成纤维细胞生长因子21对非酒精性脂肪性肝炎的作用及机制的研究

目的:探索成纤维细胞生长因子21(FGF-21)对非酒精性脂肪性肝炎(NASH)的作用及其机制。方法:用浓度为500μmol/L的油酸和棕榈酸混合物(摩尔比=2:1)诱导HepG2细胞建立NASH细胞模型,实验分为5组:正常对照组(Control)、模型组(Model)、低剂量FGF-21组(LFGF-21,0.5μmol/L)、中剂量FGF-21组(MFGF-21,1.0μmol/L)和高剂量FGF-21组(HFGF-21,2.0μmol/L),油红O染色法观察细胞内脂滴,全自动生化分析仪检测细胞内ALT、AST、TC、TG的水平,Real-time PCR和Western blot分别检测细胞内核因子E2相关因子-2(Nrf-2)、核苷酸结合寡聚化结构域样受体3(NLRP3)的m RNA和蛋白水平,ELISA检测IL-1β、TNF-α水平。结果:NASH细胞造模成功,油红O染色结果显示对照组细胞无明显脂滴蓄积,模型组细胞内可见大量橘红色脂滴,并出现融合现象。不同浓度FGF-21治疗组的细胞内红色脂滴明显减少,并呈剂量依赖性。模型组ALT、AST、TC、TG、IL-1β、TNF-α和NLRP3的水平均高于对照组(P0.05),FGF-21治疗组其水平低于模型组(P0.05)。模型组Nrf2的水平低于对照组(P0.05),FGF-21治疗组Nrf2的水平高于模型组(P0.05)。结论:FGF-21通过促进Nrf-2、抑制NLRP3减少非酒精性脂肪性肝炎细胞的脂质沉积,减轻炎症反应,对NASH有保护作用。     

葛根素联合小檗碱干预非酒精性脂肪性肝炎两种动物模型的病理学研究

目的:从病理学的角度探讨葛根素及小檗碱对非酒精性脂肪性肝炎(NASH)的干预作用。方法:制备高脂饮食诱导的SD大鼠NASH模型及蛋氨酸-胆碱缺乏饮食诱导的C57BL/6小鼠NASH模型,各给药组造模并同时灌胃给药,大鼠持续8周后取材,小鼠持续2周后取材。肝组织制成石蜡切片进行HE染色,制成冰冻切片进行油红O染色,经光镜观察摄片后,采用NAFLD活动度积分对各组进行NASH评估。结果:HE及油红O检测提示葛根素联合小檗碱可减轻两种NASH动物模型肝脏的脂肪变性、抑制肝细胞空泡化的发生,减少肝小叶内炎性病灶的数量。给予葛根素联合小檗碱的SD大鼠NAS总分为2.60±0.52(3),给予葛根素联合小檗碱的C57BL/6小鼠NAS总分为2.80±0.79(3),均已排除NASH。结论:葛根素联合小檗碱可显著抑制NASH相关病理变化的发生发展,对NASH具有一定的干预作用。     

非酒精性脂肪性肝病的研究进展

非酒精性脂肪性肝病(NAFLD)在西方国家较为常见,近年来在我国的发病呈上升趋势,且发展逐渐低龄化。非酒精性脂肪性肝病患者可能因持续性肝损伤而导致纤维化进展,可与慢性病毒性肝炎和酒精性肝病一样发展到终末期肝硬化,并出现肝硬化严重并发症,也有可能发展成肝癌,最终需要肝移植治疗。它严重危害人类的健康,影响人类的生活及生存质量。多因素的发病机制使其愈来愈被人们所重视,研究和了解非酒精性脂肪性肝病的流行病学、发病机制、诊断及治疗方法,对人类非常重要,如果在疾病的早期,也就是单纯性脂肪肝阶段就对疾病进行干预,这样可以取得很好的治疗效果,NAFLD是人类在本世纪需要面对的疾病之一,因此研究它的发病机制及治疗方法是非常必要的。     

Identification of isotschimgine as a novel farnesoid X receptor agonist with potency for the treatment of obesity in mice

Obesity and its associated non-alcoholic fatty liver disease (NAFLD) have become epidemic medical problems worldwide; however, the current available therapeutic options are limited. Farnesoid X receptor (FXR) has recently emerged as an attractive target for obesity treatment. Here we demonstrate that isotschimgine (ITG), a constituent in genus Ferula, as a novel FXR agonist with anti-obesity and anti-hepatic steatosis effects. The results showed that ITG activated the FXR transactivity and bound with the ligand binding dormain (LBD) of FXR with gene reporter assays and AlphaScreen assays. In high-fat diet-induced obese (DIO) mice, ITG lowered body weight and fat mass, improved insulin resistance and hepatic steatosis. Mechanistic studies showed that ITG altered the expression levels of FXR downstream genes, lipid synthesis and energy metabolism genes in the liver of mice. Our findings suggest that ITG is a novel FXR agonist and may be a potential therapeutic choice for obesity associated with NAFLD.     

