肝血窦内皮细胞介导的他莫昔芬对非酒精性脂肪性肝炎治疗作用的转录组学分析

摘要 目的：探究他莫昔芬对饮食诱导的非酒精性脂肪性肝炎小鼠肝血窦内皮细胞的代谢、炎症及纤维化等通路基因表达的影响。方法：采用8周龄的雄性C57BL/6小鼠,给予MCD饲料喂养6周后,每天腹腔注射一次他莫昔芬（100 mg/kg）,持续5天。分离并收集肝血窦内皮细胞,加入1 mL TRIzol试剂吹打至沉淀消失,放入-80℃冰箱保存。样本后续送至基迪奥生物公司进行转录组测序并在Omicsmart平台进行生物信息学分析。部分生物信息学分析数据来自已经发表的文献并通过Omicshare分析平台分析。结果：转录组测序发现,差异基因KEGG和GO分析发现差异基因在免疫和炎症通路富集。通过分析肝脏内皮特异性代谢基因表达,我们发现他莫昔芬治疗逆转了NASH过程中部分代谢基因的下调,以及NASH过程中CCL2、CXCL2、CXCL5和VCAM-1等促炎基因和Col1a1、Col1a2、Col3a1、Tgfb2、和Timp1等促纤维化基因的表达上调。同时,GSEA分析也显示他莫昔芬抑制了炎症和纤维化通路的表达。结论：他莫昔芬可能通过逆转非酒精性脂肪性肝炎对小鼠肝血窦内皮细胞代谢基因的改变以及炎症及纤维化相关基因的上调来治疗非酒精性脂肪性肝炎。     

利用NASH大鼠原代肝细胞与原代Kupffer细胞共培养建立NASH原代细胞模型*

目的: 通过分离并提纯非酒精性脂肪性肝炎(NASH)大鼠原代肝细胞以及原代Kupffer细胞建立体外NASH原代细胞模型,为研究NASH提供可靠的细胞实验技术支持。方法: 选择SD大鼠40只,随机分为2组(n=20):对照组和NASH组,对照组大鼠利用普通饲料喂养,NASH组大鼠利用高脂饲料(88%基础饲料+10%猪油+ 2%胆固醇)喂养,6～8周后,利用NASH评分表,病理观察下肝组织切片脂肪变+小叶内炎症+气球样变评分≥4 分,表明大鼠NASH模型的成功建立,利用胶原酶原位灌注法分离并提纯NASH模型大鼠原代肝细胞以及原代Kupffer细胞,利用CK-18及CD68免疫荧光以及墨汁吞墨实验进行细胞鉴定,利用油红O染色、试剂盒测定谷丙转氨酶(ALT)、谷草转氨酶(AST)含量观察NASH大鼠原代肝细胞脂质累积和肝功情况,Western blot检测原代Kupffer细胞炎症因子表达情况,最后采用原代肝细胞:原代Kupffer细胞=6∶1比例共培养,显微镜下观察细胞状态。结果: 实验成功分离并提纯NASH原代肝细胞以及原代Kupffer细胞,通过油红O染色,NASH组大鼠原代肝细胞存在明显的脂肪沉积,且NASH组大鼠原代肝细胞中AST、ALT明显高于对照组,存在明显肝损伤(P＜0.05),Western blot测定原代Kupffer细胞TNF-α、IL-1β以及MCP-1,NASH组大鼠明显高于对照组(P＜0.05)。结论: 通过胶原酶原位灌注法可以成功分离NASH大鼠原代肝细胞以及原代Kupffer细胞,同时成功建立比例共培养大鼠体外原代细胞NASH模型。     

Impaired macrophage autophagy increases the immune response in obese mice by promoting proinflammatory macrophage polarization

Recent evidence that excessive lipid accumulation can decrease cellular levels of autophagy and that autophagy regulates immune responsiveness suggested that impaired macrophage autophagy may promote the increased innate immune activation that underlies obesity. Primary bone marrow-derived macrophages (BMDM) and peritoneal macrophages from high-fat diet (HFD)-fed mice had decreased levels of autophagic flux indicating a generalized impairment of macrophage autophagy in obese mice. To assess the effects of decreased macrophage autophagy on inflammation, mice with a Lyz2-Cre-mediated knockout of Atg5 in macrophages were fed a HFD and treated with low-dose lipopolysaccharide (LPS). Knockout mice developed systemic and hepatic inflammation with HFD feeding and LPS. This effect was liver specific as knockout mice did not have increased adipose tissue inflammation. The mechanism by which the loss of autophagy promoted inflammation was through the regulation of macrophage polarization. BMDM and Kupffer cells from knockout mice exhibited abnormalities in polarization with both increased proinflammatory M1 and decreased anti-inflammatory M2 polarization as determined by measures of genes and proteins. The heightened hepatic inflammatory response in HFD-fed, LPS-treated knockout mice led to liver injury without affecting steatosis. These findings demonstrate that autophagy has a critical regulatory function in macrophage polarization that downregulates inflammation. Defects in macrophage autophagy may underlie inflammatory disease states such as the decrease in macrophage autophagy with obesity that leads to hepatic inflammation and the progression to liver injury.     

