HEPATIC INTERCELLULAR COMMUNICATION IN SHOCK AND INFLAMMATION

The liver is well recognized as a target for injury during low flow or inflammatory states. Functionally, the result is both metabolic and host defense dysfunction. Although the liver is clearly responsive to changes in systemic levels of various mediators, it is becoming apparent that substantial changes occur within the fiver that are not directly dependent on extrahepatic factors. This is the result of complex interactions among the various cell types that exist in a highly organized arrangement within the functional subunit of the liver. The purpose of this review is to summarize the structural relationships which form the basis for this system of cell-cell communication and their functional implications both in the normal liver and during both low-flow and normal-flow inflammatory states.