Document Detail


Splenic vasculopathy in portal hypertension patients.
MedLine Citation:
PMID:  16718761     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To investigate the interaction between portal hypertension, splanchnic hyperdynamic circulation and splanchnic vasculopathy by observing splenic arterial and venous pathological changes and the ro1e of extra-cellular matrix in the pathogenesis of portal hypertensive vasculopathy by measuring the expression of type I and type III procollagen mRNA in splenic venous walls of portal hypertensive patients. METHODS: Morphological changes of splenic arteries and veins taken from portal hypertensive patients (n=20) and normal controls (n=10) were observed under optical and electron microscope. Total RNA was extracted and the expression of type I and type III procollagen mRNA in splenic venous walls of portal hypertensive patients (n=20) was semi-quantitatively detected using reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Under optical microscope, splenic arterial intima was destroyed and internal elastic membrane and medial elastic fibers of the splenic arterial walls were degenerated and broken. Splenic venous intima became remarkably thick. Endothelia1 cells were not intact with formation of mural thrombus. The tunica media became thickened significantly due to hypertrophy of smooth muscles. Fibers and connective tissues were increased obviously. Under electron microscope, smooth muscle cells of the splenic arteries were degenerated and necrotized. Phenotypes of smooth muscle cells changed from constrictive into synthetic type. Red blood cells and platelets accumulated around the damaged endothelial cells. Synthetic smooth muscle cells were predominant in splenic veins and their cytoplasma had plentiful rough endoplasmic reticulum ribosomes and Golgi bodies. Along the vascular wall, a lot of collagen fibers were deposited, the intima was damaged and blood components accumulated. There was no significant difference in the expression of type I procollagen mRNA in splenic venous wall between the patients with portal hypertension and those without portal hypertension (P>0.05), but the expression of type III procoagen mRNA was significantly stronger in the patients with portal hypertension than in those without portal hypertension (P<0.01). CONCLUSION: Type III procollagen and collagen might be important extra-cellular matrix resulting in neointimal formation and vascular remodeling in the pathogenesis of portal hypertensive vasculopathy. The pathological changes in splenic arteries and veins exist in portal hypertension patients. There might be an interaction between portal hypertension, splanchnic hyperdynamic circulation and splanchnic vasculopathy.
Authors:
Tao Li; Ji-Yuan Ni; Yan-Wu Qi; Hai-Yang Li; Tong Zhang; Zhen Yang
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  12     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-23     Completed Date:  2006-07-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  2737-41     Citation Subset:  IM    
Affiliation:
Department of Hepatic Surgery, Tongji Hospita1, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei province, China. litaoforgood@tom.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Circulation / physiology
Case-Control Studies
Collagen Type I / genetics,  physiology
Collagen Type III / genetics,  physiology
Endothelium, Vascular / chemistry,  pathology
Extracellular Matrix / chemistry,  physiology
Female
Gene Expression Regulation
Humans
Hypertension, Portal / etiology,  pathology*,  physiopathology*
Male
Microscopy, Electron, Scanning
Muscle, Smooth, Vascular / blood supply,  pathology
RNA, Messenger / genetics
Regional Blood Flow / physiology
Reverse Transcriptase Polymerase Chain Reaction
Spleen / blood supply
Splenic Artery / pathology*,  physiopathology
Splenic Vein / pathology*,  physiopathology
Tunica Intima / chemistry,  pathology
Chemical
Reg. No./Substance:
0/Collagen Type I; 0/Collagen Type III; 0/RNA, Messenger

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