间充质干细胞对肝纤维化进展的调控机制

肝纤维化是各种病因引起肝损伤后细胞外基质沉积或瘢痕形成的过程,可持续进展为肝硬化,甚至肝癌等终末期肝脏疾病,严重危害人类健康。间充质干细胞(mesenchymal stem cells, MSCs)是一类具有多向分化潜能的多能干细胞,近年来被广泛应用于多种疾病治疗。现今,MSCs移植已被运用于肝纤维化治疗研究,治疗结局众说纷纭,其作用机制莫衷一是。现就MSCs通过免疫、炎症、归巢等途径对肝纤维化进展的调控机制做一综述。     

肝巨噬细胞与肝星状细胞交互作用对肝纤维化发生与逆转的影响

肝纤维化是由各种病因所导致的肝脏病理性反应,是发展成肝硬化甚至肝癌的必经途径。以往研究发现,肝纤维化甚至是肝硬化早期都可以通过一定的干预治疗抑制与逆转病情,该过程有多种肝实质以及非实质细胞参与,肝星状细胞(hepatic stellate cell, HSC)与肝巨噬细胞是肝纤维化进程中关键的细胞类型。HSCs是肝纤维化的核心细胞,而肝巨噬细胞是肝纤维化进程中的主要调控细胞,HSCs与巨噬细胞间可通过分泌趋化因子、炎症因子以及凋亡因子诱导双方细胞的活化、分化、增殖和凋亡,并且能够调节细胞外基质(ECM)的生成与降解,进而影响肝纤维化的发生发展与抑制逆转。该文立足于HSCs与肝巨噬细胞的各自特征性功能,通过对它们之间的相互影响的阐述,探究两者在促进与逆转肝纤维化中的作用,以期探究肝纤维化复杂病理过程中的机制,为治疗逆转肝纤维化提供新的思路和有效靶点。     

肝星形细胞在肝纤维化发生及治疗中的作用

肝纤维化是指在修复肝脏损害和炎症的过程中,肝脏细胞外基质过度增多和过度沉积的病理过程。目前认为,肝星形细胞在肝纤维化形成的过程中起着非常重要的作用。细胞外基质主要来自肝星形细胞,肝实质中降解细胞外基质的基质金属蛋白酶也来自肝星形细胞。肝星形细胞已成为肝纤维化治疗的新靶点。     

胆汁淤积性肝损伤治疗靶点与药物治疗进展

胆汁淤积(cholestasis)是由于胆汁合成、分泌、转运、排泄等代谢功能紊乱引起的肝内胆汁淤留,肠中缺乏胆汁,血中胆汁成分过多的一种病理状态。胆汁酸信号传递过程以及胆汁淤积过程中炎症的发展和延续这些与胆汁淤积相关的肝损伤方面的分子机制已经取得重大进展。核受体作为肝脏疾病的靶标被广泛讨论,了解核受体在病理生理条件下的调节,是肝脏疾病的潜在治疗方法。本文基于中药治疗和分子免疫机制受体水平方面对胆汁淤积性肝病进行综述。     

铁和铁调素在肝纤维化中的作用

多种慢性肝纤维化疾病均伴有肝脏过多的铁沉积,铁在肝纤维化发病中起重要作用。其机制包括:铁通过催化自由基生成和脂质过氧化反应破坏细胞生物大分子,引起细胞凋亡和坏死,激活肝星状细胞转化为肌成纤维细胞等。近来研究证实,由肝脏产生的铁调素(Hepc)表达的降低在慢性肝纤维化疾病肝脏铁沉积中起重要作用,补充外源性Hepc可以降低肝纤维化患者肝脏铁含量。因此,铁调素用于治疗铁过载疾病及肝纤维化具有重要价值。     

