外源性H2S对糖尿病小鼠肝纤维化的作用及其机制*

目的: 探讨外源性硫化氢(H₂S)对糖尿病小鼠肝纤维化作用及其相关机制。方法: 将 C57 雄性体重为(22±2)g 24只小鼠随机分为3组(n=8):①正常对照组(Control):小鼠腹腔注射生理盐水,注射时间同实验组;②糖尿病模型组(HG):按体重(150 mg/kg)一次性腹腔注射链脲佐菌素(STZ)诱导小鼠建立糖尿病模型;③NaHS 处理组(HG + NaHS):方法同组别②,只是糖尿病模型建立后,腹腔注射NaHS(100 μmol/L·kg·d),每天一次,连续12周。HE染色检测肝细胞损伤;Masson染色检测肝纤维化;Western blot检测相关蛋白胱硫醚-β-合成酶(CBS,内源性H₂S产生的关键酶)、胶原I (Col-I)、胶原III (Col-III)和基质金属蛋白酶-9(MMP-9)的表达。结果: 与对照组比较,糖尿病模型组肝细胞损伤及肝纤维化均显著加重,CBS 蛋白表达显著减少(P＜0.01),Col-I、Col-III和MMP-9蛋白表达均显著增加(P＜0.01)。与糖尿病模型组比较,NaHS处理组肝细胞损伤及肝纤维化均显著减轻、CBS 蛋白表达显著增加、Col-I、Col-III和MMP-9蛋白表达均减少(P＜0.01)。结论: 外源性H₂S可抑制糖尿病小鼠肝纤维化,其机制与降低胶原含量和基质金属蛋白酶-9的表达相关。     

外泌体在肝纤维化中的作用

外泌体(exosomes)是一种能被大多数细胞分泌的微小膜泡,是具有脂质双层膜结构的细胞外囊泡。现认为外泌体是细胞外囊泡(extracellular vesicles, EVs)的一种亚群。研究表明,外泌体是细胞间信息传递的一种载体。肝脏既可以分泌外泌体,同时也是其他组织细胞产生的外泌体的作用靶点,且肝内与肝外来源的外泌体与肝纤维化的形成、发生、发展均有密切联系。本文主要就外泌体在肝纤维化相关疾病中的作用及外泌体与肝纤维化指标之间的关系进行综述。     

蚓激酶在慢性乙型肝炎治疗中的潜在作用

纤连蛋白(FN)是参与乙型肝炎病毒感染和肝脏纤维化的重要分子。 蚓激酶(LK)是从赤子爱胜蚓(Eisenia foetide)中提取的一组蛋白水解同工酶,能水解纤维蛋白治疗凝血相关疾病。 从这组同工酶中分离纯化出单一活性成分,在体外可降解纤连蛋白,被命名为蚯蚓纤连蛋白水解酶(EFNase)。 然而,LK 能否预防乙型肝炎病毒感染以及缓解因乙型肝炎导致的肝脏损伤等问题还不清楚。本研究以人肝癌细胞系HepG2.2.15为细胞模型,观察LK 对乙型肝炎表面抗原(HBsAg)或 FN 水平的影响;以 C57BL / 6J-HBV 转基因小鼠为动物模型,探讨 LK 对小鼠血清中 HBsAg、FN、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)水平及肝脏病理改变的影响。结果表明,LK 在体内外均能抑制HBsAg 的生成,降低血清和肝脏FN。与生理盐水处理组相比,LK 改善了肝脏的状态。这些数据为理解LK 作为治疗乙型肝炎的潜在有效药物的治疗作用提供了有价值的信息。     

Pathophysiological relationship between hypoxia associated oxidative stress,Epithelial-mesenchymal transition,stemness acquisition and alteration of Shh/ Gli-1 axis during oral sub-mucous fibrosis and oral squamous cell carcinoma

