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A morphometric study of the hepatic arterioles in end-stage primary sclerosing cholangitis

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Abstract

Primary sclerosing cholangitis (PSC) is typified by a heterogeneous histology with periductal fibroinflammatory lesions. The hepatic arterioles in PSC have not been well characterized. Using image analysis, we sought to examine the dimensions of hepatic arterioles in PSC. We identified 30 livers from patients transplanted for PSC as well as 10 explants each from cirrhotic patients (serving as controls) having primary biliary cirrhosis, hepatitis C (HCV), and alcoholic liver disease. At least two representative hematoxylin and eosin-stained slides were selected, and ten cross-sectioned hepatic arterioles were photographed for image analysis. The vessels were measured at their longest span and width based on the outer portions of the tunica media. Wall thickness was measured at its thickest portion from the intima to the outer portion of the tunica media; the perimeter of the luminal area was outlined by the endothelial lining, generating the total luminal area. Mean arteriolar length, width, and wall thickness (p = 0.012, p = 0.004, p = 0.001, respectively) were greater in the PSC group; luminal area was similar between the groups. When compared to the individual sub-groups, wall thickness of arterioles in PSC remained significantly greater. End-stage PSC has even larger-sized arterioles and greater wall thickness as compared to that of other cirrhotic livers. This increased wall thickness found in PSC cannot be solely attributed to cirrhosis itself. These vessel changes may potentially be the result of, or contribute to, the pathogenesis of PSC.

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References

  1. Singh S, Talwalkar JA (2013) Primary sclerosing cholangitis—diagnosis, prognosis and management. Clin Gastroenterol Hepatol 11:898–907

    Article  PubMed Central  PubMed  Google Scholar 

  2. Molodecky NA, Kareemi H, Parab R et al (2011) Incidence of primary sclerosing cholangitis: a systematic review and meta-analysis. Hepatology 53:1590–1599

    Article  PubMed  Google Scholar 

  3. Wiesner RH, LaRusso NF, Ludwig J, Dickson ER (1985) Comparison of the clinicopathologic features of primary sclerosing cholangitis and primary biliary cirrhosis. Gastroenterology 88:108–114

    Article  CAS  PubMed  Google Scholar 

  4. Portmann B, Zen Y (2012) Inflammatory disease of the bile ducts-cholangiopathies: liver biopsy challenge and clinicopathological correlation. Histopathology 60:236–248

    Article  PubMed  Google Scholar 

  5. Bjornsson E (2009) Small-duct primary sclerosing cholangitis. Curr Gastroenterol Rep 11:37–41

    Article  PubMed  Google Scholar 

  6. Graziadei IW, Wiesner RH, Marotta PJ et al (1999) Long-term results of patients undergoing liver transplantation for primary sclerosing cholangitis. Hepatology 30:1121–1127

    Article  CAS  PubMed  Google Scholar 

  7. Gelbmann CM, Rummele P, Wimmer M et al (2007) Ischemic-like cholangiopathy with secondary sclerosing cholangitis in critically ill patients. Am J Gastroenterol 102:1221–1229

    Article  PubMed  Google Scholar 

  8. Crawford JM (2010) Vascular disorders of the liver. Clin Liver Dis 14:635–650

    Article  PubMed  Google Scholar 

  9. Mocellin S, Pasquali S, Nitti D (2009) Fluoropyrimidine-HAI (hepatic arterial infusion) versus systemic chemotherapy (SCT) for unresectable liver metastases from colorectal cancer. Cochrane Database Syst Rev 3, CD007823

    PubMed  Google Scholar 

  10. Nakanuma Y, Hoso M, Sanzen T, Sasaki M (1997) Microstructure and development of the normal and pathologic biliary tract in humans, including blood supply. Microsc Res Tech 38:552–570

    Article  CAS  PubMed  Google Scholar 

  11. Desmet VJ, Roskams T, De Vos R (1997) Normal anatomy in gall bladder and bile ducts. In: LaRusso N (ed) Gastroenterology and hepatology. The comprehensive visual reference, vol 6. Current Medicine, Philadelphia, pp 1–29

    Google Scholar 

  12. Roskams T, Desmet VJ, Verslype C (2007) Development, structure and function of the liver. In: Burt AD, Portman BC, Ferrel LD (eds) MacSween’s pathology of the liver, 5th edn. Churchill Livingstone Elsevier, Philadelphia, pp 1–73.13

    Google Scholar 

  13. Fiel MI, Deniz K, Elmali F, Schiano TD (2011) Increasing hepatic arteriole wall thickness and decreased luminal diameter occur with increasing age in normal livers. J Hepatol 55:582–58614

