TGF-β1和FBRS可指示肝纤维化发展程度

为了探讨转化生长因子(TGF-β1)、外周血纤维化蛋白(FBRS)表达水平变化与肝纤维化发生发展的相关性,本研究选取自2015年5月至2017年6月间在我院诊治的慢性病毒性肝炎患者120例,设为肝炎组。采用免疫组化法检测肝组织TGF-β1的表达水平,酶联免疫分析检测血清中TGF-β1的含量,RT-PCR检测外周血单个核细胞FBRS mRNA的表达水平,分析TGF-β1、FBRS与肝纤维化程度的相关性。研究结果表明:随肝纤维化程度的不同,肝组织TGF-β1、血清TGF-β1表达水平、FBRS mRNA表达水平与肝脏胶原含量同步性升高(p<0.05)。进一步的相关分析表明:肝组织TGF-β1水平、FBRS mRNA与肝纤4项检查,即血清Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原片段(Ⅳ-C)、层粘连蛋白(LN)和透明质酸(HA)水平之间均呈正相关。本研究结果初步得出结论,慢性病毒性肝炎肝组织TGF-β1、血清TGF-β1表达水平、外周血FBRS的表达水平与肝组织纤维化程度呈正相关。     

大鼠肝纤维化组织中TGF-β1的研究

目的 观察转化生长因子-β1(transforming growth factor-β1,TGF-β1)在大鼠肝纤维化组织中的动态表达,探讨TGF-β1在肝纤维化中的意义.方法 采用腹腔内注射二甲基亚硝胺(DMN)构建大鼠肝纤维化模型,造模后4天、1周、2周、4周、6周、8周分别检测血清ALT、AST、ALB的变化,同时取肝组织用半定量RT-PCR方法检测TGF-β1 mRNA的表达.采用HE染色及Masson三色染色,光学显微镜下观察肝组织损伤情况.采用单因素方差分析进行多组均数间的比较.结果 肝纤维化模型组血清ALT、AST明显升高,ALB明显下降.TGF-β1 mRNA在对照组大鼠和肝纤维化模型组大鼠肝组织中均有表达.与对照组相比,肝纤维化模型组4天～1周时,TGF-β1 mRNA表达差异无统计学意义(P均＞0.05).2～4周较对照组显著升高(P均＜0.05),4周时达高峰.6～8周较4周时显著下降(P均＜0.05),但仍显著高于对照组(P均＜0.05).8周较6周时下降,差异无统计学意义(P＞0.05).TGF-β1 mRNA表达与肝纤维化病程呈正相关(P＜0.01).结论 TGF-β1 mRNA在正常SD大鼠肝脏中有表达,在肝纤维化大鼠肝组织中表达增加,与大鼠肝脏病理分期正相关.     

异甘草酸镁对纤维化大鼠肝脏TGF-β1及Smad蛋白表达的影响

目的:观察异甘草酸镁对四氯化碳诱导的肝纤维化大鼠肝脏组织TGF-β1及Smad蛋白表达的影响,以期揭示其抗纤维化的机制。方法:利用腹腔注射四氯化碳(CCl4)建立大鼠肝纤维化模型,然后应用不同剂量的异甘草酸镁和INF-γ处理,于实验第16周末检测大鼠血清透明质酸(HA)、层粘连蛋白(LN)、III型前胶原(PC-III)、IV型胶原(C-IV)的水平,采用RT-PCR法检测TGF-β1,Smad3,Smad7mRNA的表达。结果:与模型组比较,异甘草酸镁各剂量组血清HA,LN,PC-III,C-IV水平显著下降(P<0.05),肝脏TGF-β1、smad3的表达明显降低(P<0.05),smad7则有所上升。结论:异甘草酸镁可以改善肝纤维化大鼠肝组织纤维化程度,其作用机理与抑制TGF-β1、Smad3mRNA的表达,上调Smad7mRNA的表达有密切关系。     

