Hemostasis and Liver Regeneration.

Hemostasis and Liver Regeneration.
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止血和肝脏再生。

DOI:
10.1055/s-0040-1715450
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发表时间:
2020-09
影响因子:
5.7
通讯作者:
Groeneveld DJ
Groeneveld DJ
中科院分区:
医学2区
文献类型:
--
作者:
Starlinger P;Luyendyk JP;Groeneveld DJ

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肝脏在其非凡的再生能力方面是独一无二的,这使得肝脏切除术能够用于治疗特定的肝脏疾病,包括去除肿瘤性肝脏疾病。切除后,剩余的肝组织(即肝残体)再生以维持正常的肝功能。在实验环境和患者中,切除多达2/3的肝脏质量会刺激快速和高度协调的过程,导致剩余肝脏的再生。控制再生的起始和终止的机制仍在继续被发现,并且许多控制肝实质细胞增殖的基本信号传导途径(即,肝细胞)已被发现。有趣的是,虽然止血并发症(即,出血和血栓形成)主要被认为是手术本身的并发症,但强有力的证据表明,止血系统的成分实际上是肝脏再生的强大驱动力。本文综述了支持止血系统和肝再生之间联系的临床和翻译证据,以及止血系统指导肝再生的机制。
The liver is unique in its remarkable regenerative capacity, which enables use of liver resection as a treatment for specific liver diseases, including removal of neoplastic liver disease. After resection, the remaining liver tissue (i.e, liver remnant) regenerates to maintain normal hepatic function. In experimental settings as well as patients, removal of up to 2/3rd of the liver mass stimulates a rapid and highly coordinated process resulting in regeneration of the remaining liver. Mechanisms controlling the initiation and termination of regeneration continue to be discovered, and many of the fundamental signaling pathways controlling proliferation of liver parenchymal cells (i.e., hepatocytes) have been uncovered. Interestingly, while hemostatic complications (i.e., bleeding and thrombosis) are primarily thought of as a complication of surgery itself, strong evidence suggests that components of the hemostatic system are in fact, powerful drivers of liver regeneration. This review focuses on clinical and translational evidence supporting a link between the hemostatic system and liver regeneration, and the mechanisms whereby the hemostatic system directs liver regeneration discovered using experimental settings.
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