己酮可可碱对非酒精性脂肪性肝炎大鼠肝脏超微结构和酶组织化学的影响

目的研究己酮可可碱(PTX)对非酒精性脂肪性肝炎(NASH)大鼠肝脏超微结构和酶组织化学的影响。方法高脂饮食建立大鼠非酒精性脂肪性肝炎模型。取SD大鼠40只,分为对照组、12w模型组、16w模型组和治疗组,每组10只。腹主动脉采血,测ALT、AST、血糖等水平。取肝组织做电镜和SDH、CCO、ATPase、LDH的酶组织化学染色。结果两个模型组均比对照组ALT、AST、血糖升高,LDL降低(P<0.05)。治疗组血糖、AST比16w模型组降低(P<0.05)。电镜显示16w模型组线粒体肿大,嵴排列紊乱,基质密度降低。治疗组结构改善。酶组织化学显示四种酶的活性16w模型组均较对照组降低(P<0.05),治疗组活性均较16w模型组升高(P<0.05)。结论NASH时存在肝细胞能量代谢障碍,经PTX治疗后能量代谢障碍得到改善。     

网络抗氧化剂对大鼠非酒精性脂肪肝炎模型疗效的动态观察

目的:研究网络抗氧化荆对大鼠非酒精性脂肪肝炎的治疗效果.方法:雄性SD大鼠72只,随机分为正常对照组、模型组、网络抗氧化剂组(n=24).正常对照组喂以普通饲料,网络抗氧化剂组及模型组均予高脂饮食.网络抗氧化剂组高脂饮食同时使用维生素E(100mg/kg)、硫辛酸(40mg/kg)、辅酶Q10(100mg/kg)、维生素C(100mg/kg)、还原性谷热水胱甘肽(100mg/kg)联合灌胃治疗,1次/日.分别在8周、10周、12周通过肝功能、血脂及肝组织病理动态观察病情转归情况,检测MDA、SOD评定网络抗氧化剂在病情转归中起到的抗氧化作用.结果:网络抗氧化剂组体重、肝指数、血清ALT、AST、MDA、TC及肝组织MDA均显著低于模型组;血清、肝组织SOD显著高于模型组;病理学模型组在8-10周出现多处肝细胞内脂滴堆积,出现气球样变,且有少量炎细胞浸润,随着进食高脂饮食时间的延长病变程度逐渐加重,至12周脂肪变及炎症程度均有所加重,出现点灶状坏死、桥接坏死.甚至出现部分肝纤维化.同期网络抗氧化剂肝组织病理显示脂肪变及炎症显著轻于模型组,无明显肝纤维化出现.结论:网络抗氧化剂对NASH有较好的防治效果.     

小檗碱与罗格列酮干预高脂饮食诱导大鼠非酒精性脂肪性肝炎的比较观察

目的:比较中药单体化合物小檗碱和噻唑烷二酮类药物罗格列酮对高脂饲料诱导大鼠非酒精性脂肪性肝炎(NASH)的干预作用,探讨小檗碱成为天然胰岛素增敏剂的可能性。方法:雄性SD大鼠40只,随机分为4组,采用连续饲喂高脂饲料的方法诱导大鼠NASH,以预防给药的方式灌胃给予小檗碱(100 mg/kg体重)和罗格列酮(20 mg/kg体重),持续8周后取材。采用生化分析的方法检测大鼠血清胆固醇(CHO)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、空腹血糖(FPG)及空腹胰岛素(FINS)并计算胰岛素抵抗指数(HOMA-IR)。采用常规石蜡切片HE染色、冰冻切片油红O染色评估NASH的病理程度,用常规免疫组织化学方法检测了肝组织中PPAR-γ的表达。结果:小檗碱和罗格列酮均能较好的干预高脂饲料诱导大鼠NASH的病理过程。此外,二者均能改善大鼠胰岛素抵抗状态、上调肝组织中PPAR-γ的水平。结论:小檗碱和罗格列酮均能较好的改善高脂饲料诱导的大鼠NASH病理过程,二者共同的药理机制是改善胰岛素抵抗状态和上调肝组织中PPAR-γ的表达。该实验结果提示:小檗碱有望开发为具有胰岛素增敏作用的天然药物。     