    Article  PubMed  Google Scholar 

  14. Burak KW, Angulo P, Lindor KD (2003) Is there a role for liver biopsy in primary sclerosing cholangitis? Am J Gastroenterol 98:1155–1158

    Article  PubMed  Google Scholar 

  15. Roskams TA, Theise ND, Balabaud C et al (2004) Nomenclature of the finer branches of the biliary tree: canals, ductules, and ductular reactions in human livers. Hepatology 39:1739–1745

    Article  PubMed  Google Scholar 

  16. Bombardieri G, Conti LR (1997) Pathophysiology of liver circulation with an overview of medical and invasive treatments. Rays 22:196–210

    CAS  PubMed  Google Scholar 

  17. Alazmi WM, McHenry L, Watkins JL et al (2006) Chemotherapy-induced sclerosing cholangitis: long-term response to endoscopic therapy. J Clin Gastroenterol 40:353–357

    Article  PubMed  Google Scholar 

  18. Ruemmele P, Hofstaedter F, Gelbmann CM (2009) Secondary sclerosing cholangitis. Nat Rev Gastroenterol Hepatol 6:287–295

    Article  PubMed  Google Scholar 

  19. Gaudio E, Franchitto A, Pannarale L et al (2006) Cholangiocytes and blood supply. World J Gastroenterol 12:3546–3552

    PubMed Central  CAS  PubMed  Google Scholar 

  20. Abraham SC, Kamath PS, Eghtesad B, Demetris AJ, Krasinskas AM (2006) Liver transplantation in precirrhotic biliary tract disease: portal hypertension is frequently associated with nodular regenerative hyperplasia and obliterative portal venopathy. Am J Surg Pathol 30:1454–1461

    Article  PubMed  Google Scholar 

  21. Terada T, Hoso M, Nakanuma Y (1989) Microvasculature in the small portal tracts in idiopathic portal hypertension. A morphological comparison with other hepatic diseases. Virchows Arch A Pathol Anat Histopathol 415:61–67

    Article  CAS  PubMed  Google Scholar 

  22. Vollmar B, Menger MD (2009) The hepatic microcirculation: mechanistic contributions and therapeutic targets in liver injury and repair. Physiol Rev 89:1269–1339

    Article  CAS  PubMed  Google Scholar 

  23. Schiano TD, Adrain AL, Cassidy MJ et al (1996) Use of high-resolution endoluminal sonography to measure the radius and wall thickness of esophageal varices. Gastrointest Endosc 44:425–428

    Article  CAS  PubMed  Google Scholar 

  24. Rappaport AM (1980) Hepatic blood flow: morphologic aspects and physiologic regulation. Int Rev Physiol 21:1–63

    CAS  PubMed  Google Scholar 

  25. Eipel C, Abshagen K, Vollmar B (2010) Regulation of hepatic blood flow: the hepatic arterial buffer response revisited. World J Gastroenterol 16:6046–6057

    Article  PubMed Central  PubMed  Google Scholar 

  26. Lautt WW (1985) Mechanism and role of intrinsic regulation of hepatic arterial blood flow: hepatic arterial buffer response. Am J Physiol 249:G549–G556

    CAS  PubMed  Google Scholar 

  27. Putensen C, Wrigge H, Hering R (2006) The effects of mechanical ventilation on the gut and abdomen. Curr Opin Crit Care 12:160–165

    Article  PubMed  Google Scholar 

  28. Orlandi A, Bochaton-Piallat ML, Gabbiani G, Spagnoli LG (2006) Aging, smooth muscle cells and vascular pathobiology: implications for atherosclerosis. Atherosclerosis 188:221–230

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Pathology, The Mount Sinai Medical Center, Box 1194, New York, NY, USA

    M. Isabel Fiel

  2. Department of Medicine, Mount Sinai Services, Veterans Affairs Hospital, Bronx, NY, USA

    Hamid R. Sima

  3. Division of Statistics, Mashhad University of Medical Sciences, Mashhad, Iran

    Amirabbas Azarian

  4. Recanati-Miller Transplant Institute and Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Thomas D. Schiano

  5. Department of Pathology, Icahn School of Medicine at Mount Sinai, Box 1194, 1468 Madison Avenue, New York, NY, 10029, USA

    M. Isabel Fiel

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  1. M. Isabel Fiel
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  2. Hamid R. Sima
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  3. Amirabbas Azarian
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  4. Thomas D. Schiano
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Correspondence to M. Isabel Fiel.

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Fiel, M.I., Sima, H.R., Azarian, A. et al. A morphometric study of the hepatic arterioles in end-stage primary sclerosing cholangitis. Virchows Arch 466, 143–149 (2015). https://doi.org/10.1007/s00428-014-1680-9

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  • DOI: https://doi.org/10.1007/s00428-014-1680-9

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