Carcinoma-associated perisinusoidal laminin may signal tumour cell metastasis to the liver

Summary The perisinusoidal space of the liver shows extensive modulation of the extracellular matrix in response to various pathological conditions. We studied perisinusoidal laminin expression immunohistochemically using polyclonal and monoclonal antibodies in 110 human liver specimens obtained at autopsy. In normal adult liver the perisinusoidal spaces contained only minimal amounts of immunoreactive laminin. In 86% of patients dying from cancer with liver metastasis, however, a distinct increase in the amount of perisinusoidal laminin could be demonstrated. The perisinusoidal space also contained laminin in cancer patients without liver metastasis. In 3 cases of leukaemia sinusoids were laminin negative. In cirrhosis and chronic passive congestion there was, as expected, laminin immunoreactivity in the perisinusoidal space. The results obtained using polyclonal antibodies against laminin were confirmed using chain-specific monoclonal antibodies against B2 laminin. In an ex vivo assay, viable tumour cells (Panc-1 and clone A) were found to bind with remarkable specificity to frozen sections of liver tissue containing perisinusoidal laminin as opposed to liver tissues without laminin. We suggest that this perisinusoidal laminin may directly on indirectly mediate tumour cell metastasis to the liver.     

Basement Membrane Type IV Collagen and Laminin: An Overview of Their Biology and Value as Fibrosis Biomarkers of Liver Disease

Basement membranes provide structural support to epithelium, endothelium, muscles, fat cells, Schwann cells, and axons. Basement membranes are multifunctional: they modulate cellular behavior, regulate organogenesis, promote tissue repair, form a barrier to filtration and tumor metastasis, bind growth factors, and mediate angiogenesis. All basement membranes contain type IV collagen (Col IV), laminin, nidogen, and perlecan. Col IV and laminin self‐assemble into two independent supramolecular networks that are linked to nidogen and perlecan to form a morphological discernable basement membrane/basal lamina. The triple helical region, 7S domain and NCI domain of Col IV, laminin and laminin fragment P1 have been evaluated as noninvasive fibrosis biomarkers of alcoholic liver disease, viral hepatitis, and nonalcoholic fatty liver disease. Elevated serum Col IV and laminin are related to degrees of fibrosis and severity of hepatitis, and may reflect hepatic basement membrane metabolism. But the serum assays have not been linked to disclosing the anatomical sites and lobular distribution of perisinusoidal basement membrane formation in the liver. Hepatic sinusoids normally lack a basement membrane, although Col IV is a normal matrix component of the space of Disse. In liver disease, laminin deposits in the space of Disse and codistributes with Col IV, forming a perisinusoidal basement membrane. Concomitantly, the sinusoidal endothelium loses its fenestrae and is transformed into vascular type endothelium. These changes lead to capillarization of hepatic sinusoids, a significant pathology that impairs hepatic function. Accordingly, codistribution of Col IV and laminin serves as histochemical marker of perisinusoidal basement membrane formation in liver disease. Anat Rec, 300:1371–1390, 2017. © 2017 Wiley Periodicals, Inc.     

Perisinusoidal fibrosis of the liver in patients with thrombocytopenic purpura

Summary 10 patients with thrombocytopenic purpura (TP) underwent splenectomy. Eight of these patients had idiopathic TP (certain or probable). All had normal liver function tests. Liver histology of the surgical biopsy was normal with the exception of a non specific mild portal infiltration in 6 cases. On Sirius red staining the perisinusoidal network was normal in 3 cases, mildly or moderately increased in 5 cases and often associated with perivenular fibrosis. Collagen types I, III, IV, laminin and fibronectin were increased in the 8 biopsies tested. On semi-thin sections, numerous Kupffer cells were observed. Under the electron microscope, sinusoidal abnormalities were very similar in all 7 patients studied: numerous Kupffer cells containing abundant lysosomes, numerous collagen bundles in the Disse space, active endothelial cells, transformation of some perisinusoidal cells into cells with some of the characteristics of fibroblasts (increased RER) and myofibroblasts (peripheral condensations of the filamentous network), increased fragments of basement membrane-like material. In two cases there was an increase in the number of perisinusoidal cells loaded with lipids. The similarity of the lesions and the absence of other fibrogenic causes (except in 2 cases) suggest that TP may represent another group of diseases with perisinusoidal fibrosis. The aetiology of fibrosis remains unknown but platelet derived growth factor and activated macrophages may play a major role.     

