Medical and surgical treatment options for polycystic liver disease1

来自 Wiley

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作者：

JPH Drenth，M Chrispijn，DM Nagorney，PS Kamath，VE Torres

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摘要：

One of the potential factors in promoting cyst growth is cAMP. Secretin, the major cAMP agonist in cholangiocytes, stimulates the targeting and insertion of several transporters and channels into the apical membrane of cholangiocytes. Biliary epithelia maintain a cAMP-dependent Cl and HCO3 secretion that facilitates fluid secretion.45, 46 Intravenous administration of secretin in ADPKD patients increased fluid secretion in hepatic cysts.47 This suggests that increased cAMP drives fluid secretion in hepatic cysts. Somatostatin analogs are cAMP level inhibitors and decrease fluid secretion and cell proliferation in many cell types, including cholangiocytes,18, 48-51 thereby providing a novel opportunity to modulate cystogenesis. The basic concept is that cyst growth is regulated by a continuous process of secretion and reabsorption. Inhibition of secretion by somatostatin analogs may ultimately result in shrinking of hepatic cysts. The first experiments in humans with massively polycystic livers in the early 1990s failed to demonstrate any decrease in hepatic cyst growth or size following octreotide administration.52 The techniques used to evaluate liver volume were not sensitive enough to detect small but significant differences.

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关键词：

Animals Humans Cysts Liver Diseases Somatostatin Sclerotherapy Punctures Liver Transplantation TOR Serine-Threonine Kinases Female