m6A修饰在肝纤维化中的研究进展

N⁶-甲基腺苷(N⁶-methyladenosine,m⁶A)作为真核生物中最丰富的RNA内部修饰,影响RNA的加工,调节mRNA翻译效率,并与多种表观遗传学机制发生交互作用,进而在多种生理过程中调控基因的表达。肝纤维化是细胞外基质(extracellular matrix,ECM)蛋白(主要是Ⅰ型和Ⅲ型胶原蛋白)积累形成的纤维瘢痕取代正常组织的过程,是肝脏对慢性损伤的病理性修复反应。m⁶A修饰直接参与肝细胞损伤、炎症细胞募集和肝星状细胞激活等肝纤维化过程,并通过降低HBV蛋白的表达、与微RNA (microRNA)和肠道菌群相互作用等途径间接影响肝纤维化的发生发展。由于肝脏的再生能力较强,当慢性炎症或肝损伤的主要病因去除后,早期已经发生纤维化的肝脏可逆转为正常肝脏。m⁶A修饰在肝纤维化中的双重作用可为平衡机体纤维化过程提供思路。该文综述了m⁶A修饰在肝纤维化中的功能和作用机制,以期为相关疾病的诊疗提供新的思路。     

SOCS-3在肝纤维化中的作用及中药干预的研究进展

慢性肝病是全世界发病率及死亡率最高的疾病之一。肝纤维化是各种慢性肝病进展为肝硬化的必经阶段。大量研究证实,肝纤维化的病理过程可以逆转,但目前尚未被攻克,因此,寻找有效治疗肝纤维化的方法十分必要。近些年来研究表明,SOCS-3在肝纤维化不同阶段扮演不同角色,其可通过影响细胞增殖、细胞周期、细胞因子及信号转导等干预肝纤维化,可能成为治疗肝纤维化的潜在靶标。同时,很多中药可通过影响SOCS-3来发挥改善肝纤维化的作用。本文就SOCS-3在肝纤维化中的作用及中药干预的研究进行分析综述,为进一步研究治疗肝纤维化的有效方法提供参考。     

肝窦内皮细胞在肝纤维化发生发展中的作用及其机制

肝窦内皮细胞(liver sinusoidal endothelial cells,LSECs)是肝脏抵御炎症和免疫反应的第一道防线,其独特的窗孔结构及功能特性决定它在肝纤维化发生发展中起重要作用。LSECs主要通过介导肝脏炎症反应、肝窦毛细血管化、活化肝星状细胞(hepatic stellate cells,HSC)、引发细胞外基质(extracellular matrix,ECM)的生成与降解失衡等途径参与肝纤维化的发生发展。靶向LSECs对治疗肝纤维化极具潜力,阐述清楚二者调控关系,将为抗肝纤维化治疗提供新的理论依据。     

天然产物通过诱导铁死亡改善肝纤维化的研究进展

肝纤维化是多种慢性肝病发展为肝硬化和肝癌所必须经历的共同病理过程,在其发生、发展过程中受到多种细胞因子以及信号通路的调控。铁死亡是由铁过载、氧化还原稳态紊乱和脂质过氧化增加引起的一种新的细胞死亡调控模式,与肝纤维化密切相关。诱导肝星状细胞发生铁死亡可能是肝纤维化治疗的潜在靶标。许多天然产物可以诱导肝星状细胞发生铁死亡进而抑制肝纤维化的进展,因此越来越受到关注。然而,关于天然产物通过铁死亡途径调节肝纤维化的综述文章却相对较少。该文简述了天然产物通过铁死亡调控影响肝纤维化的干预机制及应用,重点探讨铁死亡与肝纤维化的关系,以及天然产物靶向铁死亡对肝纤维化的调控作用,旨在为天然产物治疗代谢性疾病和肝脏疾病的发展提供新的理论依据,也为将来的药物制取提供更多的备选策略。     

JNK和MMP-2、TIMP-2在大鼠肝脏纤维化模型中的表达及中药肝复康对其的影响

目的:研究JNK和MMP-2、TIMP-2在肝脏纤维化大鼠模型中的表达以及中药复方制剂肝复康对肝脏纤维化的治疗作用及其机制.方法:大鼠肝脏纤维化模型采用CCl4作用12周(0.5 mg/kg,2次/周);治疗组大鼠在CCl4作用同时从第9周开始,给予肝复康(31.25,312.5 and 3125 mg/kg/d,po);设立正常对照组;所有大鼠于20周末处死;HE染色光镜观察肾脏病理改变,并进行组织学评分;RT-PCR检测肝组织JNK和MMP-2、TIMP-2 mRNA水平.对三者的mRNA水平进行相关性分析.结果:HE染色观察到显著肝脏纤维化改变,肝脏纤维化模型复制成功;模型组JNK和MMP-2、TIMP-2基因表达较正常对照组明显增加(P＜0.01);三者的mRNA水平在各组间均呈显著正相关;GFK中剂量治疗组二者表达显著降低.结论:GFK可以通过抑制JNK和MMP-2、TIMP-2的mRNA表达,发挥抗纤维化的作用.     