Light microscopic and ultrastructural distribution of type VI collagen in human liver: alterations in chronic biliary disease

We have investigated the distribution of type VI collagen in normal human liver obtained from cadaveric renal transplant donors, using a peroxidase-antiperoxidase method for light microscopic visualization, and an immunogold labelling method for ultrastructural localization. The distribution was compared with that of the more abundant interstitial collagen type III, using antibodies to amino terminal procollagen type III. Staining for type VI collagen was identified in Glisson's capsule, in portal tract stroma and within the space of Disse. Perisinusoidal staining showed intra-acinar heterogeneity with the intensity in acinar zones 2 and 3 being greater than in zone 1. Type III collagen was also found in the space of Disse although no significant intra-acinar variation in staining intensity was noted. Immuno-gold labelling for type VI collagen was demonstrated on amorphous or microfilamentous material lying between, and occasionally appearing to interconnect, cross-striated collagen fibrils, whereas labelling for amino terminal procollagen type III was exclusively on fibrils. Intracellular staining for type VI collagen was noted in perisinusoidal (lto) cells. These results confirm that type VI collagen is a ubiquitous constituent of the normal hepatic extracellular matrix and suggest that it may be synthesized by perisinusoidal (lto) cells. The distribution of type VI collagen was also studied in biopsy material from patients with different histological stages of primary biliary cirrhosis. Intense staining was noted around proliferating bile ductules within developing fibrous septa and in established septa of cirrhotic liver. These observations indicate that this 'minor' matrix component may play an important role in hepatic fibrogenesis.     

人肝贮脂细胞表达结蛋白的免疫细胞化学观察

用免疫细胞化学法观察了正常人肝贮脂细胞表达结蛋白中间丝。发现结蛋白阳性细胞位于血窦旁旁狄氏间隙内,呈星形或纺锤形,于肝小叶内大致均匀分布,有些细胞内含有空泡,每高倍(400X)视野细胞数为15～25个。汇管区结缔组织内及肝静脉周围散在少数与小叶内形态相似的结蛋白阳性细胞。结果表明正常人肝贮脂细胞表达结蛋白,可作为研究该细胞的良好标志,并支持了贮脂细胞的肌源性学说。[关键词]贮脂细胞,结     

Extracellular matrix in hepatoblastoma: an immunohistochemical investigation

Eleven hepatoblastomas of various subtypes and normal liver tissue were investigated with antibodies against collagen types I-VI, laminin, fibronectin and endothelial and macrophage-associated antigens. Epithelial hepatoblastoma cells, unlike non-neoplastic hepatocytes, exhibited intracellular immunoreactivity for various extracellular matrix proteins (depending on the subtype: laminin, fibronectin and collagen types III, IV and V). The intracellular expression of extracellular matrix proteins by the tumour cells increased from the fetal subtype, through the embryonal subtype, to the small cell subtype. The epithelial tumours exhibited sinusoid-like blood vessels in numbers that varied according to the subtype. These contained Kupffer cells and exhibited greater amounts of the basement membrane components collagen type IV and laminin in the perisinusoidal space than those in the normal liver. The small cell hepatoblastoma exhibited smaller numbers of sinusoids, pronounced intracellular expression of extracellular matrix proteins and large numbers of fibres immunoreactive for collagen type III. In the mixed hepatoblastomas, the extracellular matrix of the osteoid was most strongly immunoreactive for collagen type I and that of the spindle cell areas for collagen type III.     