Lysophosphatidylcholine as a death effector in the lipoapoptosis of hepatocytes

The pathogenesis of nonalcoholic steatohepatitis (NASH) is unclear, despite epidemiological data implicating FFAs. We studied the pathogenesis of NASH using lipoapoptosis models. Palmitic acid (PA) induced classical apoptosis of hepatocytes. PA-induced lipoapoptosis was inhibited by acyl-CoA synthetase inhibitor but not by ceramide synthesis inhibitors, suggesting that conversion products other than ceramide are involved. Phospholipase A(2) (PLA(2)) inhibitors blocked PA-induced hepatocyte death, suggesting an important role for PLA(2) and its product lysophosphatidylcholine (LPC). Small interfering RNA for Ca(2+)-independent phospholipase A(2) (iPLA(2)) inhibited the lipoapoptosis of hepatocytes. PA increased LPC content, which was reversed by iPLA(2) inhibitors. Pertussis toxin or dominant-negative Galpha(i) mutant inhibited hepatocyte death by PA or LPC acting through G-protein-coupled receptor (GPCR)/Galpha(i). PA decreased cardiolipin content and induced mitochondrial potential loss and cytochrome c translocation. Oleic acid inhibited PA-induced hepatocyte death by diverting PA to triglyceride and decreasing LPC content, suggesting that FFAs lead to steatosis or lipoapoptosis according to the abundance of saturated/unsaturated FFAs. LPC administration induced hepatitis in vivo. LPC content was increased in the liver specimens from NASH patients. These results demonstrate that LPC is a death effector in the lipoapoptosis of hepatocytes and suggest potential therapeutic values of PLA(2) inhibitors or GPCR/Galpha(i) inhibitors in NASH.     

Pentoxifylline with metformin treatment improves biochemical parameters in patients with nonalcoholic steatohepatitis

BackgroundThe progression of the nonalcoholic fatty liver disease to nonalcoholic steatohepatitis (NASH) is multifactorial, and there is still a lack of approved medications for its treatment. The study aimed to evaluate the impact of combined treatment with Pentoxifylline and Metformin on biochemical parameters in patients with Nash. Setting: Outpatient hepatology clinic.MethodsA prospective trial was conducted. The first cohort included patients with biopsy-proven Nash, while the second cohort consisted of patients with biopsy-confirmed NAFLD. Blood tests were checked at baseline and every three months. Pentoxifylline at a dosage of 400 mg t.i.d. and Metformin at the dosage of 500 mg t.i.d. were introduced for six months in Nash group. The impact of the treatment was assessed based on biochemical results after combined treatment with low-cost medications.ResultsAll 33 Nash patients completed 24 weeks of treatment. We observed significant improvement (p<0.05) of median values after treatment for the following parameters: serum uric acid levels decreased by 51.0 mmol/L, calcium decreased for 0.27 mmoL/L, magnesium showed an increase of 0.11 mmoL/L. Insulin resistance improved as a reduction of HOMA - IR by 1.3 was detected. A significant decrease of median in liver enzymes, alanine aminotransferase, aspartate aminotransferase and gamma-glutamyltransferase by 24.0 U/L, 9.1 U/L, 10.8 U/L respectively, was noted.ConclusionsPentoxifylline and Metformin may provide possible treatment option in Nash. Some new potential benefit of the therapy in improving liver function whilst decreasing cardiovascular risk was perceived.     

蚕蛹油对大鼠非酒精性脂肪肝形成的影响

目的观察蚕蛹油对高脂大鼠模型的非酒精性脂肪肝形成的影响。方法SD大鼠100只,雌雄各半,按体重并参考血脂水平随机分为9组:空白对照组,高脂对照组,预防低剂量组,预防中剂量组,预防高剂量组,治疗低剂量组,治疗中剂量组,治疗高剂量组,及阳性对照组(月见草油),分别喂饲各种饲料。于第11周处死大鼠,检测肝脏的肝重指数和肝脏甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、丙二醛(malondialde-hyde,MDA)水平。结果实验11周末,预防组、治疗组和阳性对照组大鼠的肝重指数,肝脏TG、TC及MDA水平均明显低于高脂对照组(P<0.05),并具有剂量依赖性。结论蚕蛹油可通过调整脂质代谢,具有十分显著的预防和治疗非酒精性脂肪肝形成的效果,优于月见草油。     