Hepatobiliary changes, antibody response, and alteration of liver enzymes in hamsters re-infected with Opisthorchis viverrini

We investigated pathological changes, antibody response, and liver enzymes in hamsters re-infected with Opisthorchis viverrini. Group 1 received a single dose of 50 metacercariae; Groups 2 and 3 were first dosed with of 30 metacercariae and re-infected with 20 more once or twice at three month intervals. Inflammation and liver cell necrosis were observed on 3D (day 3) for Group 3 and 7D for Group 2 in comparison with 21D for Group 1. Pathological changes included peri-ductal fibrosis, bile duct dilation, and small bile duct formation. Increased O. viverrini-specific IgG levels ranked in the order Group 3>Group 2>Group 1. Liver enzyme activity was related to inflammatory cell infiltration. Re-infection induced faster inflammation and more severe pathological changes in association with parasite-specific antibody during chronic inflammation. This study emphasizes that there is an important relationship between the gradual decreases of inflammation with a concomitant increase in fibrosis after re-infection.     

Herbogenomics: from traditional Chinese medicine to novel therapeutics

Traditional Chinese medicine (TCM) has a long history of development and application and has demonstrated on evidence basis its efficacy in the treatment of many diseases affecting multiple organ systems. In particular, TCM is effective in the prevention and treatment of chronic diseases and metabolic syndromes. However, the value of TCM has not been fully recognized worldwide due to the lack of definitive information of active ingredients in almost any TCM preparation. Novel functional genomics and proteomics approaches provide alternate perspectives on the mechanism of action of TCM. The target molecules on which TCM either activates or inactivates can be identified by functional genomics and proteomics, thus the affected critical signaling pathway cascades leading to effective recovery of chronic diseases can be studied. Several TCM preparations have been available for the treatment of liver fibrosis and cirrhosis, even advanced liver cirrhosis that has been shown to be irreversible and has no US-FDA approved therapy. In the TCM-treated livers with fibrosis and cirrhosis, some critical molecules that are significantly involved in the recovery can be identified through functional genomics and proteomics studies. These molecules become novel targets for drug discovery and development and candidates for the development of gene therapy. Gene therapy developed based on this strategy for the treatment of advanced liver fibrosis and cirrhosis in animal models has obtained promising results. This process thus establishes a herbogenomics approach to understand mechanisms of action of TCM and to identify effective molecular targets for the discovery and development of novel therapeutics.     

The collagenolytic effects of the traditional Chinese medicine preparation,Han-Dan-Gan-Le,contribute to reversal of chemical-induced liver fibrosis in rats

Han-Dan-Gan-Le (HDGL), a Chinese herb preparation composed of Stephaniat tetrandra, Salvia miltorrhiza, Radix paeoniae, Astragalus membranaceus, and Ginkgo biloba, has been used to treat human liver fibrosis. This study was designed to examine the therapeutic effect of HDGL on chemical-induced liver fibrosis in adult Wistar rats. Liver fibrosis was produced in rats by carbon tetrachloride (1.2 ml CCl(4)/kg, 2 times/week, after an initial dose of 5.0 ml CCl(4)/kg, sc), plus a diet of 20% fat, 0.05% cholesterol (continuous) and 30% alcohol in the drinking water ad libitum (every other day) for 8 weeks. HDGL (0.5 and 1.0 g/kg, ig, daily for 6 weeks) was administered to rats 72 hrs after the last dose of CCl(4) to examine its therapeutic effects on chemical-induced liver fibrosis. Upon pathological examination, the HDGL treatment had significantly reversed chemical-induced liver fibrosis and other hepatic lesions. Hepatic collagen accumulation induced by CCl(4) was markedly reduced by HDGL treatment, as evidenced by hepatic collagen content and by immunohistochemical analysis of type-I collagen in liver. HDGL appeared to stimulate the collagenolytic process in the liver, as a 30-50% increase in urinary excretion of hydroxyproline was observed with HDGL treatment as compared to rats only given CCl(4). In conclusion, HDGL can effectively reverse chemically induced liver fibrosis, and this appears to be due, at least in part, to the stimulation of hepatic collagenolysis, resulting in a resolution of hepatic fibrosis.     

