细胞因子与酒精性肝病

酒精性肝病(alcoholic liver disease,ALD)的发生发展过程与体内多种细胞因子有关,尤其是肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和转化生长因子-β(transforming growth factor-β,TGF-β)在调节肝细胞的凋亡过程中具有重要作用。TNF-α可引起肝细胞凋亡与炎症反应等,抗TNF-α治疗能明显减轻酒精引起的肝损害;TGF-β具有增加细胞外基质的合成和抑制细胞外基质降解的作用,TGF-β1升高与肝纤维化密切相关。细胞因子可能是防治酒精性肝病的有效分子靶点。     

酒精性肝病合并HBV感染并发肝衰竭对NF-κB信号通路的影响

由于酗酒人数的增长,HBV感染合并酒精性肝病患者的数量在中国逐年增加,酒精性肝病与HBV感染会严重影响肝功能。目前中国已成为引起肝硬化的第二大病因。而乙型肝炎病毒感染合并酒精性肝病是最常见的,且会对肝脏造成严重的损伤。本实验的检测了NF-κB信号通路和IL-8、TNF-α和Cleaved caspase-3基因及蛋白的表达,结果表明,酒精性肝病合并HBV感染并发肝衰竭会激活NF-κB信号通路,并上调IL-8、TNF-α和Cleaved caspase-3基因和蛋白的表达,说明酒精性肝病合并HBV感染不仅对肝脏造成了极其严重的损伤,还造成肝脏组织或细胞炎症的发生和细胞凋亡及组织纤维化。通过以上的研究,本实验为揭示酒精性肝病合并HBV并发肝衰竭的分子机制,以及为后续研究酒精性肝病合并HBV并发肝衰竭的靶向治疗提供理论参考。     

酒精性肝病发病过程中氧化应激指标的变化

目的酒精性肝病发病过程中氧化应激指标的变化。方法用酒精灌胃建立大鼠酒精性肝病模型,分别于4、8、12和16周留取血清和肝组织,用OLYMPUSAU-600全自动生化分析仪(日本)检测血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、胆碱酯酶(CHE);用生化比色法检测肝匀浆6-酮-前列腺素F1α(6-K-PGF1α)、血栓素B2(TXB2)、甘油三酯(TG)、氧自由基(ORF)、抗超氧阴离子(ASOA)、超氧化物歧化酶(SOD)及丙二醛(MDA)含量;用HE染色、苏丹Ⅳ染色和天狼星红染色观察肝组织病理学改变。结果随着病程进展,酒精性肝病大鼠肝脏呈现肝细胞脂肪变性、小叶内炎性坏死灶、窦周纤维化和汇管区纤维间隔形成等病理改变,血清ALT和AST逐渐升高,CHE降低,肝组织匀浆TG、OFR、MDA和TXB2含量逐渐升高,SOD、ASOA和6-K-PGF1α降低,与正常对照组比较P<0·05或P<0·01。结论ALD发病过程中存在氧化应激,氧化应激在酒精性肝病发病中发挥着重要作用。     

非酒精性脂肪性肝病的发病机制及治疗进展

近年来,随着人们生活水平的提高,脂肪性肝病的发病率明显上升,且患病年龄趋于低龄化,已经成为严重危害我国人民健康的常见疾病,我国非酒精性脂肪性肝病的发病率明显高于酒精性脂肪性肝病。本文主要对NAFLD的发病机制及相关治疗进展做简要的综述。NAFLD的发病机制与胰岛素抵抗、氧化应激、代谢综合征、脂肪细胞因子的作用、内质网应激、及铁超载等多种因素有关。NAFLD的治疗可以从防治原发病或相关危险因素、基础治疗(行为或生活方式干预;调整饮食;运动疗法)、药物治疗以及手术治疗等方面进行。了解国际上NAFLD的发病机制以及相关治疗进展,对遏制非酒精性脂肪性肝病的发生、发展趋势有着十分重要的意义。     