Cholesterol-lowering drugs cause dissolution of cholesterol crystals and disperse Kupffer cell crown-like structures during resolution of NASH

Cholesterol crystals form within hepatocyte lipid droplets in human and experimental nonalcoholic steatohepatitis (NASH) and are the focus of crown-like structures (CLSs) of activated Kupffer cells (KCs). Obese, diabetic Alms1 mutant (foz/foz) mice were a fed high-fat (23%) diet containing 0.2% cholesterol for 16 weeks and then assigned to four intervention groups for 8 weeks: a) vehicle control, b) ezetimibe (5 mg/kg/day), c) atorvastatin (20 mg/kg/day), or d) ezetimibe and atorvastatin. Livers of vehicle-treated mice developed fibrosing NASH with abundant cholesterol crystallization within lipid droplets calculated to extend over 3.3% (SD, 2.2%) of liver surface area. Hepatocyte lipid droplets with prominent cholesterol crystallization were surrounded by TNFα-positive (activated) KCs forming CLSs (≥3 per high-power field). KCs that formed CLSs stained positive for NLRP3, implicating activation of the NLRP3 inflammasome in response to cholesterol crystals. In contrast, foz/foz mice treated with ezetimibe and atorvastatin showed near-complete resolution of cholesterol crystals [0.01% (SD, 0.02%) of surface area] and CLSs (0 per high-power field), with amelioration of fibrotic NASH. Ezetimibe or atorvastatin alone had intermediate effects on cholesterol crystallization, CLSs, and NASH. These findings are consistent with a causative link between exposure of hepatocytes and KCs to cholesterol crystals and with the development of NASH possibly mediated by NLRP3 activation.     

Low hepatic manganese concentrations in patients with hepatic steatosis – A cohort study of copper,iron and manganese in liver biopsies

Background and aimsHepatic steatosis is the most common histopathological finding on liver biopsy, with the most prevalent etiology being NAFLD. The pathogenesis of hepatic steatosis and NAFLD is multifactorial, however, studies on the importance of manganese in NAFLD are limited. We aimed to study hepatic manganese content, and other trace elements, in relation to hepatic steatosis in patients with chronic liver diseases of different etiology, mainly NAFLD.MethodsPatients with chronically elevated liver function tests underwent a diagnostic work-up, including routine blood tests and two liver biopsies. One of the biopsies was sent for histopathological evaluation, and the other for ultra-trace elemental determinations. Steatosis was graded using conventional histopathological methodology, and fat content was also quantitated in biopsy samples by measuring the steatotic area of the section using stereological point counting (SPC). Ultra-trace elemental analysis was utilized for determining manganese, iron, and copper using inductively coupled plasma sector field mass spectrometry (ICP-SFMS).Results76 patients were included in the study. Hepatic manganese concentrations in patients with steatosis were lower than in patients without hepatic steatosis (3.8 ± 1.1 vs. 6.4 ± 1.8, P < 0.001). Similar results were seen for blood manganese levels and hepatic steatosis. We found a strong inverse correlation between steatosis grade and hepatic manganese content (ρ=-0.743, P < 0.001). Also, low levels of manganese independently predicted the presence of steatosis (aOR 0.07 [95%CI: 0.01−0.63]).ConclusionPatients with NAFLD, or other CLD and concomitant hepatic steatosis, showed lower levels of hepatic manganese content with increasing grade of steatosis.     

血管紧张素Ⅱ受体拮抗剂对非酒精性脂肪性肝炎治疗作用的研究

目的 研究血管紧张素Ⅱ受体拮抗剂(洛沙坦)对非酒精性脂肪性肝炎(NASH)的治疗作用.方法 采用自身对照的方法,30例同时患有NASH与高血压的患者给予洛沙坦(50 mg/d)治疗,持续1年.结果 治疗后,患者血清TGF-β1、ALT及铁蛋白水平显著下降,同时病理学检查证实20例患者(67％)出现肝脏炎性坏死的减轻、15例患者(75％比例?)出现铁沉积的消失.此外,在治疗的过程中没有发现任何副作用.结论 本研究提示血管紧张素Ⅱ受体拮抗剂可能对NASH具有治疗作用.     

