双语字幕 Scar wars: Repairing the liver 肝脏瘢痕修复 Scarring of the liver was once thought to be an irreversible situation, but a new and exciting field of experimental drugs may put an end to this dogma. 肝脏瘢痕曾一度被认为是不可逆转的，但是一项新型激动人心的实验药物有望打破这种传统观念。 The liver is a large smooth organ that carries out many essential functions. It stores and releases nutrients, aids digestion and breaks down unwanted substances. 肝脏是一种具有许多重要功能的巨大平滑器官。它储存和释放营养物质，促进消化，分解多余的物质。 Unfortunately, numerous chronic diseases damage the liver and when they continue for a long time they cause scarring — a condition called fibrosis. 然而，许多慢性疾病都会损伤肝脏，长期损害会导致瘢痕形成，即肝脏纤维化。 The most common causes are hepatitis viruses, long-term heavy drinking and fatty liver disease associated with obesity and diabetes. This scarring is caused by a buildup of fibrous collagen proteins which begin to replace healthy tissue. 最常见的病因是肝炎病毒、长期酗酒，以及肥胖和糖尿病相关的脂肪肝疾病。纤维胶原蛋白聚集，开始替代健康组织，引起肝脏瘢痕形成。 If the fibrosis keeps worsening, the liver can progress to a state known as cirrhosis. 如果纤维化持续恶化，肝脏会发展为肝硬化。 At this stage, excessive scarring hampers the liver's blood flow and stops it being able to do its job. Unchecked cirrhosis can lead directly to liver failure, and puts patients at high risk for liver cancer. Cirrhosis currently kills a million people worldwide each year. 在此阶段，大量瘢痕形成会阻断肝脏血流，使其无法正常工作。如果不及时诊断治疗，则可能直接导致肝脏衰竭，增加肝癌风险。目前，全世界范围内，肝硬化每年的致死人数为100万人。 The good news is that the liver has its own mechanisms that degrade scar tissue,and this discovery has spurred a new wave of research into developing drugs which can halt the progression of fibrosis, or speed up healing once the underlying disease has been treated.所幸，肝脏具有降解瘢痕组织的自身机制，这一发现激发了新一轮研发可阻止纤维化进展，或治疗潜在疾病后加速愈合的药物的热潮。 The best way to reduce fibrosis is to avoid it altogether by removing the risk factors associated with the disease, but now scientists are examining the biology of the scar-causing cells as potential targets for therapeutic interventions.减少纤维化的最佳方式是解决疾病相关的风险因素，从而避免纤维化。但是，现在，科学家正在研究将瘢痕形成细胞的生物学特性作为潜在的治疗靶点的治疗方法。 Scars are generated by cells called myofibroblasts.When these cells become activated, they proliferate, migrate to injury sites and secrete collagen into the extracellular matrix. 瘢痕由称为肌成纤维细胞的细胞产生。这些细胞活化后，增殖，并迁移至受损区域，将胶原蛋白分泌入细胞外基质。 As these collagen fibres accumulate, they become cross-linked into a mesh which stiffens the tissue and blocks its function. So researchers are aiming their sites, first and foremost, at myofibroblasts.随着胶原纤维积聚，它们交联成网状结构，从而使组织变僵硬并阻碍其功能。因此，研究人员将首先研究肌成纤维细胞。 One strategy is to target the messenger molecules which coordinate their activation. 一种策略是靶向协调其活化的信使分子。 These are released by damaged liver cells and immune cells and could targeted by new drugs. One example is a drug called Cenicriviroc that blocks receptors for profibrosis messengers called cytokines. 它们由受损的肝脏细胞和免疫细胞释放，可作为靶点研发新药。例如cenicriproc可阻断促纤维化信使--细胞因子的受体。 Another set of drugs could inactivate myofibroblasts by targeting receptors on their surface called integrins that allow them to interact with other cells and the extracellular matrix. 另一类药物可通过靶向肌成纤维细胞表面的受体--整合素，阻断它们与其他细胞和细胞外基质相互作用，从而使其失活。 Multiple drugs that work this way are currently being explored and will enter human trials soon. 当前，研究人员正在研发多种具有这种机制的药物，并将很快投入人体试验。 Blocking the myofibroblasts' ability to make collagen is another option. These drugs work by inserting small bits of RNA into the nucleus of myofibroblasts, destabilising the machinery that creates collagen fibres. 另一种选择是阻断肌成纤维细胞制造胶原的能力。这类药物通过将少量RNA插入肌成纤维细胞的细胞核，破坏制造胶原纤维机器的稳定性。 Another approach is to block the enzymes that cross-link collagen fibres to stiffen the scar matrix. This makes the collagen easier for the body to degrade.另一种方法是阻断交联胶原纤维的酶，使疤痕基质变硬。这样，胶原蛋白更容易降解。 Finally, an exciting new avenue is the use of cell therapies. Introducing extra immune cells called macrophages into rodents' livers strongly boosts the organ's intrinsic anti-scarring mechanisms and now human trials using patient's own macrophages have begun. 最后，一种新型途径是使用细胞疗法：将免疫细胞巨噬细胞引入啮齿动物的肝脏，极大地增强器官内在的抗瘢痕形成机制。现在已经使用患者自身的巨噬细胞开始人体试验。 All these therapies will require clinical trials, and due to the slow progressive nature of liver fibrosis, this may take years. 所有这些疗法都需要临床试验，肝脏纤维化进展缓慢，可能需要数年的时间。 But new biomarkers in development may speed up trials considerably by showing whether the drugs are working, even before the overall fibrosis starts to decline. Hopefully these new approaches will help us to victory in the scar wars. 但是，整体纤维化开始减少前，我们可以通过正在研发中的新标记物，验证药物是否有效，来大幅加速试验进程。希望这些新方法将帮助我们赢得这场“瘢痕”修复战争。相关单词学习
Cirrhosis
①发音和释义 cir•rho•sis/sə'rəʊsɪs/n.肝硬化；肝硬变A chronic disease of the liver in which fibrous tissue replaces normal tissue.单词 cirrhosis由下列成分构成 cirrho-（构词成分）黄色（肝）+-osis（后缀）病变状态，形成，过程（图源：太帅图库）
Myofibroblast
my•o•fi•bro•blast/maɪɔ:'faɪbrɒblɑ:st/n. 肌成纤维细胞An atypical fibroblast combining the ultrastructural features of a fibroblast and a smooth muscle cell. 单词 myofibroblast 由下列成分构成myo-（前缀）肌+fibro-（前缀）纤维+-blast 表示胚(芽)，胚胎，胚层，细胞，原基 （图源：太帅图库）
Integrins
in•te•grins/ˈintiɡrəlz/n.整合素，整合蛋白A family of cell membrane glycoproteins that are heterodimers composed of α- and β-chain subunits.（图源：太帅图库）往期内容推荐： 1. 肝功能丨医学英语视听学习2. 乙肝丨医学英语视听学习3.肝硬化丨医学英语视听学习4. 900套医学视频课程可以免费学！