肠道菌群影响非酒精性脂肪性肝病的机制及应对策略

非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的发病率逐年升高,已成为最常见的肝脏疾病之一。目前其发病机制未被完全阐明,尚无有效治疗药物。肠道菌群与人体共生,作为人体的“第二基因组”,其在消化、吸收及代谢中发挥重要作用。新近研究表明,肠道菌群已成为影响NAFLD发生、进展的重要因素,肠道菌群失调和肠肝轴紊乱与非酒精性单纯性脂肪肝(nonalcoholic fatty liver,NAFL)发展为非酒精性脂肪性肝炎(nonalcoholic steatohepatitis,NASH)、肝纤维化和肝细胞癌(hepatocellular carcinoma,HCC)密切相关。因此,肠道微生态干预有望成为预防或治疗NAFLD的新手段。本综述主要探讨肠道菌群异常对NAFLD/NASH发病过程、机制的影响及干预措施。     

非酒精性脂肪性肝病细胞凋亡的内质网应激启动机制

内质网应激反应,是由于某些因素导致内质网的生理功能紊乱引起的一种细胞自我防御保护机制.内质网应激所诱导的细胞凋亡是近年来新被认识的一种凋亡途径,它不同于既往经典线粒体、死亡受体介导的细胞凋亡.当短暂性内质网应激时,通过激活未折叠蛋白反应来增强机体自我保护及生存能力;而持续性应激状态下,如非酒精性脂肪性肝病所诱导的内质网应激启动一系列凋亡途径如CHOP、JNK、Caspase等,上述凋亡途径可以加速诱导肝细胞凋亡,使NAFLD向肝纤维化方向甚至肝硬化发展.     

降脂益生菌对非酒精性脂肪性肝病小鼠胆汁酸代谢及转运的影响和机制初探

目的 探讨降脂益生菌(鼠李糖乳杆菌DM9054和植物乳杆菌86066联合制剂)对非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)小鼠胆汁酸代谢及转运的影响和可能机制。 方法 18只雄性FXR / 小鼠随机分为3组(n=6):正常饮食组、高脂饮食组和高脂饮食+降脂益生菌组。其中正常饮食组给予普通饮食和生理盐水灌胃,高脂饮食组给予高脂饮食和生理盐水灌胃,高脂饮食+降脂益生菌组给予高脂饮食和降脂益生菌灌胃。所有小鼠干预12周,处死小鼠1周前行胰岛素耐量试验和腹腔注射葡萄糖耐量试验。小鼠处死后自动生化分析仪检测血脂、胆汁酸及肝功能指标;RT PCR检测肝脏和回肠组织炎症因子相对表达量;HE染色评估肝脏和回肠组织病理情况;Western blot检测法尼醇受体(Farnesoid X receptor,FXR)通路中的成纤维细胞生长因子15(fibroblast growth factor 15,FGF15)、成纤维细胞生长因子受体4(fibroblast growth factor receptor 4,FGFR4)和小分子异源二聚体(short heterodimer partner,SHP)、胆汁酸合成限速酶胆固醇7α 羟化酶(cholesterol 7α hydroxylase,CYP7A1)及胆汁酸转运相关的胆盐输出泵(bile salt export pump,BSEP)的蛋白表达。 结果 和高脂饮食组相比,高脂饮食+降脂益生菌组小鼠血清中胆汁酸含量明显下降(P=0.000 1),FGF15、FGFR4和BSEP蛋白表达水平升高(P=0.009 7、0.024 2、0.000 1),CYP7A1的蛋白表达水平降低(P=0.006 9)。此外,通过降脂益生菌干预还明显改善了高脂饮食FXR / 小鼠的糖脂代谢紊乱(P=0.002 4)、肝脏脂肪变性、肝脏和回肠组织炎症(P=0.013 8、0.000 1、0.000 1)以及肠黏膜屏障功能(P=0.014 2)。 结论 降脂益生菌具有类似选择性肠道FXR激动剂的作用,能够通过调控肠道FXR FGF15通路改善胆汁酸的代谢及转运,进而缓解高脂饮食FXR / 小鼠的NAFLD。     

非酒精性脂肪性肝病

非酒精性脂肪性肝病(NALFD)是近年来愈来愈多被认知的肝相关联疾病之一。在北美及欧洲NAFLD已成为严重影响公共健康的课题。美国胃肠病学会(AGA)和美国肝病学会(AASLD)提出了临床诊断及治疗标准,现综述如下。     

