Platelet therapy:A novel strategy for liver regeneration,anti-fibrosis,and anti-apoptosis

• 作者: Kazuhiro Takahashi Nobuhiro Ohkohchi Soichiro Murata
• 来源期刊: 世界外科手术杂志
• 学科: 医学
• 关键词: PLATELET THERAPY LIVER regeneration LIVER fibrosis HEPATOCYTE apoptosis Growth factor
• 年，卷（期）: 2013,（3）
• 页码范围: 29-36
• 页数: 8页
• 分类号: R

摘要

Platelets contain bio-physiological substances,including insulin-like growth factor-1,vascular endothelial growth factor,platelet-derived growth factor,hepatocyte growth factor,serotonin,transforming growth factor-β,adenosine diphosphate,adenosine tri-phosphate,and epidermal growth factor.Platelets have conventionally been considered to exacerbate the inflammatory response and liver injury.Recently,platelets were discovered to have a positive impact on the liver.In this review,we present experimental and clinical evidence indicating that platelets accelerate liver regeneration and have anti-fibrosis and antiapoptosis activity,and we detail the mechanisms of action.Platelets accelerate liver regeneration by three different mechanisms:(1)a direct effect on hepatocytes,(2)a cooperative effect with liver sinusoidal endothelial cells,and(3)a collaborative effect with Kupffer cells.Platelets exert anti-fibrotic activity by deactivating hepatic stellate cells via the adenosinecyclic adenosine 5’-monophosphate signaling pathway.Platelets prevent hepatocyte apoptosis by activating the Akt pathway and up-regulating Bcl-xL,which suppresses caspase-3 activation.Platelet therapy with thrombopoietin,thrombopoietin receptor agonists,and platelet transfusion has the advantages of convenience and cost-efficiency over other treatments.We propose that in the future,platelet therapy will play a promising role in the treatment of the various liver disorders that currently challenge the surgical field,such as liver failure after a massive hepatectomy,hepatectomy of a cirrhotic liver,and small grafts in liver transplantation.