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Accumulation of platelets in the liver may be an important contributory factor to thrombocytopenia and liver fibrosis in chronic hepatitis C

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Thrombocytopenia is a marked feature of chronic liver disease and cirrhosis. We tried to clarify whether an accumulation of platelets in the liver contributes to thrombocytopenia and liver fibrosis in chronic liver disease.

Methods

Thirty-eight patients who underwent hepatectomy for hepatocellular carcinoma (HCC) with hepatitis C virus infection were included. The locations of platelets and Kupffer cells and the expression of platelet-derived growth factor (PDGF) receptor-β and smooth muscle actin (SMA) were identified by immunohistochemistry. Perisinusoidal mesenchymal cells that express PDGF receptor-β and SMA were interpreted as transformed hepatic stellate cells (HSCs).

Results

Patients with cirrhosis had a more extensive platelet area in the liver compared to controls (5601 ± 5611 vs. 564 ± 361 μm2, p = 0.02), although the blood platelet count significantly decreased along with the progression of liver fibrosis. In cirrhotic liver, most platelets were present in the sinusoidal space of the periportal area with inflammation, where HSCs expressing PDGF receptor-β were frequently observed. In addition, the platelet and Kupffer cell areas were significantly smaller in cancerous tissue than those in noncancerous tissues (platelet area: 492 ± 823 vs. 3643 ± 4055 μm2, p = 0.001; Kupffer cell area: 450 ± 841 vs. 3012 ± 3051 μm2, p = 0.001).

Conclusions

The accumulation of platelets in the liver with chronic hepatitis may be involved in thrombocytopenia and liver fibrosis through the activation of HSCs. In addition, our findings also indicate that both platelets and Kupffer cells decrease in HCC tissues.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

    Reiichiro Kondo, Hirohisa Yano, Ken Tanikawa & Yoriko Nomura

  2. Department of Diagnostic Pathology, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan

    Reiichiro Kondo, Yoriko Nomura & Masayoshi Kage

  3. Department of Clinical Laboratory Medicine, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan

    Osamu Nakashima

  4. Research Center for Innovative Cancer Therapy, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan

    Masayoshi Kage

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  1. Reiichiro Kondo
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Correspondence to Reiichiro Kondo.

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Kondo, R., Yano, H., Nakashima, O. et al. Accumulation of platelets in the liver may be an important contributory factor to thrombocytopenia and liver fibrosis in chronic hepatitis C. J Gastroenterol 48, 526–534 (2013). https://doi.org/10.1007/s00535-012-0656-2

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  • DOI: https://doi.org/10.1007/s00535-012-0656-2

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