维生素A的毒性和肝病理:综合性审查
María L Pestalardo1, Cecilia S Bevilacqua2, Marcelo Fabián Amante3
1División Patología, Hospital General de Agudos Cosme Argerich, Buenos Aires C1155AHA, Argentina.
World journal of hepatology
|September 3, 2025
概括
过量摄入维生素A会导致肝脏毒性 (维生素A过多),导致脂肪积累,纤维化和肝硬化. 了解这些机制对于安全摄入维生素A和预防肝损伤至关重要.
科学领域:
- 肝病学
- 毒理学
- 营养科学
背景情况:
- 维生素A对视力,免疫力和细胞功能至关重要.
- 过度摄入或过度维生素A会导致肝脏显著毒性.
- 成人的正常血清视网醇水平在0. 3至1.2毫克/升之间.
研究的目的:
- 阐明维生素A引起的肝毒性的病理和分子机制.
- 确定A型维生素过多的临床表现和治疗策略.
- 突出研究缺口和未来理解和治疗维生素A毒性的方向.
主要方法:
- 从肝肥胖症到纤维化和肝硬化病的病态进展.
- 分子路径的分析,包括氧化应激,细胞亡和纤维化.
- 症状和治疗方法的临床相关性.
主要成果:
- 维生素A的毒性压倒肝细胞,导致视网膜积累,氧化应激和炎症.
- 病理变化包括肝细胞膨胀,星状细胞激活和周周纤维化.
- 分子机制涉及ROS,细胞亡和调节失调的TGF-β和NF-κB通路,驱动纤维化和破坏脂质代谢.
结论:
- 维生素A的毒性带来严重的肝脏风险,导致肝硬化.
- 管理包括限制摄入量和探索抗氧化剂和抗纤维治疗.
- 需要进一步研究更好的生物标志物,个性化风险评估和精细的饮食指南.
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