益气法制剂对CCL4所致肝纤维化大鼠TGF-β1/Smad信号通路的影响北大核心CSCD

探讨益气法制剂(黄芪、白术)对CCL4所致肝纤维化大鼠的治疗作用及作用机制。采用腹腔注射40%四氯化碳(CCL4)玉米油溶液联合高脂低蛋白饮食建立肝纤维化模型大鼠。成模后分别给予相应药物灌胃治疗12周。HE、Masson染色法观察肝组织形态学变化,生化分析法检测血清肝功能,酶联免疫吸附法(ELISA)检测血清胶原蛋白含量。RT-q PCR检测肝组织内TGF-β1、TβRⅠ、Smad3、Samd7、α-SMA、HGF mRNA表达。给药治疗后,益气法制剂和秋水仙碱均可减轻大鼠胶原沉积,并可改善大鼠肝功能,其机制与抑制TGF-β1/Smad信号通路有关。     

益气法制剂对CCL4所致肝纤维化大鼠TGF-β1/Smad信号通路的影响

探讨益气法制剂(黄芪、白术)对CCL4所致肝纤维化大鼠的治疗作用及作用机制。采用腹腔注射40%四氯化碳(CCL4)玉米油溶液联合高脂低蛋白饮食建立肝纤维化模型大鼠。成模后分别给予相应药物灌胃治疗12周。HE、Masson染色法观察肝组织形态学变化,生化分析法检测血清肝功能,酶联免疫吸附法(ELISA)检测血清胶原蛋白含量。RT-q PCR检测肝组织内TGF-β1、TβRⅠ、Smad3、Samd7、α-SMA、HGF mRNA表达。给药治疗后,益气法制剂和秋水仙碱均可减轻大鼠胶原沉积,并可改善大鼠肝功能,其机制与抑制TGF-β1/Smad信号通路有关。     

重组截短型TGF-βⅡ型受体蛋白对肝纤维化大鼠的治疗作用研究

目的:研究截短型TGF-βⅡ型受体蛋白对肝纤维化大鼠的治疗作用。方法:取含有重组截短型TGF-βⅡ型受体载体的大肠杆菌BL21,通过培养繁殖,诱导,纯化得到重组截短型TGF-βⅡ型受体蛋白。使用CCl4诱导的方法来制备肝纤维化大鼠模型,观察截短型TGF-βⅡ型受体蛋白对大鼠肝纤维化的影响。SDS-PAGE检测纯化的截短型TGF-βⅡ型受体蛋白。生化检测血清谷丙转氨酶(glutamic pyruvic transaminase,ALT)及谷草转氨酶(glutamic oxalacetic transaminase,AST)含量。用实时荧光定量PCR(real-time PCR)方法和免疫荧光方法来检测各组大鼠肝组织中的α平滑肌肌动蛋白(alpha-smooth muscle actin,α-SMA),1型胶原(collagen1,Col1)和4型胶原(collagen4,Col4)的表达情况。用HE,MASSON,PAS这三种病理学染色的方法来观察各组大鼠肝纤维化的变化。结果:SDS-PAGE检测结果显示,纯化后获得高纯度截断型TGF-βⅡ型受体蛋白。截短型TGF-βⅡ型受体蛋白治疗组可以减少血清中谷丙转氨酶和谷草转氨酶的含量。截短型TGF-βⅡ型受体蛋白治疗组可以降低肝组织中α-SMA、FN、Col1和Col4的mRNA和蛋白质的表达。三种病理学染色的方法显示,与肝纤维化大鼠模型组相比,治疗组的纤维化程度明显减轻。结论:重组截短型TGF-βⅡ型受体蛋白对大鼠肝纤维化的程度有抑制作用,为治疗肝纤维化及其他纤维化疾病提供了一个潜在的治疗手段。     