Polyunsaturated fat in the methionine-choline-deficient diet influences hepatic inflammation but not hepatocellular injury

Methionine-choline-deficient (MCD) diets that cause steatohepatitis in rodents are typically enriched in polyunsaturated fat. To determine whether the fat composition of the MCD formula influences the development of liver disease, we manufactured custom MCD formulas with fats ranging in PUFA content from 2% to 59% and tested them for their ability to induce steatohepatitis. All modified-fat MCD formulas caused identical degrees of hepatic steatosis and resulted in a similar distribution of fat within individual hepatic lipid compartments. The fatty acid composition of hepatic lipids, however, reflected the fat composition of the diet. Mice fed a PUFA-rich MCD formula showed extensive hepatic lipid peroxidation, induction of proinflammatory genes, and histologic inflammation. When PUFAs were substituted with more saturated fats, lipid peroxidation, proinflammatory gene induction, and hepatic inflammation all declined significantly. Despite the close relationship between PUFAs and hepatic inflammation in mice fed MCD formulas, dietary fat had no impact on MCD-mediated damage to hepatocytes. Indeed, histologic apoptosis and serum alanine aminotransferase levels were comparable in all MCD-fed mice regardless of dietary fat content. Together, these results indicate that dietary PUFAs promote hepatic inflammation but not hepatotoxicity in the MCD model of liver disease. These findings emphasize that individual dietary nutrients can make specific contributions to steatohepatitis.     

Cholesterol crystallization within hepatocyte lipid droplets and its role in murine NASH

We recently reported that cholesterol crystals form in hepatocyte lipid droplets (LDs) in human and experimental nonalcoholic steatohepatitis. Herein, we assigned WT C57BL/6J mice to a high-fat (15%) diet for 6 months, supplemented with 0%, 0.25%, 0.5%, 0.75%, or 1% dietary cholesterol. Increasing dietary cholesterol led to cholesterol loading of the liver, but not of adipose tissue, resulting in fibrosing steatohepatitis at a dietary cholesterol concentration of ≥0.5%, whereas mice on lower-cholesterol diets developed only simple steatosis. Hepatic cholesterol crystals and crown-like structures also developed at a dietary cholesterol concentration ≥0.5%. Crown-like structures consisted of activated Kupffer cells (KCs) staining positive for NLRP3 and activated caspase 1, which surrounded and processed cholesterol crystal-containing remnant LDs of dead hepatocytes. The KCs processed LDs at the center of crown-like structures in the extracellular space by lysosomal enzymes, ultimately transforming into lipid-laden foam cells. When HepG2 cells were exposed to LDL cholesterol, they developed cholesterol crystals in LD membranes, which caused activation of THP1 cells (macrophages) grown in coculture; upregulation of TNF-alpha, NLRP3, and interleukin 1beta (IL1β) mRNA; and secretion of IL-1beta. In conclusion, cholesterol crystals form on the LD membrane of hepatocytes and cause activation and cholesterol loading of KCs that surround and process these LDs by lysosomal enzymes.     

Calpain-mediated proteolytic production of free amino acids in vascular endothelial cells augments obesity-induced hepatic steatosis

Free amino acids that accumulate in the plasma of patients with diabetes and obesity influence lipid metabolism and protein synthesis in the liver. The stress-inducible intracellular protease calpain proteolyzes various substrates in vascular endothelial cells (ECs), although its contribution to the supply of free amino acids in the liver microenvironment remains enigmatic. In the present study, we showed that calpains are associated with free amino acid production in cultured ECs. Furthermore, conditioned media derived from calpain-activated ECs facilitated the phosphorylation of ribosomal protein S6 kinase (S6K) and de novo lipogenesis in hepatocytes, which were abolished by the amino acid transporter inhibitor, JPH203, and the mammalian target of rapamycin complex 1 inhibitor, rapamycin. Meanwhile, calpain-overexpressing capillary-like ECs were observed in the livers of high-fat diet–fed mice. Conditional KO of EC/hematopoietic Capns1, which encodes a calpain regulatory subunit, diminished levels of branched-chain amino acids in the hepatic microenvironment without altering plasma amino acid levels. Concomitantly, conditional KO of Capns1 mitigated hepatic steatosis without normalizing body weight and the plasma lipoprotein profile in an amino acid transporter–dependent manner. Mice with targeted Capns1 KO exhibited reduced phosphorylation of S6K and maturation of lipogenic factor sterol regulatory element–binding protein 1 in hepatocytes. Finally, we show that bone marrow transplantation negated the contribution of hematopoietic calpain systems. We conclude that overactivation of calpain systems may be responsible for the production of free amino acids in ECs, which may be sufficient to potentiate S6K/sterol regulatory element–binding protein 1–induced lipogenesis in surrounding hepatocytes.