[Pathogenesis of liver fibrosis in patients with chronic hepatitis B].
OBJECTIVE
To explore the role of sinusoidal endothelial cell in the development of liver fibrosis, and to dissect the relationship among hepatic microcirculation disorders, hepatic sinusoidal capilarization and liver fibrosis.


METHODS
Liver biopsy was performed in fifty-six patients with chronic hepatitis B. The liver tissues were observed under light microscope and transmitted electronic microscope.


RESULTS
Of 56 cases, 39 cases were mild hepatitis, 10 were moderate hepatitis, and 7 were severe hepatitis. The morphology of hepatic stellate cells (HSCs) was similar to that of fibroblasts in the tissues of the patients with chronic hepatitis B. Collagenous fibers were deposited around the hepatic stellate cells. Electron-dense materials were deposited between sinusoidal endothelial cell and hepatic stellate cell. The size and amount of fenestraes of sinusoidal endothelial cells were reduced in 53 of 56 cases. The consecutive or inconsecutive membrane-like materials were observed along sinusoidal endothelial cells in 20 cases. Collagen fibers were observed in the space of Disse in 15 cases. Even in the patients with normal hepatic functions, red blood cells aggregation and microthrombi could be observed in the liver tissues.


CONCLUSIONS
Sinusoidal endothelial cells are involved in development of liver fibrosis by interacting with hepatic stellate cells. Hepatic microcirculation disorders and sinusoidal capillarization are important changes in the early stage of liver fibrosis.
Shi
Jun
J
Center for Liver Diseases, Provincial Hospital Affiliated to Shandong University, Jinan, China. sdshij@yahoo.com.cn
Hao
Jing-hua
JH
Ren
Wan-hua
WH
Zhu
Ju-ren
JR
Wang
Shu-yun
SY
Xie
Ying-bo
YB
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D042783:Endothelial Cells / Q000473:pathology / Q000648:ultrastructure; D005260:Female; D055166:Hepatic Stellate Cells / Q000473:pathology / Q000648:ultrastructure; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000473:pathology* / Q000648:ultrastructure; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000209:etiology* / Q000473:pathology*; D008297:Male; D008833:Microcirculation; D008854:Microscopy, Electron; D008875:Middle Aged; D055815:Young Adult