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Pseudocapilarización hepática y aterosclerosis en el envejecimiento
David G Le Couteur1, Robin Fraser, Victoria C Cogger
1Centre for Education and Research on Ageing, and Anzac Research Institute, University of Sydney, Concord RG Hospital, Sydney, NSW, Australia. dlecouteur@med.usyd.edu.au
Lancet (London, England)
|June 6, 2002
Resumen
El envejecimiento perjudica el hígado.
Área de la Ciencia:
- Gerontología Gerontología.
- Biología Vascular Biología Vascular
- Hepatología Hepatología.
Sus antecedentes:
- Las enfermedades cardiovasculares (ECV) son una de las principales causas de muerte, siendo el envejecimiento el principal factor de riesgo.
- La aterosclerosis subyace en gran parte de estas enfermedades cardiovasculares relacionadas con la edad.
- La comprensión actual carece de un vínculo directo entre el envejecimiento del hígado y la patogénesis de la aterosclerosis.
Objetivo del estudio:
- Proponer una nueva hipótesis que vincule los cambios estructurales del hígado relacionados con la edad con la aterosclerosis.
- Para aclarar el papel de las fenestraciones del endotelio sinusoidal del hígado en este proceso.
Principales métodos:
- Revisión y síntesis de la literatura existente sobre el envejecimiento del hígado y la aterosclerosis.
- Desarrollo de modelos hipotéticos basados en mecanismos patógenos establecidos.
Principales resultados:
- La pseudocapilarización relacionada con la edad del endotelio sinusoidal del hígado implica engrosamiento endotelial, formación de membrana basal y pérdida de fenestración (defenestración).
- Esta defenestración perjudica la función de tamiz del hígado, lo que dificulta el aclaramiento de los restos de quilomicrón.
- El aclaramiento deteriorado conduce a la hipertrigliceridemia postprandial, un conocido contribuyente a la aterosclerosis.
Conclusiones:
- La pérdida de las fenestraciones hepáticas inducida por la edad contribuye directamente al desarrollo de la aterosclerosis.
- El mantenimiento o la restauración de las fenestraciones hepáticas puede ofrecer una nueva estrategia terapéutica para las ECV relacionadas con la edad.
- Dirigirse a la permeabilidad del tamiz hepático podría mitigar el riesgo cardiovascular en los ancianos.
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