7 Taking all of these observations together, it is likely that serotonin decreases hepatocyte proliferation by binding

to the 5-HT2B receptor on activated HSCs, whereas serotonin promotes hepatocyte proliferation through the 5-HT2A receptor on hepatocytes in healthy livers (Fig. 1). The authors AZD3965 further determined the mechanism as to how serotonin, through the 5-HT2B receptor, induces TGFB1 gene expression. Binding of serotonin to the 5-HT2B receptor induces an activation of mitogen-activated protein kinase 1 and 2, which then phosphorylates JunD, a transcription factor that binds to the promoter region of the TGFB1 gene, thereby increasing TGF-β1 expression in activated HSCs. Moreover, expression of the 5-HT2B receptor is context-dependent. Its expression is relatively low in healthy livers,8 but increases significantly in activated HSCs. These differences in the expression pattern of serotonin receptors may reflect the varying stages of hepatocyte proliferation mediated by serotonin in healthy versus diseased livers. Furthermore, apoptotic clearance of activated HSCs that occurs during the resolving stage of wound repair may switch serotonin signaling in favor of liver regeneration via 5-HT2A receptors on hepatocytes. The authors also showed a significant increase in expression

of the 5-HT2B receptor in HSCs isolated from mice undergoing PHx. This finding raises an interesting question about the Staurosporine price activation status of HSCs in the regenerating liver. If 5-HT2B receptors are specifically expressed in activated HSCs, those HSCs found in the regenerating liver after PHx could also be activated and similar to those found 上海皓元 in fibrotic livers. Given that TGF-β1 is known to inhibit hepatocyte proliferation in the regenerating liver,11 those HSCs, through the 5-HT2B–mediated

TGF-β1 synthesis, may also help the liver to end regeneration. This aspect of HSC biology warrants further investigation. From a pathophysiological perspective, Wanless and colleagues many years ago showed that extensive intrahepatic thrombosis was found in 70% of cirrhotic explants.12 Because platelets, the major source of serotonin, initiate the thrombotic cascade, it can be presumed that the areas of thrombosis would also be associated with the greatest degree of serotonin signaling and fibrosis. In fact, thrombosis was associated with the most confluent areas of fibrosis and parenchymal extinction,12 thereby providing an anatomical correlation with the findings presented in the current study. The current findings, moreover, may extend to other vascular-related liver disorders where thrombosis is a hallmark. The findings of this study also have potential therapeutic implications.