Effects of FGF21‐secreting adipose‐derived stem cells in thioacetamide‐induced hepatic fibrosis

Mesenchymal stem cells (MSCs) have been investigated to treat liver diseases, but the efficiency of MSCs to treat chronic liver diseases is conflicting. FGF21 can reduce inflammation and fibrosis. We established FGF21‐secreting adipose derived stem cells (FGF21_ADSCs) to enhance the effects of ADSCs and transplanted them into thioacetamide (TAA)‐induced liver fibrosis mice via the tail vein. Transplantation of FGF21_ADSCs significantly improved liver fibrosis by decreasing serum hyaluronic acid and reducing the expression of fibrosis‐related factors such as α‐smooth muscle actin (α‐SMA), collagen and tissue inhibitor of metalloproteinase‐1 (TIMP‐1) compared with the Empty_ADSCs by inhibition of p‐JNK, NF‐κB and p‐Smad2/3 signalling. α‐lactoalbumin (LA) and lactotransferrin (LTF), secretory factors produced from FGF21_ADSCs inhibited TGF‐β1‐induced expression of α‐SMA and collagen in LX‐2 cells. These results suggest that transplantation of FGF21_ADSCs inhibited liver fibrosis more effectively than Empty_ADSCs, possibly via secretion of α‐LA and LTF.     

The S100 calcium binding protein A11 promotes liver fibrogenesis by targeting TGF-β signaling

Liver fibrosis is a key transformation stage and also a reversible pathological process in various types of chronic liver diseases. However, the pathogenesis of liver fibrosis still remains elusive. Here, we report that the calcium binding protein A11 (S100A11) is consistently upregulated in the integrated data from GSE liver fibrosis and tree shrew liver proteomics. S100A11 is also experimentally activated in liver fibrosis in mouse, rat, tree shrew, and human with liver fibrosis. While overexpression of S100A11 in vivo and in vitro exacerbates liver fibrosis, the inhibition of S100A11 improves liver fibrosis. Mechanistically, S100A11 activates hepatic stellate cells (HSCs) and the fibrogenesis process via the regulation of the deacetylation of Smad3 in the TGF-β signaling pathway. S100A11 physically interacts with SIRT6, a deacetylase of Smad2/3, which may competitively inhibit the interaction between SIRT6 and Smad2/3. The subsequent release and activation of Smad2/3 promote the activation of HSCs and fibrogenesis. Additionally, a significant elevation of S100A11 in serum is observed in clinical patients. Our study uncovers S100A11 as a novel profibrogenic factor in liver fibrosis, which may represent both a potential biomarker and a promising therapy target for treating liver fibrosis and fibrosis-related liver diseases.     

Addressing Liver Fibrosis with Liposomes Targeted to Hepatic Stellate Cells

Liver fibrosis is a chronic disease that results from hepatitis B and C infections, alcohol abuse or metabolic and genetic disorders. Ultimately, progression of fibrosis leads to cirrhosis, a stage of the disease characterized by failure of the normal liver functions. Currently, the treatment of liver fibrosis is mainly based on the removal of the underlying cause of the disease and liver transplantation, which is the only treatment for patients with advanced fibrosis. Hepatic stellate cells (HSC) are considered to be key players in the development of liver fibrosis. Chronically activated HSC produces large amounts of extracellular matrix and enhance fibrosis by secreting a broad spectrum of cytokines that exert pro-fibrotic actions in other cells, and in an autocrine manner perpetuate their own activation. Therefore, therapeutic interventions that inhibit activation of HSC and its pro-fibrotic activities are currently under investigation worldwide. In the present study we applied targeted liposomes as drug carriers to HSC in the fibrotic liver and explored the potential of these liposomes in antifibrotic therapies. Moreover, we investigated effects of bioactive compounds delivered by these liposomes on the progression of liver fibrosis. To our knowledge, this is the first study demonstrating that lipid-based drug carriers can be selectively delivered to HSC in the fibrotic liver. By incorporating the bioactive lipid DLPC, these liposomes can modulate different processes such as inflammation and fibrogenesis in the fibrotic liver. This dual functionality of liposomes as a drug carrier system with intrinsic biological effects may be exploited in new approaches to treat liver fibrosis.     