Oral sub-mucous fibrosis (OSF) is a pathophysiological state of oral cavity or oropharynx having a high chance of conversion to oral squamous cell carcinoma (OSCC). It involves fibrotic transformation of sub-epithelial matrix along with epithelial abnormalities. The present work aims to unveil the mechanistic domain regarding OSF to OSCC conversion exploring the scenario of hypoxia associated oxidative stress, epithelial-mesenchymal transition (EMT), metastasis and stemness acquisition. The study involves histopathological analysis of the diseased condition along with the exploration of oxidative stress status, assessment of mitochondrial condition, immunohistochemical analysis of HIF-1α, E-cadherin, vimentin, ERK, ALDH-1, CD133, Shh, Gli-1 and survivin expressions in the oral epithelial region together with the quantitative approach towards collagen deposition in the sub-epithelial matrix. Oxidative stress was found to be associated with type-II EMT in case of OSF attributing the development of sub-epithelial fibrosis and type-III EMT in case of OSCC favoring malignancy associated metastasis. Moreover, the acquisition of stemness during OSCC can also be correlated with EMT. Alteration of Shh and Gli-1 expression pattern revealed the mechanistic association of hypoxia with the phenotypic plasticity and disease manifestation in case of OSF as well as OSCC. Shh/ Gli-1 signaling can also be correlated with survivin mediated cytoprotective phenomenon under oxidative stress. Overall, the study established the correlative network of hypoxia associated oxidative stress, EMT and manifestation of oral pre-cancerous and cancerous condition in a holistic approach that may throw rays of hope in the therapeutic domain of the concerned diseases.     

Improved durable pulmonary vein isolation with shorter procedure times and lower energy levels using RF ablation with ablation index and a stringent lesion contiguity

BackgroundThe single procedure success rates of durable pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) varies between 80 and 90%. Ablation index, incorporating contact force, stability, time and power is a more profound parameter of significant lesion size and has been established. Equally important is a stringent contiguity of the lesion set.Methods and resultsA total number of 100 consecutive patients undergoing de-novo catheter ablation for paroxysmal atrial fibrillation (PAF) were analyzed between 2016 and 2019. In the first 50 patients (group A) PVI was performed using a surround flow, contact force catheter (Biosense Webster Thermocool STSF, Biosense Webster, USA) with a drag-and-ablate technique to encircle the PVs. In the following 50 patients (group B), PVI was performed using ablation index and a stringent lesion contiguity with an interlesion distance (ILD) of <5 mm. The baseline characteristics showed no significant differences between both groups. During a mean follow-up of 18 ± 3 months after a single procedure, 36 (72%) patients of group A were free of arrhythmia recurrence versus 43 (86%) patients in group B (p = 0.047). A total of 14 patients (group A: 10 (20%), group B: 4 (8%); underwent a redo-procedure. 7 patients of group A (14%) and 2 patients of group B (4%) showed recovered veins. In 3 patients of group A and 2 patients of group B the PVs were durably isolated. In these patients persistent AF recurrence was caused by extra-PV AF sources. Four patients of group A and three patients of group B had continued paroxysmal or persistent AF but did not undergo redo-procedure. With regard to the procedural data, the procedure time, the total energy and the fluoroscopy time were significantly lower in group B (AI and ILD <5 mm) (128.86 ± 18.19 versus 115.35 ± 15.38; p < 0.05; 1619.16 ± 988.56 versus 1186.26 ± 756.34; p < 0.05; 11.49 ± 3.20 versus 9.66 ± 3.86; p = 0.04). Both procedures were performed with a low number of complications, no pericardial effusion was seen in either group.ConclusionsPVI using ablation index in combination with a stringent lesion contiguity improves clinical outcome after first-time PVI with lower PVI recovery, shorter procedure times, lower total energy and shorter fluoroscopy times and therefore, is more efficient.     

