

摘要： 尽管很早就知道肝小叶汇管区、肝血窦、中央区等不同位置存在不同结构和功能的微血管，但一直以来这些血管在肝纤维化中的变化与功能并不完全清楚。最近的研究发现，在小鼠肝纤维化模型中，汇管区、肝血窦、中央区的血管在病变极早期即发生了不同的变化，提示其具有不同的功能：汇管区血管减少，肝血窦毛细血管化增加，中央静脉区血管增多；汇管区血管增多抑制肝纤维化，肝血窦毛细血管化增加促进肝纤维化，中央静脉区血管增多促进肝纤维化。从干预肝血管的角度来治疗肝纤维化需要充分考虑针对这些不同血管进行不同调控，因此，彻底研究清楚这些不同血管独特的调控通路非常重要，组合多种血管调控信号来精准靶向这些不同的血管使之正常化是治疗肝纤维化的新策略。沿着这个思路，进一步研究肝脏发育、再生及各种病变中不同位置血管的变化与功能，将有可能带来重要突破。本综述总结了肝三种微血管在肝纤维化中的不同变化与作用，重点关注并讨论门脉、肝血窦、中央静脉三者的不同变化与功能，并指出该领域未来的研究方向。

关键词: 肝血管系统；血管新生；门静脉；中央静脉；肝血窦毛细血管化

Abstract: Although the portal vessels, liver sinusoids, and central vessels are known to contain microvessels with different structures and functions, their changes and roles in liver fibrogenesis have not been fully understood. Recent studies suggest that in mouse models of liver fibrogenesis, vascular changes can occur at a very early stage, and different liver vessels undergo different changes and play different roles, as shown by a decreased number of portal vessels, increased sinusoid capillarization and increased central vessels. The increase of portal vessels alleviates liver fibrosis, while the increase of central vessels and sinusoid capillarization aggravates liver fibrosis. A full understanding of the regulatory mechanisms of each of these vessels is vital for treatment of liver fibrosis. A combined regulation of different endothelial cell (EC) regulatory signaling pathways for vascular normalization may provide new strategies for liver fibrosis therapy. Further studies of the changes and functions of blood vessels in different liver diseases, liver development and regeneration may bring about important breakthroughs. This review summarizes the changes of 3 hepatic microvessels and their roles in liver fibrogenesis and propose the major directions of future studies in this field.

Key words: hepatic vascular system; angiogenesis; portal vein; central vein; sinusoid capillarization