肝组织中NF-κB、TGF-β1及其Ⅰ型受体mRNA和HSC在肝纤维化中的改变及护肝片对其的影响

目的探讨中、晚期纤维化大鼠肝组织中肝星状细胞(HSC)的活化与增殖、核转录因子-κB(NF-κB)及转化生长因子-β1(TGF-β1)及其Ⅰ型受体(TβRⅠ)表达的改变及护肝片对其的影响。方法采用12.5%CCl4诱导的大鼠肝纤维化模型,自造模之日起,大鼠分组灌胃给药(护肝片921mg/kg)或溶媒,每日一次,直至8或13周末,分别处死动物,取左叶肝组织石蜡包埋,制作组织芯片。免疫组化S-P法检测大鼠肝组织α-平滑肌肌动蛋白(-αSMA)和NF-κB p65蛋白的表达,原位杂交检测TGF-β1及TβRⅠmRNA的表达;并用MetaMorph图像分析系统计数-αSMA阳性细胞数,对NF-κB p65蛋白、TGF-β1及TβRⅠmRNA的表达量进行定量分析。结果 1.模型复制8周和13周,模型组的肝损伤及其纤维化分级均明显高于正常组(P<0.01),护肝片组的肝损伤及其纤维化分级均轻于模型组。2.模型复制8周和13周,模型组活化的HSC(即-αSMA阳性细胞)数量较正常组明显增多,NF-κB p65蛋白、TGF-β1及TβRⅠmRNA的表达均较正常组明显增强(P<0.01);3.护肝片显著抑制8、13周纤维化肝组织HSC的活化与增殖和NF-κB p65蛋白、TGF-β1及TβRⅠmRNA的表达(P<0.01)。结论抑制HSC的活化与增殖和NF-κB p65蛋白与TGF-β1及TβRⅠmRNA的表达可能是护肝片抗肝纤维化作用的靶点之一。     

复合致病因素诱导肝硬化大鼠TGF-α和TGF-β1的动态变化

目的:观察复合致病因素诱导肝硬化大鼠肝组织中转化生长因子-α(TGF-α)和转化生长因子-β1(TGF-β1)的动态变化。方法:采用复合致病因素法复制大鼠肝硬化模型:首次皮下注射CCl4原液(0.5 ml/100 g·w),之后每隔3天皮下注射40%CCl4油溶液(0.3 ml/100 g·w),同时辅以低胆碱、高胆固醇、高脂肪、高醇饮食。随机将大鼠分为肝硬化模型4周、6周和8周组,并分别设立同期正常对照组。检测各组大鼠血浆中谷丙转氨酶(ALT)、内毒素、肿瘤坏死因子-α(TNF-α)和同型半胱氨酸(Hcy)的水平;肝组织切片行HE染色,TGF-α和TGF-β1的免疫组化染色。结果:与相应的同期正常对照组比较,大鼠血浆中ALT、内毒素、TNF-α和Hcy水平在肝硬化模型4周、6周和8周组均逐渐显著升高(P0.05);肝组织中TGF-α的表达在肝硬化模型4周组明显增加(P0.05),而肝组织中TGF-β1的表达则随着肝硬化病程的进展持续显著增加(P0.05)。结论:在肝硬化形成过程中,TGF-α的表达先增加后被抑制,TGF-β1的表达持续增加,导致肝细胞再生先增强后被抑制,而肝纤维化程度不断加重,最终发生肝硬化。TGF-α和TGF-β1的这一特征性动态变化可能与内毒素血症、TNF-α水平增高以及高同型半胱氨酸血症有关。     

田基黄提取物抗CCl_4诱导大鼠肝纤维化的作用及其机制研究

探讨田基黄提取物(HJT)抗四氯化碳(CCl_4)诱导的大鼠肝纤维化(HF)的作用及其机制。将60只雄性SD大鼠随机分为正常组、模型组、秋水仙碱(0. 12 mg/kg)组和HJT(16 000、8 000、4 000 mg/kg)剂量组,每组10只。除正常组外,其余各组大鼠均腹腔注射40%的CCl_4橄榄油溶液(1 mL/kg),2次/周,建立HF模型;同时各给药组灌胃相应剂量药物,正常组和模型组给予等体积蒸馏水,连续6周。末次给药后,采用HE染色和Masson染色观察大鼠肝组织病理学改变;生化法检测血清中ALT、AST活性;生化法检测肝组织中SOD、GSH-PX活性和MDA含量;ELISA法检测血清中HA、LN、PCⅢ、Ⅳ-C含量;ELISA法检测肝组织IL-1β、IL-6和TNF-α的含量;Western blot法检测大鼠肝组织中TGF-β1和α-SMA表达水平。结果显示,HJT(16 000、8 000、4 000 mg/kg)剂量组和秋水仙碱组能显著降低HF大鼠血清中ALT、AST、HA、LN、PC-Ⅲ、Ⅳ-C活性或含量,降低肝组织MDA含量,增加SOD和GSH-PX活性,同时减少肝组织IL-1β、IL-6及TNF-α含量,抑制肝组织TGF-β1和α-SMA蛋白表达;病理组织切片结果显示:HJT各剂量组和秋水仙碱组大鼠肝组织炎症坏死和HF病变程度明显减轻。本研究结果表明,HJT对CCl_4诱导的HF大鼠有显著保护作用,其机制可能与抗炎、抗氧化和抑制TGF-β1蛋白表达有关。     

