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2017 ; 23
(18
): 3228-3239
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Platelets in liver disease, cancer and regeneration
#MMPMID28566882
Kurokawa T
; Ohkohchi N
World J Gastroenterol
2017[May]; 23
(18
): 3228-3239
PMID28566882
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Although viral hepatitis treatments have evolved over the years, the resultant
liver cirrhosis still does not completely heal. Platelets contain proteins
required for hemostasis, as well as many growth factors required for organ
development, tissue regeneration and repair. Thrombocytopenia, which is
frequently observed in patients with chronic liver disease (CLD) and cirrhosis,
can manifest from decreased thrombopoietin production and accelerated platelet
destruction caused by hypersplenism; however, the relationship between
thrombocytopenia and hepatic pathogenesis, as well as the role of platelets in
CLD, is poorly understood. In this paper, experimental evidence of platelets
improving liver fibrosis and accelerating liver regeneration is summarized and
addressed based on studies conducted in our laboratory and current progress
reports from other investigators. In addition, we describe our current
perspective based on the results of these studies. Platelets improve liver
fibrosis by inactivating hepatic stellate cells, which decreases collagen
production. The regenerative effect of platelets in the liver involves a direct
effect on hepatocytes, a cooperative effect with liver sinusoidal endothelial
cells, and a collaborative effect with Kupffer cells. Based on these
observations, we ascertained the direct effect of platelet transfusion on
improving several indicators of liver function in patients with CLD and liver
cirrhosis. However, unlike the results of our previous clinical study, the
smaller incremental changes in liver function in patients with CLD who received
eltrombopag for 6 mo were due to patient selection from a heterogeneous
population. We highlight the current knowledge concerning the role of platelets
in CLD and cancer and anticipate a novel application of platelet-based clinical
therapies to treat liver disease.
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