The pivotal role of the liver sieve in balancing incoming lipoproteins (chylomicrons) from the diet with those synthesised in the liver. This balance maybe lost from nicotine intake, excess alcohol, some viral hepatitises and often in ageing and diabetes, so leading to high cholesterol levels, heart disease, strokes, osteoporosis, dementias and in some cases fatty liver and cirrhosis.
We have recently shown contact of T lymphocytes and NK cells through the sinusoidal fenestrae influences immune tolerance. The defenestration of old age may thus lead to an increase in autoimmune disease, perhaps even cancer.
In the last 6 years we have shown the importance of the Liver Sieve in admitting entrance to the Space of Disse and Heptocytes of vectors of genetic manipulates in the exciting new fields of genomics & epigenomics in the therapy of familial diseases as diverse as Haemophilia, Atherosclerosis ( egPC2K9) and Amyloidosis.