Cellular and molecular aspects of hepatic fibrosis

Hepatic fibrosis, a consequence of most forms of chronic liver disease, is a dynamic process involving complex interactions between several cell types, the net result of which is accumulation of several distinct extracellular matrix (ECM) proteins. The resultant disruption of intrahepatic blood flow contributes to the development of portal hypertension. The effects, however, are not merely a space-occupying phenomenon; by changing the composition of the ECM, fibrosis may also alter hepatocyte function via cellular integrins. The principal source of ECM proteins in normal and fibrotic liver is the perisinusoidal cells which lie in the space of Disse. The response of this cell population to acute and chronic liver injury has been studied in detail. Perisinusoidal cells proliferate and become activated following hepatocyte necrosis. This phenomenon is transient in acute injuries, but in chronic liver disease, continued activation is associated with phenotypic modulation of perisinusoidal cells to myofibroblasts. This process is mediated by various cytokines including TGF-β and PDGF. Some of the growth factors involved are derived from activated Kupffer cells and there is evidence of a complex interplay between mediators; injured sinusoidal endothelial cells and platelets are possible additional sources. Accumulation of ECM proteins in fibrosis can be explained not only by increased synthesis, but also by decreased degradation. There is growing evidence that in fibrotic liver there is decreased interstitial collagenase activity. This is, at least in part, due to expression of a tissue inhibitor of metalloproteinase, TIMP-1, by activated perisinusoidal cells.     

Pathways of interstitial fluid and lymph flow in the liver acinus of the sheep and mouse

In the acinus of the sheep and mouse liver, lymphatic vessels are restricted to the portal tracts. Vessels less than about 25 μm across form a network around portal venules, and are closely associated with the limiting plate of hepatocytes. The perisinusoidal space of Disse is continuous with the interstitial space of the portal tracts at the origin of the sinusoids. It seems likely that excess interstitial fluid derived from the sinusoids flows along the perisinusoidal space of Disse to enter the portal tracts near the portal venules, and then enters the small lymphatics which lie adjacent to those venules. It then enters the larger vessels, which are adjacent to hepatic arterioles and bile ductules.     

Cellular and matrix changes in drug abuser liver sinusoids: A semiquantitative and morphometric ultrastructural study

The aim of the present work was to analyse, at the ultrastructural level, the action of heroin of 150 centrilobular sinusoids from liver biopsies of five intravenous drug abusers, who presented clinical and biological manifestations of hepatic impairment. A comparative study of 90 sinusoids from liver biopsies of three control patients was performed. Electron microscopic observations showed a thickening of the sinusoidal wall related to endothelial cell hypertrophy and to fibrosis of the space of Disse. This was generally associated with basement-membrane-like material and hepatocyte microvilli flattening. In addicts, hepatic vascular pole changes were a constant finding, accompanied by interhepatocyte space disjunction and perisinusoidal collagenization. Morphometric assessment confirmed a significant increase of sinusoidal wall surface, endothelial cell body and processes and Ito cell process surface was significantly different between the patient groups. This cellular hypertrophy may represent hyperactivation of the sinusoidal cell functional capacity, triggering the fibrogenesis in the space of Disse. While this mechanical barrier might hinder the free exchange through the space of Disse, it may equally well protect the liver against heroin toxicity.     

The lymphatics of the liver

An overview of our current knowledge of the hepatic lymph vessels is given, and the different lymph node stations that are related to the liver are described. The lymphatics of the liver itself can be divided into a superficial and a deep system. The superficial vessels are mainly situated in the liver capsule, the deep ones follow the triads of Glisson or the efferent hepatic veins. There are no direct communications between spaces in the liver parenchyma and the first lymphatic capillaries, which end blindly in the surrounding connective tissue. Nevertheless, the perisinusoidal space of Disse, the space of Mall, directly adjacent to the outer limiting plate of the parenchyma, and the space of Comparini, surrounding the sublobular hepatic veins can be regarded as prelymphatic spaces from which the hepatic lymph could originate. The extracellular matrix in the space of Disse is apparently continuous with the extraparenchymal areas of the connective tissue. Collagens and proteoglycans offer a morphological pathway for the transport of fluid, the physiological prerequisites of which are discussed.     

“Sternzellen” in the liver: Perisinusoidal cells with special reference to storage of vitamin A

The “Sternzellen” (von Kupffer, 1876) in the liver of normal animals and of those injected with excess vitamin A were examined with the light and electron microscopes. These cells were stellate perisinusoidal cells located in the space of Disse and were separated from the sinusoidal lumen by the endothelium. Their cytoplasm contained a number of lipid droplets which reacted intensely with gold chloride. These lipid droplets imparted intense vitamin A fluorescence under the fluorescence microscope. Following the administration of excess vitamin A, these lipid droplets increased remarkably. The “Sternzellen” were identical with cells described as “interstitial” or “fat-storing” cells by others, and were quite different from the so-called Kupffer cells of the liver reticulo-endothelial system.     

