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Esophageal Varices-II: Clinical Features and Management01:28

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Liver Physiology01:30

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The liver, an essential organ in the human body, performs over 200 vital functions that can be broadly categorized into metabolic, hematological, endocrine regulation, and bile production.
Metabolic Regulation:
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The liver is an important organ in vertebrates that plays an essential role in metabolism. It is also responsible for storing and redistributing nutrients such as carbohydrates, fats, and vitamins in the body. Additionally, the liver releases bile salts which are critical for digesting food and eliminating toxic metabolites from the body.
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Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
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The microscopic anatomy of the liver is a complex and intricate system that comprises numerous structural units known as liver lobules, each of which is comparable in size to a sesame seed. These hexagonal structures consist of plates of liver cells or hepatocytes, which are characterized by their versatility and abundance of cellular apparatus like rough and smooth ER, Golgi apparatus, peroxisomes, and mitochondria.
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Two-photon Intravital Imaging of Leukocytes During the Immune Response in Lipopolysaccharide-treated Mouse Liver
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敗血症と肝臓

Eleni V Geladari1, Anastasia-Amalia C Kalergi1, Apostolos A Evangelopoulos2

  • 13rd Department of Internal Medicine & Liver Unit, "Evangelismos" General Hospital, 45-47 Ipsilantou Str, 106 76 Athens, Greece.

Diseases (Basel, Switzerland)
|December 24, 2025
PubMed
まとめ

敗血症関連肝障害(SALI)は、患者の転帰に影響を与える distinct な炎症相と免疫抑制相を伴います。研究は、SALI の改善された管理のための炎症、代謝、および腸肝軸を標的とする個別化治療法の開発を目指しています。

科学分野:

  • 肝臓学
  • 免疫学
  • 集中治療医学

背景:

  • 敗血症関連肝障害(SALI)は敗血症の重篤な合併症であり、 distinct な過炎症相と免疫抑制相を特徴とします。
  • これらの相は患者の表現型を決定し、治療戦略に影響を与えます。

研究 の 目的:

  • SALIの distinct な炎症相と免疫抑制相を特徴づけること。
  • 敗血症における個々の免疫応答に合わせた免疫調節戦略の開発の基礎を確立すること。

主な方法:

  • SALIの病因に関する既存の文献のレビュー。
  • 敗血症における細胞経路、代謝障害、および腸肝軸の分析。
  • 現在および調査中の診断および治療アプローチの評価。

主要な成果:

  • 炎症相はNF-κBおよびNLRP3インフラマソームの活性化を伴い、サイトカインストーム、肝細胞損傷、および死亡リスクの増加につながります。
  • 免疫抑制相は、感染制御の障害、代謝機能障害(例:脂肪酸酸化障害)、およびミトコンドリア機能障害を特徴とします。
  • 腸肝軸はSALIの病因の中心であり、腸内細菌叢の変化と腸管透過性の亢進が肝障害を悪化させます。新規バイオマーカーは診断の有望性を示しています。
キーワード:
バイオマーカー腸肝軸炎症カスケードミトコンドリア機能障害敗血症関連肝障害(SALI)

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結論:

  • 今後の研究では、SALIの代表的なモデルの開発とバイオマーカーの検証を優先すべきです。
  • 臨床試験は、炎症、代謝、および腸肝軸を標的とする個別化治療法を可能にするために必要です。
  • SALIの転帰を改善するには、その複雑な病態生理に対処する多面的なアプローチが必要です。