磷脂酰胆碱对酒精性肝病保护作用的研究进展

酒精性肝病已逐渐成为第二大肝脏疾病,威胁着人类的健康。乙醇引发肝损伤的机制主要包括其代谢产物乙醛对肝细胞造成的毒性作用、自由基损伤及对肝脏线粒体产生的毒性作用等。已证实,磷脂酰胆碱对酒精肝损伤具有明显的保护作用。简要介绍了酒精肝病机制及磷脂酰胆碱对酒精性肝损伤的保护作用研究进展,以期为治疗酒精性肝病提供帮助。     

基于网络药理学与分子对接探究黄芩有效成分对酒精性肝病的作用机制及效果验证

通过网络药理学和分子对接技术探究中药黄芩治疗酒精性肝病的作用机制,并通过体外细胞实验验证黄芩有效成分对酒精性肝病的治疗效果。在TCMSP、Swiss ADME和Swiss Target Prediction数据库中检索获得黄芩有效成分及其作用靶点;在GeneCards、OMIM、DisGeNET、TTD和PharmGKB数据库中检索获得酒精性肝病相关的疾病靶点;利用String数据库构建靶点相互作用网络;通过Metascape数据库对关键靶点进行京都基因与基因组百科全书(KEGG)通路富集分析、基因本体(GO)富集分析。采用Cytoscape 3.8.0软件构建黄芩治疗酒精性肝病的“有效成分-靶点-通路”互作网络,并筛选出黄芩有效成分和关键靶点进行分子对接。基于网络药理学和分子对接结果,采用体外细胞实验初步验证预测结果。将黄芩有效成分进行ADME筛选后共获得27个,且这27个有效成分可以通过257个基因靶点对酒精性肝病起到治疗作用,其中关键核心靶点有SRC、AKT1、PIK3R1、STAT3、PIK3CA等。KEGG信号通路富集分析结果显示,黄芩治疗酒精性肝病的主要信号通路包括癌症的途...     

MicroRNAs in alcoholic liver disease: Recent advances and future applications

Alcoholic liver disease (ALD) is characterized by hepatocyte damage, inflammatory cell activation, and increased intestinal permeability leading to the clinical manifestations of alcoholic hepatitis. Selected members of the family of microRNAs (miRNAs) are affected by alcohol, resulting in an abnormal miRNA profile in the liver and circulation in ALD. Increasing evidence suggests that miRNAs that regulate inflammation, lipid metabolism and promote cancer are affected by excessive alcohol administration in mouse models of ALD. This communication highlights recent findings in miRNA expression and functions as they relate to the pathogenesis of ALD. The cell-specific distribution of miRNAs, as well as the significance of circulating extracellular miRNAs, is discussed as potential biomarkers. Finally, the prospects of miRNA-based therapies are evaluated in ALD.     

Noncoding RNAs in alcoholic liver disease

Alcoholic liver disease (ALD) is a complex process with high morbitity and can cause liver dysfunction, which contains a wide spectrum of hepatic lesions, including steatohepatitis, fibrosis, cirrhosis, and eventually hepatocellular carcinoma. To date, the molecular mechanisms for ALD have not been fully explored and an effective therapy is still missing. Overwhelming evidence shows dysregulation of noncoding RNAs (ncRNAs), particularly microRNAs (miRNAs), is correlated with etiopathogenesis and progress of ALD including hepatocyte damage, disrupted lipid metabolism, aggressive inflammatory responses, oxidative stress, programmed cell death, fibrosis, and epigenetic changes induced by alcohol. For example, circulating miRNA-122 is a marker of hepatocyte damage, and miRNA-155 is a potential marker of inflammation, indicating their diagnosis therapeutic potential in ALD. In addition, roles for long noncoding RNAs (lncRNAs) and circular RNAs in ALD are being uncovered. Further, circulating ncRNAs and exosome-derived ncRNAs have attracted more attention lately, suggesting a role in the prevention and treatment of ALD. This review covers the roles of ncRNAs in ALD, and the potential uses as markers for diagnosis and therapeutic options.     