ELECTRON MICROSCOPIC STUDY OF MAMMALIAN LIVER WITH PERIODIC ACID METHENAMINE SILVER STAIN—BASEMENT MEMBRANE STRUCTURE and FIBROGENESIS IN SPACE OF DISSE

The author has studied the morphologic architecture of the basement membrane-like structure wich is rarely seen in the space of Disse of the human liver. Special attention has been paid to the histochemical staining properties of the construction using the periodic acid methena-mine silver (PAM) stain and the ruthenium red (RR) stain which are regarded as good methods for the demonstration of mucopolysaccharide. The former showed a high affinity to the materials such as collagen fibrils or basement membrane proper, while the latter Is effective to detect the more labile mucoprotein such as glycocalyx containing sia-lomucin. The substance in the space of Disse could be defined to be usually composed of labile mucopolysaccharide materials reacting with ruthenium red stain. According to the PAM stain, the basement membrane-like structure was selectively demonstrated, but it appeared never to be a constant feature as seen in the bile ductule, converting into fine filamentous, irregular mottled or diffuse amorphous architectures in the space of Disse. It might be concluded that the structure was not the basement membrane proper in the usual sense, and should be understood as an alternation of mucopolysaccharide content in the perisinusoidal spaces in a histochemical aspect. Interestingly the fat-storing cell in the space of Disse and the fibroblast in the connective tissue constituents of the liver have common properties showing aggregates of fine granules positively impregnated by the PAM stain in their cytoplasmic processes. Moreover, the fine granules were related to the surrounding matured collagen fibrils with high intimacy. The author would like to define those granules as a precursor of collagen fibrils.     

The lymphatics of the liver

An overview of our current knowledge of the hepatic lymph vessels is given, and the different lymph node stations that are related to the liver are described. The lymphatics of the liver itself can be divided into a superficial and a deep system. The superficial vessels are mainly situated in the liver capsule, the deep ones follow the triads of Glisson or the efferent hepatic veins. There are no direct communications between spaces in the liver parenchyma and the first lymphatic capillaries, which end blindly in the surrounding connective tissue. Nevertheless, the perisinusoidal space of Disse, the space of Mall, directly adjacent to the outer limiting plate of the parenchyma, and the space of Comparini, surrounding the sublobular hepatic veins can be regarded as prelymphatic spaces from which the hepatic lymph could originate. The extracellular matrix in the space of Disse is apparently continuous with the extraparenchymal areas of the connective tissue. Collagens and proteoglycans offer a morphological pathway for the transport of fluid, the physiological prerequisites of which are discussed.     

Benign Recurrent Cholestasis: A Light and Electron Microscopic Study with Emphasis on Sinusoidal Cells

A liver biopsy was performed on a patient with benign recurrent cholestasis. Cholestasis was mainly centrolobular with infiltration by sinusoidal macrophages. There was no necrosis. All the classic and specific ultrastructural criteria of cholestasis were observed in hepatocytes under electron microscopy. Perfusion-fixation of the biopsy allowed in addition a good visualization of sinusoids and sinusoidal cells. Numerous macrophages (Kupffer cells) with intense phagocytic activity were present in the lumen; some formed the sinusoidal barrier or were infiltrated in the Disse space. Endothelial cells contained numerous dense bodies and had few fenestrae. Cellular debris of hepatocytic origin which were not phagocytized in the Disse space were extruded in the lumen either through enlarged endothelial pores or by progressive invagination in the endothelial wall followed by outpouching in the sinusoid. In an enlarged Disse space containing amorphous material and collagen fibrils some perisinusoidal cells were transitional cells. These results indicate that pure cholestasis leads not only to hepatocyte injury with intense phagocytic activity but also to some degree of sinusoidal cell damage and extracellular matrix changes.     

Light chain deposition disease with liver dysfunction

Light and transmission electron microscopic study as well as immunohistochemical investigation were performed on three cases of light chain deposition disease (LCDD) with severe liver dysfunction. In two cases, the amount of light chain deposits in the liver was moderate and did not correlate with the severity of clinical and biological symptoms. Ultrastructural study demonstrated a collagenization of the Disse's space, with basement membrane-like material in association with light chain deposits. Immunohistochemical investigation showed a marked increase of collagen types I, III, and IV, as well as fibronectin and laminin in perisinusoidal space. This study suggests that collagenization of the Disse's space has a minor role in liver dysfunction. The analogy between kidney and liver lesions in diabetes and in LCDD is stressed, but the mechanism of this abnormal accumulation of matrix proteins remains unknown.     

