Anatomy and function of sensory hepatic nerves
Anatomy and function of sensory hepatic nerves
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DOI：
10.1002/ar.a.20088
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发表时间：
2004-09-01
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影响因子：
--
通讯作者：
Berthoud, HR
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作者：
Berthoud, HR
迷走神经和脊髓传入神经对门静脉肝区的支配还没有像对其他重要器官的支配那样深入研究。一般认为，与去甲肾上腺素能交感传出神经纤维不同，迷走神经或背根/脊髓起源的感觉神经纤维不直接支配肝细胞，而是限于肝血管系统和胆管的三联体周围的基质，以及门静脉和胆管的肝外部分。对于迷走神经传入神经支配，大鼠逆行和顺行追踪研究清楚地表明，只有一小部分肝总分支支配肝脏区域，而大部分在胃十二指肠分支下降到十二指肠，胰腺和幽门。肝副神经节、胆管和门静脉接受密集的迷走神经传入神经支配。Calretinin可能是门肝间隙迷走神经传入支配的一个相对特异的标志物。降钙素基因相关肽（CGRP）是背根传入的特异性标记物，CGRP免疫反应阳性纤维主要存在于肝内血管束和胆管附近，以及含有迷走神经传入的相同肝外隔室中。由于肝神经的特殊解剖组织，选择性肝去神经支配，无论是选择性的迷走神经或交感神经，或传出神经和传入神经，几乎是不可能的。因此，在解释所谓的特定肝去神经研究的功能结局时，必须非常谨慎。(C)2004 Wiley-Liss，Inc.
Vagal and spinal afferent innervation of the portal hepatic area has not been studied as thoroughly as the innervation of other important organs. It is generally agreed that unlike noradrenergic sympathetic efferent nerve fibers sensory nerve fibers of either vagal or dorsal root/spinal origin do not directly innervate hepatocytes, but are restricted to the stroma surrounding triades of hepatic vasculature and bile ducts, and to extrahepatic portions of the portal vein and bile ducts. For vagal afferent innervation, retrograde and anterograde tracing studies in the rat have clearly shown that only a minor portion of the common hepatic branch innervates the liver area, while the major portion descends in the gastroduodenal branch toward duodenum, pancreas, and pylorus. Hepatic paraganglia, bile ducts, and portal vein receive the densest vagal afferent innervation. Calretinin may be a relatively specific marker for vagal afferent innervation of the portal-hepatic space. Calcitonin gene-related peptide (CGRP) is a specific marker for dorsal root afferents, and CGRP-immunoreactive fibers are mainly present near the intrahepatic vascular bundles and bile ducts, and in the same extrahepatic compartments that contain vagal afferents. Because of the specific anatomical organization of hepatic nerves, selective hepatic denervation, whether selective for the vagal or sympathetic division, or for efferents and afferents, is nearly impossible. Great caution is therefore necessary when interpreting functional outcomes of so-called specific hepatic denervation studies. (C) 2004 Wiley-Liss, Inc.