育阴软肝颗粒剂对肝纤维化大鼠TGF-β1表达的影响

目的：观测育阴软肝颗粒剂对大鼠肝纤维化模型的防治作用及对转化生长因子-β1（TGF-β1）表达的影响。方法：将Wistar大鼠分为6组（n=10）,注射四氯化碳、饲以高脂饲料并饮用20%乙醇6周复制肝纤维化大鼠模型,经6.2~24.8 g/kg育阴软肝颗粒剂干预（qd）6周后,测定肝纤维化大鼠血清丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）活性、透明质酸（HA）、Ⅲ型前胶原（PCⅢ）、Ⅳ型胶原（C-Ⅳ）及板层素（LN）含量,观测肝组织病理学及肝组织TGF-β1表达的变化,对育阴软肝颗粒剂防治肝纤维作用及机制进行研究。结果：实验第7周,模型组大鼠肝组织出现明显的纤维化病变（P<0.01）;与模型组比较,6.2~24.8g/kg的育阴软肝颗粒剂能明显降低肝指数以及血清ALT、AST活性与HA、PCⅢ、C-Ⅳ、LN含量,缓解肝组织纤维化病理变化,抑制纤维化肝组织TGF-β1的表达（P<0.05,0.01）。结论：育阴软肝颗粒剂对多因素复制肝纤维化大鼠造模具有明显的治疗作用,而抑制TGF-β1的表达可能是其作用机制之一。     

奥美沙坦减轻高脂饮食诱导的非酒精性脂肪肝病的机制研究

目的探讨奥美沙坦对于高脂诱导的非酒精性脂肪肝病（NAFLD）的影响及可能机制。方法健康雄性8周龄C57BL／6小鼠24只随机分为高脂组（n=16）和正常饮食组（n=8）,高脂组小鼠高脂饮食（60％的脂肪）12w后再随机分为高脂饮食对照组（n=8）、高脂饮食治疗组（n=8）。高脂饮食治疗组小鼠给予0．75mg／kg／d的奥美沙坦灌胃8w,灌胃结束后处理小鼠,留取空腹血样本检测AST和ALT。肝组织冰冻切片行油红O染色观察脂肪变;石蜡切片行HE和F4／80免疫组化染色观察肝脏炎症变化;实时荧光定量PCR检测肝脏TNF-α和IL-6mRNA的表达水平;WesternBlot检测肝组织中IκB-α、p-IκBa、NF—κB信号通路的活化。结果奥美沙坦显著抑制了高脂诱导的NAFLD脂肪变性,并明显改善肝功能。实时荧光定量PCR结果表明奥美沙坦能显著降低肝脏组织中TNF-α和IL-6mRNA表达水平（P〈0．05）;Western Blot结果显示奥美沙坦显著抑制肝脏NF-κB信号通路活化。结论奥美沙坦显著抑制NAFLD小鼠肝脏炎性病变而保护肝功能,其机制与抑制NF-κB信号通路活化以及降低肝脏TNF-α和IL-6mRNA水平有关。     

Ascorbic acid supplementation down-regulates the alcohol induced oxidative stress, hepatic stellate cell activation, cytotoxicity and mRNA levels of selected fibrotic genes in guinea pigs

Both oxidative stress and endotoxins mediated immunological reactions play a major role in the progression of alcoholic hepatic fibrosis. Ascorbic acid has been reported to reduce alcohol-induced toxicity and ascorbic acid levels are reduced in alcoholics. Hence, we investigated the hepatoprotective action of ascorbic acid in the reversal of alcohol-induced hepatic fibrosis in male guinea pigs (n = 36), and it was compared with the animals abstenting from alcohol treatment. In comparison with the alcohol abstention group, there was a reduction in the activities of toxicity markers and levels of lipid and protein peroxidation products, expression of α-SMA, caspase-3 activity and mRNA levels of CYP2E1, TGF-β(1), TNF-α and α(1)(I) collagen in liver of the ascorbic acid-supplemented group. The ascorbic acid content in liver was significantly reduced in the alcohol-treated guinea pigs. But it was reversed to normal level in the ascorbic acid-supplemented group. The anti-fibrotic action of ascorbic acid in the rapid regression of alcoholic liver fibrosis may be attributed to decrease in the oxidative stress, hepatic stellate cells activation, cytotoxicity and mRNA expression of fibrotic genes CYP2E1, TGF-β(1), TNF-α and α(1) (I) collagen in hepatic tissues.     