Codistribution of Collagen Type IV and Laminin in Liver Fibrosis of Elderly Cadavers: Immunohistochemical Marker of Perisinusoidal Basement Membrane Formation

Liver sinusoids are lined by a fenestrated endothelium that lacks a basement membrane. Formation of perisinusoidal basement membranes beneath the endothelium is an integral feature of capillarization of sinusoids that is a significant pathology found in advanced fibrosis. Liver fibrosis is prevalent in elderly cadavers; however, basement membrane formation in these liver samples has yet to be studied. Collagen type IV and laminin are major basement membrane proteins and their codistribution around sinusoids provides an immunohistochemical marker of basement membrane formation. Here, we examined the intralobular sites of perisinusoidal basement membrane formation in elderly cadaveric livers having various stages of fibrosis. Collagen IV and laminin codistributed in basement membranes of portal and septal ductular and vascular structures, providing a positive control. In the parenchyma, collagen IV immunostaining of sinusoids was panlobular in all stages of fibrosis, and the stain was continuous along the sinusoids. In contrast, laminin was not detected in livers, showing minimal fibrotic change. It was rarely seen in perisinusoidal/pericellular fibrosis, but frequently in septa formation, bridging fibrosis, and cirrhosis. The laminin stain was patchy, occurring principally in sinusoids of periportal and periseptal areas, less commonly in mid‐lobular and rarely in centrilobular areas. Consecutive sections revealed that laminin codistributed with collagen IV in these sinusoidal locations, thus marking the sites of perisinusoidal basement membrane formation in aged fibrotic livers. This development is presumably related to aging of the liver and exacerbated by liver injury caused by advanced liver fibrosis, possibly resulting in sinusoidal capillarization. Anat Rec, 296:953–964, 2013. © 2013 Wiley Periodicals, Inc.     

Defect of Fc receptors and phenotypical changes in sinusoidal endothelial cells in human liver cirrhosis.

To analyze the pathological changes occurring in Fc receptors (FcRs) in sinusoidal endothelial cells (SECs) in chronic liver diseases, we first characterized immunohistochemically the SEC FcRs by using monoclonal antibodies (MAbs) to FcRs and then investigated the distribution of the SEC FcRs by using peroxidase-antiperoxidase IgG complexes as a ligand on frozen sections. MAb 2E1 to FcRII reacted with SECs in a similar manner to peroxidase-antiperoxidase IgG and blocked the peroxidase-antiperoxidase IgG binding to SECs, whereas MAbs 3G8 and Leu-11b to FcRIII did not. FcRs in normal liver were found along the sinusoidal walls, except for those in the outer periportal zones, but FcRs in chronic active hepatitis and cirrhosis were intermittently or focally absent. The lengths of the FcR-positive portion of sinusoids in unit areas were respectively about 54% and 76% of the normal values in active and inactive cirrhosis. Where FcRs were absent, the MAbs CD36, CD31, and EN4 revealed the presence of sinusoids and, in active cirrhosis, frequently the thickening of liver cell plates. The FcR-negative SECs in the outer periportal zones of normal livers were different from the SECs of other sites in the presence of PAL-E antigen and a rich amount of EN4 antigen, though these sinusoids possessed Kupffer cells and no perisinusoidal deposition of laminin. The FcR-negative SECs in liver diseases occasionally presented the character of ordinary blood vessels, viz., PAL-E antigen, CD34 antigen, and a deficiency of Kupffer cells, regardless of perisinusoidal laminin deposition. However, they preserved the character of normally FcR-possessing SECs, viz., CD36 antigen, and a small amount of EN4 and CD31 antigens. These findings indicate that the outer-periportal SECs in normal livers are phenotypically different from other SECs and that the SECs in diseased livers frequently undergo phenotypical changes, including loss of FcRs, regardless of perisinusoidal laminin deposition, i.e., capillarization of the sinusoids. These phenotypical changes in SECs may reduce the capacity of FcR-mediated IgG-IC metabolism in diseased livers.