牛磺酸上调基因1(TUG1)对肝纤维化的作用及其机制*

目的:探讨牛磺酸上调基因1(TUG1)在肝纤维化中的作用机制。方法:按照文献建立TGF-β1(5 ng/ml)刺激的活化肝星状细胞模型和经典的1%DMN(1 ml/kg/d)致大鼠肝纤维化模型,将肝纤维化大鼠和活化肝星状细胞(HSC)均分为模型对照组、阴性对照组(沉默TUG1阴性对照)、siRNA干扰组(TUG1基因沉默组)。实验结束后利用苏木精-伊红(HE)染色检测大鼠肝脏组织病理变化;采用逆转录-聚合酶链反应(RT-PCR)法、蛋白免疫印记(Western blot)分别测定大鼠肝组织及活化肝星状细胞中α-平滑肌肌动蛋白(α-SMA)、TUG1、I型胶原蛋白(collagenI)、基质金属蛋白酶-2(MMP-2)、金属蛋白酶组织抑制因子(TIMP-1)、Smad2、Smad3表达水平。结果:肝组织病理学检查显示,沉默TUG1能够明显缓解肝脏纤维化病理改变,Western blot结果显示,沉默TUG1能够显著降低大鼠肝组织和活化肝星状细胞中TUG1、α-SMA、collagenI、MMP-2、TIMP-1、Smad2、Smad3基因与蛋白表达水平(P＜0.05)。与模型对照组相比,阴性对照组的TUG1、α-SMA的蛋白与基因水平明显升高(P＜0.05)。与模型对照组和阴性对照组相比,siRNA干扰组中TUG1, α-SMA, collagenI, MMP-2, TIMP-1, Smad2 and Smad3的蛋白和基因水平显著降低(P＜0.05),而在模型对照组和阴性对照组中TUG1, α-SMA, collagenI, MMP-2, TIMP-1, Smad2 and Smad3的蛋白和基因表达水平之间差异无显著性。结论:TUG1在肝纤维化组织和活化的肝星状细胞中显著上调,沉默TUG1可能通过抑制转化生长因子-β1(TGF-β1)/Smad信号通路改善1%DMN致大鼠肝纤维化病理损伤,降低活化肝星状细胞中纤维化相关蛋白水平,发挥抗肝纤维化的作用。     

百草枯通过SOCE途径促进肺纤维化的发生

摘要 目的：探讨SOCE对百草枯（PQ）致肺纤维化过程的具体调控作用。方法：体外培养肺泡上皮A549细胞,设置分组为对照组、PQ组和PQ+SKF96365组。对照组不作任何处理;PQ组给予800 μM的PQ溶液处理细胞24 h;PQ+SKF96365组先加入10 μM的SKF96365预处理细胞2 h,然后再加800 μM PQ处理24 h。免疫荧光检测PQ染毒后SOCE相关蛋白的活化和胞内分布、NFATc1的表达和入核情况。清洁级小鼠40只,随机分为空白对照组、PQ组、SKF96365组和PQ+SKF96365组。PQ组及PQ+SKF96365组给予百草枯（20 mg/kg）一次性腹腔注射,对照组给予等量生理盐水;SKFS96365组及PQ+SKF96365组每天腹腔注射一次10 mg/kg的SKF96365溶液,持续3天,行HE染色、Masson染色观察肺组织病理状态改变以及胶原纤维的变化情况。结果：与正常组相比,PQ染毒组STIM1蛋白活化出现寡聚化现象并且ORAI1、TRPC1膜定位显著;PQ引起细胞质内NFATc1信号向细胞核内转移,密度差异具有统计学意义（P<0.01）,使用SOCE抑制剂后NFATc1信号减弱向细胞质内转移（P<0.01）。与对照组相比,PQ中毒的小鼠肺泡结构被破坏,肺间质大量胶原纤维沉积;与PQ组相比,PQ+SKF96365组肺泡结构相对完整并且间质胶原纤维沉积减少。结论：PQ中毒可活化SOCE并通过增加NFAT入核激活下游转录信号,促进肺纤维化的发生。