Mechanisms of Gynostemma pentaphyllum against non‐alcoholic fibre liver disease based on network pharmacology and molecular docking

As a progressive chronic disease, the effective treatment for non‐alcoholic fibre liver disease (NAFLD) has not yet been thoroughly explored at the moment. The widespread use of Gynostemma pentaphyllum (Thunb) for its anti‐insulin resistance effect indicates that potential therapeutic value may be found in Thunb for NAFLD. Hence, this research aims to discover the latent mechanism of Thunb for NAFLD treatment. To achieve the goal of discovering the latent mechanism of Thunb for NAFLD treatment, molecular docking strategy integrated a network phamacology was adopted in the exploration. We acquire Thunb compounds with activeness from TCMSP database. We collect the putative targets of Thunb and NAFLD to generate the network. Key targets and mechanism are screened by PPI analysis, GO and KEGG pathway enrichment analyses. Molecular docking simulation is introduced into the study as assessment method. Through network analysis and virtual screening based on molecular docking, 2 targets (AKT 1 and GSK3B) are identified as key therapeutic targets with satisfying binding affinity. Main mechanism is believed to be the biological process and pathway related to insulin resistance according to the enrichment analyses outcomes. Particularly, the P13K–AKT signalling pathway is recognized as a key pathway of the mechanism. In conclusion, the study shows that Thunb could be a potential treatment against NAFLD and may suppress insulin resistance through the P13K–AKT signalling pathway. The result of the exploration provides a novel perspective for approaching experimental exploration.     

Salvianic acid A alleviates chronic alcoholic liver disease by inhibiting HMGB1 translocation via down‐regulating BRD4

Alcoholic liver disease (ALD) is the major cause of chronic liver disease and a global health concern. ALD pathogenesis is initiated with liver steatosis, and ALD can progress to steatohepatitis, fibrosis, cirrhosis and even hepatocellular carcinoma. Salvianic acid A (SAA) is a phenolic acid component of Danshen, a Chinese herbal medicine with possible hepatoprotective properties. The purpose of this study was to investigate the effect of SAA on chronic alcoholic liver injury and its molecular mechanism. We found that SAA significantly inhibited alcohol‐induced liver injury and ameliorated ethanol‐induced hepatic inflammation. These protective effects of SAA were likely carried out through its suppression of the BRD4/HMGB1 signalling pathway, because SAA treatment largely diminished alcohol‐induced BRD4 expression and HMGB1 nuclear translocation and release. Importantly, BRD4 knockdown prevented ethanol‐induced HMGB1 release and inflammatory cytokine production in AML‐12 cells. Similarly, alcohol‐induced pro‐inflammatory cytokines were blocked by HMGB1 siRNA. Collectively, our results reveal that activation of the BRD4/HMGB1 pathway is involved in ALD pathogenesis. Therefore, manipulation of the BRD4/HMGB1 pathway through strategies such as SAA treatment holds great therapeutic potential for chronic alcoholic liver disease therapy.     

Inhibition of MD2‐dependent inflammation attenuates the progression of non‐alcoholic fatty liver disease

Non‐alcoholic fatty liver disease (NAFLD) can progress to the more serious non‐alcoholic steatohepatitis (NASH), characterized by inflammatory injury and fibrosis. The pathogenic basis of NAFLD progressing to NASH is currently unknown, but growing evidence suggests MD2 (myeloid differentiation factor 2), an accessory protein of TLR4, is an important signalling component contributing to this disease. We evaluated the effectiveness of the specific MD2 inhibitor, L6H21, in reducing inflammatory liver injury in a relevant high‐fat diet (HFD) mouse model of NASH and in the palmitic acid (PA)‐stimulated human liver cell line (HepG2). For study, genetic knockout (MD2^?/?) mice were fed a HFD or control diet for 24 weeks, or wild‐type mice placed on a similar diet regimen and treated with L6H21 for the last 8 or 16 weeks. Results indicated that MD2 inhibition with L6H21 was as effective as MD2 knockout in preventing the HFD‐induced hepatic lipid accumulation, pro‐fibrotic changes and expression of pro‐inflammatory molecules. Direct challenge of HepG2 with PA (200 μM) increased MD2‐TLR4 complex formation and expression of pro‐inflammatory and pro‐fibrotic genes and L6H21 pre‐treatment prevented these PA‐induced responses. Interestingly, MD2 knockout or L6H21 increased expression of the anti‐inflammatory molecule, PPARγ, in liver tissue and the liver cell line. Our results provide further evidence for the critical role of MD2 in the development of NASH and conclude that MD2 could be a potential therapeutic target for NAFLD/NASH treatment. Moreover, the small molecule MD2 inhibitor, L6H21, was an effective and selective investigative agent for future mechanistic studies of MD2.     