Ascorbic acid supplementation down-regulates the alcohol induced oxidative stress,hepatic stellate cell activation,cytotoxicity and mRNA levels of selected fibrotic genes in guinea pigs

Both oxidative stress and endotoxins mediated immunological reactions play a major role in the progression of alcoholic hepatic fibrosis. Ascorbic acid has been reported to reduce alcohol-induced toxicity and ascorbic acid levels are reduced in alcoholics. Hence, we investigated the hepatoprotective action of ascorbic acid in the reversal of alcohol-induced hepatic fibrosis in male guinea pigs (n = 36), and it was compared with the animals abstenting from alcohol treatment. In comparison with the alcohol abstention group, there was a reduction in the activities of toxicity markers and levels of lipid and protein peroxidation products, expression of α-SMA, caspase-3 activity and mRNA levels of CYP2E1, TGF-β₁, TNF-α and α₁(I) collagen in liver of the ascorbic acid-supplemented group. The ascorbic acid content in liver was significantly reduced in the alcohol-treated guinea pigs. But it was reversed to normal level in the ascorbic acid-supplemented group. The anti-fibrotic action of ascorbic acid in the rapid regression of alcoholic liver fibrosis may be attributed to decrease in the oxidative stress, hepatic stellate cells activation, cytotoxicity and mRNA expression of fibrotic genes CYP2E1, TGF-β₁, TNF-α and α₁ (I) collagen in hepatic tissues.     

Relationship between anti-fibrotic effect of Panax notoginseng saponins and serum cytokines in rat hepatic fibrosis

The aim of this study was to investigate the relationship between anti-fibrotic effect of Panax notoginseng saponins (PNS) and serum cytokines in rat hepatic fibrosis. Hepatic fibrosis induced by carbon tetrachloride (CCl₄) was studied in animal models using SD rats. Liver index, serum alanine amino transferase (ALT), aspartate amino transferase (AST), transforming growth factor-β1 (TGF-β1), tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured, respectively. Liver index and the degree of liver fibrosis were also determined. Our results showed that the levels of ALT, AST and liver index in PNS-treated group were markedly lower than those in model group. PNS therapy also significantly attenuated the degree of hepatic fibrosis, collagen area and collagen area percent in liver tissue. Furthermore, the levels of serum TGF-β1, TNF-α and IL-6 were strikingly reduced in PNS-treated group compared with model group while the production of IL-10 was up-regulated. These findings demonstrate that PNS has certain therapeutic effects on hepatic fibrosis probably by immunoregulating the imbalance between pro-fibrotic and anti-fibrotic cytokines.     

脾切除对肝纤维化大鼠肝脏TGFβ 1的表达和血清TGFβ 1水平的影响

目的：研究脾切除对肝纤维化大鼠肝脏TGFβ1的表达和血清TGFβ1水平的影响,探讨脾切除在肝纤维化中的意义。方法：用CCL4建立50例肝纤维化大鼠模型。于建模第3周,6周,及8周分别取大鼠肝脏和脾脏标本。用免疫组化SP方法测定其TGFβ1的表达,HE和姬姆萨染色检测肝纤维化。应用双抗体夹心ELISA方法测定15例模型大鼠行脾脏切除前后的血清TGFβ1水平,以及15例对照组大鼠的血清TGFβ1水平,并于术后4周取两组大鼠的肝脏标本,用免疫组化SP方法测定其TGFβ1的表达。应用CMIAS8彩色图像系统对阳性目标进行分析和处理。结果：随着肝纤维化程度的进展,大鼠肝脏和脾脏TGFβ1的表达也随之增加（P〈0.01）。脾切除组大鼠其血清TGF-β1的水平显著低于对照组大鼠（P〈0.05）,且脾切除组大鼠肝脏TGFβ1的表达低于对照组大鼠（P〈0.05）。结论：脾切除术在一定程度上可延缓肝纤维化的发展。     