Addressing liver fibrosis with liposomes targeted to hepatic stellate cells

Liver fibrosis is a chronic disease that results from hepatitis B and C infections, alcohol abuse or metabolic and genetic disorders. Ultimately, progression of fibrosis leads to cirrhosis, a stage of the disease characterized by failure of the normal liver functions. Currently, the treatment of liver fibrosis is mainly based on the removal of the underlying cause of the disease and liver transplantation, which is the only treatment for patients with advanced fibrosis. Hepatic stellate cells (HSC) are considered to be key players in the development of liver fibrosis. Chronically activated HSC produces large amounts of extracellular matrix and enhance fibrosis by secreting a broad spectrum of cytokines that exert pro-fibrotic actions in other cells, and in an autocrine manner perpetuate their own activation. Therefore, therapeutic interventions that inhibit activation of HSC and its pro-fibrotic activities are currently under investigation worldwide. In the present study we applied targeted liposomes as drug carriers to HSC in the fibrotic liver and explored the potential of these liposomes in antifibrotic therapies. Moreover, we investigated effects of bioactive compounds delivered by these liposomes on the progression of liver fibrosis. To our knowledge, this is the first study demonstrating that lipid-based drug carriers can be selectively delivered to HSC in the fibrotic liver. By incorporating the bioactive lipid DLPC, these liposomes can modulate different processes such as inflammation and fibrogenesis in the fibrotic liver. This dual functionality of liposomes as a drug carrier system with intrinsic biological effects may be exploited in new approaches to treat liver fibrosis.     

Early urinary candidate biomarker discovery in a rat thioacetamide-induced liver fibrosis model

Biomarker is the change associated with the disease. Blood is relatively stable because of the homeostatic mechanisms of the body. However, urine accumulates changes of the body, which makes it a better early biomarker source. Liver fibrosis is a reversible pathological condition, whereas cirrhosis, the end-stage of liver fibrosis, is irreversible. Consequently, noninvasive early biomarkers for fibrosis are desperately needed. In this study, differential urinary proteins were identified in the thioacetamide liver fibrosis rat model using tandem mass tagging and two-dimensional liquid chromatography tandem mass spectrometry. A total of 766 urinary proteins were identified, 143 and 118 of which were significantly changed in the TAA 1-week and 3-week groups, respectively. Multiple reaction monitoring (MRM)-targeted proteomics was used to further validate the abundant differentially expressed proteins. A total of 40 urinary proteins were statistically significant, 15 of which had been previously reported as biomarkers of liver fibrosis, cirrhosis or other related diseases and 10 of which had been reported to be associated with the pathology and mechanism of liver fibrosis. These differential proteins were detected in urine before the alanine aminotransferase and aspartate transaminase changes in the serum and before fibrosis was observed upon hematoxylin and eosin (HE) and Masson’s staining.     

Advances on liver cell-derived exosomes in liver diseases

Exosomes are extracellular vesicles with diameters ranging from 30 to 150 nm, which contain several donor cell-associated proteins as well as mRNA, miRNA, and lipids and coordinate multiple physiological and pathological functions through horizontal communication between cells. Almost all types of liver cells, such as hepatocytes and Kupffer cells, are exosome-releasing and/or exosome-targeted cells. Exosomes secreted by liver cells play an important role in regulating general physiological functions and also participate in the onset and development of liver diseases, including liver cancer, liver injury, liver fibrosis and viral hepatitis. Liver cell-derived exosomes carry liver cell-specific proteins and miRNAs, which can be used as diagnostic biomarkers and treatment targets of liver disease. This review discusses the functions of exosomes derived from different liver cells and provides novel insights based on the latest developments regarding the roles of exosomes in the diagnosis and treatment of liver diseases.