Granulocytic myeloid‐derived suppressor cell population increases with the severity of alcoholic liver disease

Alcoholic liver disease (ALD) is a progressive liver disease that can cause a series of complications, including cirrhosis, liver failure and hepatocellular carcinoma. Granulocytic myeloid‐derived suppressor cell (gMDSC) populations have been observed to expand in various liver diseases and to inhibit innate and adaptive immunity in patients with liver disease. However, the characteristics of gMDSCs in patients with ALD have not been studied. We studied 24 healthy controls (HCs) and 107 patients with ALD and found an accumulation of gMDSCs in the peripheral blood of patients with alcoholic liver cirrhosis (ALC). Furthermore, ALC patients with a poor prognosis displayed a significant increase in peripheral gMDSCs and showed an increased capacity for arginase I production compared to HCs. In contrast, plasma arginase I levels in ALC patients were negatively correlated with total bilirubin and international normalized ratio, two key parameters of liver damage. Importantly, gMDSCs accumulated in the livers of ALC patients, and the frequency of liver gMDSCs significantly correlated with that of peripheral gMDSCs. In addition, gMDSC enrichment in vitro significantly inhibited the function of natural killer (NK) cells, perhaps preventing the NK‐induced apoptosis of hepatic stellate cells. In summary, increased peripheral and intrahepatic gMDSC populations are present in patients with ALC and may contribute to enhancing the severity of liver cirrhosis.     

FH/Wjd大鼠酒精性肝损伤模型探讨

目的对FH/W jd大鼠酒精性肝损伤模型进行探讨。方法 FH/W jd大鼠按体重随机分为饮水组和饮酒组,两组均自由饮食。16周后取血,检测血清ALT、AST、TBIL、TG、CHO;取肝脏,匀浆后检测TG、GSH;流式细胞仪检测肝细胞凋亡率;Western blot检测肝脏组织PPARα蛋白表达;肝脏HE染色观察组织病理学改变。结果与饮水组比较,饮酒组两种性别FH/W jd大鼠血清TBIL、TG含量显著升高,饮酒组雌性大鼠血清ALT、CHO显著降低;饮酒组两种性别大鼠肝脏TG含量显著升高,GSH含量呈现降低趋势;饮酒组两种性别大鼠肝细胞凋亡率亦呈降低趋势;饮酒组肝脏PPARα蛋白表达明显上调;饮酒组组织病理学改变以小泡性脂肪变性为主。结论长期自主摄入酒精可以造成FH/W jd大鼠肝脏损伤。     

非肥胖者发生非酒精性脂肪肝的预测指标

目的：探讨能够预测非肥胖者是否发生非酒精性脂肪肝（Nonalcohohc fatty liver disease,NAFLD）的临床指标。方法：从广州社区人群中选取体重指数〈25且年龄、性别相匹配的NAFLD和非NAFLD个体分别为38和82例,测量其身高、体重、腰围、臀围及空腹血糖、甘油三脂、胆固醇、低密度脂蛋白、高密度脂蛋白、HBsAg和空腹胰岛素,计算体重指数、腰臀比、腰围身高比和HOMA胰岛素抵抗指数。先采用t检验和x^2检验对上述临床指标进行分析,对两组间存在显著差异者进行Logisde回归以发现独立的预测指标,再针对各预测指标进行受试者工作特征（reciever operating charactefistic,ROC）曲线分析判断各指标的预测准确度,并确定最佳的预测截断值。结果：NAFLD和非NAFLD的体重、腰围、臀围、体重指数、腰臀比、腰围身高比及空腹血糖、甘油三脂、低密度脂蛋白、胰岛素、HOMA胰岛素抵抗指数均有显著差异,但仅腰围、低密度脂蛋白和HOMA胰岛素抵抗指数进入Logistic回归方程,且其ROC曲线下面积均大于0．5（分别是0．821,0．665和0、722）。以腰围的预测准确度最高,且在80．5cm处敏感性和特异性之和最大。结论：腰围是预测非肥胖者是否发生NAFLD的合适指标,80．5cm为其最佳预测截断值。