Suppression of hepatic fat accumulation by highly purified eicosapentaenoic acid prevents the progression of d-galactosamine-induced hepatitis in mice fed with a high-fat/high-sucrose diet

The pathogenesis of non-alcoholic fatty liver disease (NAFLD) remains largely unknown. Here, we assessed the importance of hepatic fat accumulation on the progression of hepatitis. BALB/cA mice were fed with a standard diet (STD) or a high-fat and high-sucrose diet (HFHSD) for 14 days followed by intraperitoneal injection of d-galactosamine (DGalN) or vehicle. After 20–21 h, plasma and liver tissue were collected and analyzed. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in plasma were increased significantly in HFHSD-fed mice treated with DGalN compared to STD-fed mice treated with DGalN. This exacerbation by the HFHSD was also observed in the plasma soluble tumor necrosis factor receptor (sTNFR) levels, and hepatic levels of reactive oxygen species (ROS) and the fibrogenic gene expression, such as tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), connective tissue growth factor (CTGF) and osteopontin (OPN) in HFHSD-fed mice treated with DGalN. The triglyceride contents of the liver were significantly increased by the HFHSD. When eicosapentaenoic acid (EPA), a suppressor of sterol regulatory element binding protein 1 (SREBP-1), was administered to HFHSD-fed mice, the sensitivity of DGalN, as a result of plasma ALT and AST levels, was suppressed accompanied by reduced plasma sTNFR2 level and hepatic levels of triglyceride, ROS, and fibrogenic parameters, and by increased plasma adiponectin levels. These data suggest that the progression of steatotic liver injury closely depends on the accumulation of fat in the liver and is prevented by EPA through the suppression of the fatty liver change.     

The hepatic circadian clock is preserved in a lipid-induced mouse model of non-alcoholic steatohepatitis

Recent studies have correlated metabolic diseases, such as metabolic syndrome and non-alcoholic fatty liver disease, with the circadian clock. However, whether such metabolic changes per se affect the circadian clock remains controversial. To address this, we investigated the daily mRNA expression profiles of clock genes in the liver of a dietary mouse model of non-alcoholic steatohepatitis (NASH) using a custom-made, high-precision DNA chip. C57BL/6J mice fed an atherogenic diet for 5 weeks developed hypercholesterolemia, oxidative stress, and NASH. DNA chip analyses revealed that the atherogenic diet had a great influence on the mRNA expression of a wide range of genes linked to mitochondrial energy production, redox regulation, and carbohydrate and lipid metabolism. However, the rhythmic mRNA expression of the clock genes in the liver remained intact. Most of the circadianly expressed genes also showed 24-h rhythmicity. These findings suggest that the biological clock is protected against such a metabolic derangement as NASH.     

用~（18）F-FDG观察脂肪肝患者肝脏葡萄糖摄取变化

目的：通过PET/CT检查观察脂肪肝患者肝脏及其他组织对18F脱氧葡萄糖（18F-FDG）摄入变化,探讨脂肪肝与糖脂代谢的相关性。方法：36例做PET/CT的健康和2型糖尿病男性患者,分为对照组（n=18例）;脂肪肝组（n=9例）;糖尿病脂肪肝组（n=9例）。常规测血糖、血脂及肝肾功能。PET/CT测肝脏CT值和肝脏、肾皮质,骨骼肌组织18F-FDG的最大标准摄入值（SUVmax）及平均标准摄入值（SUVmean）。结果：1.糖尿病脂肪肝组的TG显著高于单纯脂肪肝组和正常对照组,P=0.0003,0.0000。单纯脂肪肝组的TG亦显著高于正常对照组,P=0.028。2.糖尿病脂肪肝组的肝脏18F-FDG的SUVmean和SUVmax显著高于正常对照组的SUVmean和SUVmax,P=0.0054,0.0133。单纯脂肪肝组的肝脏SUVmean和SUVmax亦高于正常对照组,但比较无统计学差异。脑皮质、肾皮质和骨骼肌组织的18F-FDG的SUVmean和SUVmax三组间比较无显著性差异。3.Spearman相关性分析发现FBG与TG显著正相关（r=0.59919,P=0.0004）;FBG和TG与肝脏的CT值显著负相关（r=-0．55625,P=0．0004;r=-0．45739,P=0．0097）。结论：脂肪肝与空腹血糖和甘油三酯升高显著相关。脂肪肝及2型糖尿病脂肪肝患者肝脏对葡萄糖摄取增高。     

