2022-01-25 リムリック大学(UL)
画期的な研究により臓器の再分類を実現したリムリック大学外科の先駆的教授が、腹部の基本的な秩序を詳細に示す新たな証拠を発表しました。ULの医学部で外科学のファウンデーションチェアを務めるJ Calvin Coffeyは、その大きな発見により2016年に腸間膜を新しい器官として分類し直しましたが、腹部の構成と構造に関する新しい研究結果を発表しました。
Professor J Calvin Coffey, Foundation Chair of Surgery at UL’s School of Medicine, whose major discovery led to the reclassification of the mesentery as a new organ in 2016, has published new research on the makeup and structure of the abdomen Picture: Alan Place
A pioneering University of Limerick professor of surgery whose groundbreaking research led to the reclassification of an organ has published new evidence detailing the fundamental order of the abdomen.
J Calvin Coffey, Foundation Chair of Surgery at UL’s School of Medicine, whose major discovery led to the reclassification of the mesentery as a new organ in 2016, has published new research on the makeup and structure of the abdomen.
In a research paper published in the Nature Portfolio journal Communications Biology, Professor Coffey’s team has detailed the development and structure of the mesentery. In doing this, they uncovered a new order by which all contents of the abdomen are organised or arranged – or the “fundamental order of the abdomen”.
The importance of these findings on the mesentery and the impact these have on our understanding of the abdomen have been further explained in a review article just published in the Lancet Gastroenterology and Hepatology.
“Since 2016, Kevin Byrnes, Dara Walsh and members of the team been looking at the development and structure of the mesentery,” explained Professor Coffey, who is also Head of Department of Surgery, Consultant General and Colorectal Surgeon at UL Hospitals Group.
“We showed how the mesentery is a single and continuous organ in and on which all abdominal digestive organs develop and then remain connected to throughout life.
“These findings revealed a simplicity in the abdomen that was not apparent in conventional descriptions of anatomy,” he explained.
In an international collaboration, Professor Coffey’s team used a variety of state of the art techniques to clarify how the mesentery develops and the shape it has in adults.
The conclusion of the work revealed that the organisation of the abdomen has a remarkably simple design. This design is summarised in a description called the ‘Mesenteric Model of Abdominal Anatomy’.
“The abdomen is not the dauntingly complex collection of separate organs it was previously thought to be,” said Professor Coffey.
“Instead, all digestive organs are neatly packaged and arranged by the mesentery into a single digestive engine. That simplicity lay hidden until clarification of the nature of the mesentery.”
The model itself was described by the team in the most recent edition of Gray’s Anatomy. The supportive evidence was published in Communications Biology and the clinical importance was explained in the review in The Lancet Gastroenterology and Hepatology – both highly respected journals.
“The most important finding here was the discovery of the fundamental order of the abdomen. At the foundation level, all contents of the abdomen are simply organised into one of two compartments,” explained Professor Coffey.
“The fundamental order of any structure is of considerable importance, in particular when it comes to diagnosing patients with illness and treating their disease. The fundamental order is the foundation from which all science launches and clinical practice is based.
“The organisational simplicity of the abdomen now immediately explains the behaviours of viral and bacterial infections, cancer, inflammatory bowel disease, obesity, diabetes and many others,” he added.
Better understanding of the mesentery and its functions has already led to improvements in surgery and the new research builds on those advances. There are also exciting areas for future investigation, Professor Coffey outlined.
“Patients are already benefiting from what we now call mesenteric-based approaches to the diagnosis and treatment of most abdominal conditions. The Mesenteric Model of Abdominal Anatomy – or the description of the order of the abdomen – is being incorporated into numerous reference curricula at this moment,” he said.
“Regarding the future, it is being argued that we are seeing a paradigmatic shift from old to new order. Already, intriguing questions are emerging that we can call ‘legitimate or admissible’ in the strictest scientific sense. Science can approach numerous questions in a new light. Clinicians can design diagnostic and treatment approaches based on a new foundation,” Professor Coffey concluded.
腸間膜の発生と構造
The development and structure of the mesentery
Kevin G. Byrnes, Dara Walsh, Leon G. Walsh, Domhnall M. Coffey, Muhammad F. Ullah,Rosa Mirapeix, Jill Hikspoors, Wouter Lamers, Yi Wu, Xiao-Qin Zhang, Shao-Xiang Zhang, Pieter Brama, Colum P. Dunne, Ian S. O’Brien, Colin B. Peirce, Martin J. Shelly,Tim G. Scanlon,Mary E. Luther,Hugh D. Brady,Peter Dockery, Kieran W. McDermott & J. Calvin Coffey
Abstract
腹部臓器の位置とその中心的な結合機構は、現在、腹膜の用語で説明されている。腹膜モデルとして、腹腔内には複数の腸間膜が存在する。最近の知見では、消化器官は1つの腸間膜に結合しているというモデルもある。その直接的な証拠は今のところないため、我々は腸間膜全体の発達と形状を調べた。その結果、腹部には1つの腸間膜があり、そこにすべての腹部消化器官が発生し、つながっていることが確認された。また、すべての腹腔内臓器は、腸間膜領域と非腸間膜領域の2つの解剖学的ドメインに組織化されていることを明らかにした。このような構成は、さまざまな動物種で共通して見られる。この発見は、腹部の解剖学的基盤を明らかにした。基盤レベルでは、腹部は内臓(すなわち腸間膜)および体性(すなわち筋骨格系)のフレームから構成されている。このレベルの組織は、すべての腹骨盤臓器、血管系、腹膜の位置解剖学を説明する基本的な秩序である。これらの知見は、腹部とその内容物を体系的に特徴づけるための新しい出発点となるものである。
www.DeepL.com/Translator で翻訳しました。
The position of abdominal organs, and mechanisms by which these are centrally connected, are currently described in peritoneal terms. As part of the peritoneal model of abdominal anatomy, there are multiple mesenteries. Recent findings point to an alternative model in which digestive organs are connected to a single mesentery. Given that direct evidence of this is currently lacking, we investigated the development and shape of the entire mesentery. Here we confirm that, within the abdomen, there is one mesentery in which all abdominal digestive organs develop and remain connected to. We show that all abdominopelvic organs are organised into two, discrete anatomical domains, the mesenteric and non-mesenteric domain. A similar organisation occurs across a range of animal species. The findings clarify the anatomical foundation of the abdomen; at the foundation level, the abdomen comprises a visceral (i.e. mesenteric) and somatic (i.e. musculoskeletal) frame. The organisation at that level is a fundamental order that explains the positional anatomy of all abdominopelvic organs, vasculature and peritoneum. Collectively, the findings provide a novel start point from which to systemically characterise the abdomen and its contents.
