Liver-spleen axis: Intersection between immunity, infections and metabolism
Liver-spleen axis: Intersection between immunity, infections and metabolism
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DOI：
10.3748/wjg.v19.i23.3534
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发表时间：
2013-06-21
影响因子：
4.3
通讯作者：
Finelli, Carmine
中科院分区：
文献类型：
--
作者：
Tarantino, Giovanni;Scalera, Antonella;Finelli, Carmine
脾脏一直被认为是一个被忽视的器官，尽管它与肝脏密切相关。脾通过清除循环凋亡细胞、分化和活化T和B细胞以及在白色髓中产生抗体，在免疫系统的调节和外周耐受性的维持中起重要作用。此外，脾巨噬细胞能够从血液中清除细菌，并在全身感染期间防止败血症。我们回顾了脾脏功能及其评估人类从脾脏疾病的描述，从先天性无脾继发性脾功能减退。从文献数据中可以清楚地看出，人类的肥胖会影响免疫系统的不同部分，尽管有关相关机制的数据仍然很少。其目的是使临床医生能够评估新认识的作用，代谢和内分泌功能的脾脏，特别强调肥胖和非酒精性脂肪肝疾病的背景下，现有的文献。此外，了解脾脏的功能可能是重要的，以制定适当的预防策略，以抵消肥胖的大流行。在这个方向上，我们建议在超声检查中的脾纵径，作为简单，廉价和广泛可用的工具，被用作新的标记，用于评估脾功能，在所谓的肝脾轴的背景下。(c)2013年百世登。All rights reserved.
Spleen has been considered a neglected organ so far, even though is strictly linked to liver. The spleen plays an important role in the modulation of the immune system and in the maintenance of peripheral tolerance via the clearance of circulating apoptotic cells, the differentiation and activation of T and B cells and production of antibodies in the white pulp. Moreover, splenic macrophages are able to remove bacteria from the blood and protect from sepsis during systemic infections. We review the spleen function and its assessment in humans starting from the description of spleen diseases, ranging from the congenital asplenia to secondary hyposplenism. From the literature data it is clear that obesity in humans affects different compartments of immune system, even thought there are still few data available on the implicated mechamisms. The intent is to enable clinicians to evaluate the newly recognized role of metabolic and endocrine functions of the spleen with special emphasis to obesity and nonalcoholic fatty liver disease in the context of the available literature. Moreover, understanding the spleen function could be important to develop appropriate prevention strategies in order to counteract the pandemia of obesity. In this direction, we suggest spleen longitudinal diameter at ultrasonography, as simple, cheap and largely available tool, be used as new marker for assessing splenic function, in the context of the so-called liver-spleen axis. (c) 2013 Baishideng. All rights reserved.