Vitamin E alleviates non-alcoholic fatty liver disease in phosphatidylethanolamine N-methyltransferase deficient mice

Phosphatidylethanolamine N-methyltransferase (PEMT) converts phosphatidylethanolamine (PE) to phosphatidylcholine (PC), mainly in the liver. Pemt^?/? mice are protected from high-fat diet (HFD)-induced obesity and insulin resistance, but develop severe non-alcoholic fatty liver disease (NAFLD) when fed a HFD, mostly due to impaired VLDL secretion. Oxidative stress is thought to be an essential factor in the progression from simple steatosis to steatohepatitis. Vitamin E is an antioxidant that has been clinically used to improve NAFLD pathology. Our aim was to determine whether supplementation of the diet with vitamin E could attenuate HFD-induced hepatic steatosis and its progression to NASH in Pemt^?/? mice. Treatment with vitamin E (0.5?g/kg) for 3?weeks improved VLDL-TG secretion and normalized cholesterol metabolism, but failed to reduce hepatic TG content. Moreover, vitamin E treatment was able to reduce hepatic oxidative stress, inflammation and fibrosis. We also observed abnormal ceramide metabolism in Pemt^?/? mice fed a HFD, with elevation of ceramides and other sphingolipids and higher expression of mRNAs for acid ceramidase (Asah1) and ceramide kinase (Cerk). Interestingly, vitamin E supplementation restored Asah1 and Cerk mRNA and sphingolipid levels. Together this study shows that vitamin E treatment efficiently prevented the progression from simple steatosis to steatohepatitis in mice lacking PEMT.     

非酒精性脂肪性肝病大鼠肝组织瘦素受体表达的变化

目的检测高脂饮食诱发的非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)大鼠肝组织瘦素受体的表达,探讨NAFLD瘦素抵抗的发生机制及瘦素抵抗在NAFLD发病中的作用.方法采用高脂饮食制备Wistar大鼠NAFLD模型;ELISA法测定大鼠血清瘦素(leptin,LP)浓度;全自动生化分析仪测血清甘油三酯(triglyceride,TG)、空腹血糖(fasting blood glucose,FBG),比色法测游离脂肪酸(free fatty acid,FFA),放射免疫法测空腹血清胰岛素(fasting insulin,FINS),计算空腹状态下胰岛素抵抗指数;对肝组织分别进行HE染色、苏丹Ⅳ染色、瘦素受体免疫组化染色,并进行半定量分析.利用SAS 8.0统计软件处理实验数据.结果模型组大鼠肝组织瘦素受体表达比正常组明显减弱,且与血清瘦素浓度、游离脂肪酸、胰岛素敏感指数、肝细胞脂变、炎症活动度显著负相关,相关系数分别为r = -0.83,-0.71, -0.65,-0.83, -0.87.多元线性回归分析显示,瘦素受体表达减弱是肝脂变的独立影响因素.结论肝组织瘦素受体表达减弱是NAFLD瘦素抵抗的重要病理机制之一,瘦素抵抗与胰岛素抵抗相互作用,共同促进了脂肪肝的发生发展.     

Structural optimization and in vitro profiling of N-phenylbenzamide-based farnesoid X receptor antagonists

Activation of the nuclear farnesoid X receptor (FXR) which acts as cellular bile acid sensor has been validated as therapeutic strategy to counter liver disorders such as non-alcoholic steatohepatitis by the clinical efficacy of obeticholic acid. FXR antagonism, in contrast, is less well studied and potent small molecule FXR antagonists are rare. Here we report the systematic optimization of a novel class of FXR antagonists towards low nanomolar potency. The most optimized compound antagonizes baseline and agonist induced FXR activity in a full length FXR reporter gene assay and represses intrinsic expression of FXR regulated genes in hepatoma cells. With this activity and a favorable toxicity-, stability- and selectivity-profile it appears suitable to further study FXR antagonism in vitro and in vivo.