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Review
. 2015 Jun 16:6:178.
doi: 10.3389/fphys.2015.00178. eCollection 2015.

Two sides of one coin: massive hepatic necrosis and progenitor cell-mediated regeneration in acute liver failure

Hong-Lei Weng  1 , Xiaobo Cai  1 , Xiaodong Yuan  1 , Roman Liebe  2 , Steven Dooley  1 , Hai Li  3 , Tai-Ling Wang  4
Affiliations
Review

Two sides of one coin: massive hepatic necrosis and progenitor cell-mediated regeneration in acute liver failure

Hong-Lei Weng et al. Front Physiol. .

Abstract

Massive hepatic necrosis is a key event underlying acute liver failure, a serious clinical syndrome with high mortality. Massive hepatic necrosis in acute liver failure has unique pathophysiological characteristics including extremely rapid parenchymal cell death and removal. On the other hand, massive necrosis rapidly induces the activation of liver progenitor cells, the so-called "second pathway of liver regeneration." The final clinical outcome of acute liver failure depends on whether liver progenitor cell-mediated regeneration can efficiently restore parenchymal mass and function within a short time. This review summarizes the current knowledge regarding massive hepatic necrosis and liver progenitor cell-mediated regeneration in patients with acute liver failure, the two sides of one coin.

Keywords: acute liver failure; acute-on-chronic liver failure; liver progenitor cell; liver regeneration; massive hepatic necrosis.

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Figures

Figure 1
Figure 1
Pathological feature of massive hepatic necrosis. A representative liver tissue was obtained from a patient with acute HBV infection who had undergone liver failure for 4 days. (A) A line depicts that the liver parenchyma had been completely destroyed. Masson staining highlights shrinkage of the liver capsule (green color in upper limit of the tissue). (B–C) Remarkable inflammatory cells (arrows) infiltration into destructive areas with ductular reaction is shown. Endophlebitis of the terminal veins is highlighted by a frame and magnified in (C) Masson staining. (D) Ductular reaction is further confirmed at the necrotic liver using immunohistochemical staining for CK19.
Figure 2
Figure 2
Dual differentiation of liver progenitor cells. The presented liver tissue was from a patient with acute HBV infection who had undergone liver failure for 13 days. CK7 immunohistochemical staining was performed. Four fields were selected to show that liver progenitor cells contribute to rebuild bile ducts and hepatocytes. (A–B) Liver progenitor cell-originated bile ducts still can be discriminated by hepatocyte-like cells inside these ducts (black arrows). (C–D) Liver progenitor cell-derived hepatocytes are highlighted by red arrows.
Figure 3
Figure 3
A scheme depicting MHN and LPC-mediated regeneration in acute liver failure.
See this image and copyright information in PMC

References

    1. Alastair D., Burt B. C. P., Linda D., Ferrel (2012). MacSween's Pathology of the Liver, 6th Edn. Eidingburg; London; New York, NY; Philadelphia, PA; Oxford; ST. Louis, MO; Toronto, ON: Churchill Livingstone Elsevier.
    1. Bantel H., Schulze-Osthoff K. (2012). Mechanisms of cell death in acute liver failure. Front. Physiol. 3:79. 10.3389/fphys.2012.00079 - DOI - PMC - PubMed
    1. Bechmann L. P., Jochum C., Kocabayoglu P., Sowa J. P., Kassalik M., Gieseler R. K., et al. . (2010). Cytokeratin 18-based modification of the MELD score improves prediction of spontaneous survival after acute liver injury. J. Hepatol. 53, 639–647. 10.1016/j.jhep.2010.04.029 - DOI - PubMed
    1. Best J., Doll,é L., Manka P., Coombes J., van Grunsven L. A., Syn W. K. (2013). Role of liver progenitors in acute liver injury. Front. Physiol. 4:258. 10.3389/fphys.2013.00258 - DOI - PMC - PubMed
    1. Bismuth H., Samuel D., Castaing D., Adam R., Saliba F., Johann M., et al. . (1995). Orthotopic liver transplantation in fulminant and subfulminant hepatitis. The Paul Brousse experience. Ann. Surg. 222, 109–119. - PMC - PubMed