异甘草酸镁对纤维化大鼠肝脏TGF-β 1及Smad蛋白表达的影响

目的：观察异甘草酸镁对四氯化碳诱导的肝纤维化大鼠肝脏组织TGF-β1及Smad蛋白表达的影响,以期揭示其抗纤维化的机制。方法：利用腹腔注射四氯化碳（CCl4）建立大鼠肝纤维化模型,然后应用不同剂量的异甘草酸镁和INF-γ处理,于实验第16周末检测大鼠血清透明质酸（HA）、层粘连蛋白（LN）、III型前胶原（PC-III）、IV型胶原（C-IV）的水平,采用RT-PCR法检测TGF-β1,Smad3,Smad7mRNA的表达。结果：与模型组比较,异甘草酸镁各剂量组血清HA,LN,PC-III,C-IV水平显著下降（P〈0.05）,肝脏TGF-β1、smad3的表达明显降低（P〈0.05）,smad7则有所上升。结论：异甘草酸镁可以改善肝纤维化大鼠肝组织纤维化程度,其作用机理与抑制TGF-β1、Smad3mRNA的表达,上调Smad7mRNA的表达有密切关系。     

Antifibrotic effect of methylated quercetin derivatives on TGFβ-induced hepatic stellate cells

Quercetin (QCT) and isorhamnetin (ISO), natural flavonoids, were both shown to possess antifibrotic activity in in vivo and in vitro models of hepatic fibrosis. Although ISO is a direct metabolite of QCT differing by a methyl group, it has been reported to be absorbed more adequately and eliminated slower than QCT after oral administration. Our aim of the study was to investigate biological effect of mono-methylated QCT derivatives against fibrosis using rat hepatic stellate cells (HSC-T6). All test derivatives were synthesized from QCT. HSC-T6 cells were induced by TGFβ and treated with derivatives followed by cell proliferation assay, immunofluorescence staining of αSMA, and gene expression analysis of fibrosis markers. All compounds showed a dose- and time-dependent antiproliferation effect. ISO, 3-O-methylquercetin (3MQ), and rhamnetin (RHA) reduced αSMA mRNA; 3MQ prevented the augmentation of collagen I mRNA; and compounds, except azaleatin and 3MQ, reduced Timp1 mRNA expression in TGFβ-induced HSCs. In conclusion, each compound had singular effect against different features of fibrosis depending on the position of methyl group although the further mechanism of action of compounds during fibrosis development remains to be investigated. These findings suggest that antifibrotic effect of quercetin can be enhanced by adding methyl group on functionally important position.     

FBXO31 modulates activation of hepatic stellate cells and liver fibrogenesis by promoting ubiquitination of Smad7

Liver fibrosis is a critical pathological process in the early stage of many liver diseases, including hepatic cirrhosis and liver cancer. However, the molecular mechanism is not fully revealed. In this study, we investigated the role of F-box protein 31 (FBXO31) in liver fibrosis. We found FBXO31 upregulated in carbon tetrachloride (CCl₄) induced liver fibrosis and in activated hepatic stellate cells, induced by transforming growth factor-β (TGF-β). The enforced expression of FBXO31 caused enhanced proliferation and increased expression of α-smooth muscle actin (α-SMA) and Col-1 in HSC-T6 cells. Conversely, suppression of FBXO31 resulted in inhibition of proliferation and decreased accumulation of α-SMA and Col-1 in HSC-T6 cells. In addition, upregulation of FBXO31 in HSC-T6 cells decreased accumulation of Smad7, the negative regulator of the TGF-β/smad signaling pathway, and suppression of the FBXO31 increased accumulation of Smad7. Immunofluorescence staining showed FBXO31 colocalized with Smad7 in HSC-T6 cells and in liver tissues of BALB/c mice treated with CCl₄. Immunoprecipitation demonstrated FBXO31 interacted with Smad7. Moreover, FBXO31 enhanced ubiquitination of Smad7. In conclusion, FBXO31 modulates activation of HSCs and liver fibrogenesis by promoting ubiquitination of Smad7.