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

更新时间:2023-08-14

【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 experimenta 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-x L, which sup-presses 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.

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