Hori Y, Takeyama Y, Ueda T, Shinkai M, Takase K, Kuroda Y
First Department of Surgery, Kobe University School of Medicine, Kobe, Japan.
Surgery. 2000 Jun;127(6):641-9. doi: 10.1067/msy.2000.105499.
The mechanism of acute pancreatitis-induced hepatocellular injury is unclear. We have observed hepatocyte apoptosis in rat acute necrotizing pancreatitis. These studies were designed to determine the mediator(s) responsible for hepatocyte apoptosis and to clarify the significance of macrophages as its source.
A rat sodium deoxycholate-induced pancreatitis model was used. Immunohistochemical studies for apoptosis-inducing mediators on hepatocytes were examined in the liver and on the peritoneal macrophages. The levels of transforming growth factor-beta1 (TGF-beta1) were also evaluated quantitatively with an enzyme-linked immunosorbent assay. Induction of apoptosis on the hepatocytes was evaluated by in situ nick-end labeling and tissue DNA fragmentation enzyme-linked immunosorbent assay. Finally, the effects of TGF-beta1 neutralization and macrophage depletion were examined.
In the liver and the peritoneal macrophages, strong expression of TGF-beta1 was detected early in the course of pancreatitis. In sodium deoxycholate-induced pancreatitis, the levels of TGF-beta1 were also elevated in the plasma (9.2 +/- 0.8 ng/mL), in the pancreatitis-associated ascitic fluid (11.5 +/- 0.6 ng/mL), and in the liver homogenate (2.8 +/- 0.3 ng/g of liver tissue). Moreover, the amount of fragmented DNA of the liver with pancreatitis was 290% +/- 20% of that with a sham operation and serum alanine aminotransferase levels elevated to 248.2 +/- 67.0 IU/L. TGF-beta1 neutralization partly blocked the positive labeling on the nuclei of the hepatocytes, the elevation of the amounts of fragmented DNA (205% +/- 10% of sham operation), and the serum alanine aminotransferase level (144.2 +/- 14.9 IU/L). On the other hand, the macrophage depletion caused a marked decrease in the TGF-beta1 protein level in the plasma (4.8 +/- 1.2 ng/mL) or in the pancreatitis-associated ascitic fluid (8.0 +/- 1.0 ng/mL). Moreover, the macrophage depletion completely inhibited the elevation of the TGF-beta1 protein level in the liver homogenate (1.5 +/- 0.4 ng/g of liver tissue), and thereafter decreased the amounts of the positive labeling on the nuclei of the hepatocytes and decreased the amount of fragmented DNA (120% +/- 18% of sham operation) and the serum alanine aminotransferase elevation (119.2 +/- 24.2 IU/L).
In a model of sodium deoxycholate-induced pancreatitis, macrophages are responsible for pancreatitis-induced hepatocellular injury by means of apoptosis, and macrophage-derived TGF-beta1 is one of the major factors inducing the hepatocyte apoptosis.
急性胰腺炎所致肝细胞损伤的机制尚不清楚。我们在大鼠急性坏死性胰腺炎中观察到了肝细胞凋亡。本研究旨在确定导致肝细胞凋亡的介质,并阐明巨噬细胞作为其来源的意义。
采用大鼠脱氧胆酸钠诱导的胰腺炎模型。对肝脏和腹腔巨噬细胞中的肝细胞凋亡诱导介质进行免疫组织化学研究。还采用酶联免疫吸附测定法定量评估转化生长因子β1(TGF-β1)的水平。通过原位缺口末端标记和组织DNA片段化酶联免疫吸附测定法评估肝细胞凋亡的诱导情况。最后,检测TGF-β1中和及巨噬细胞清除的效果。
在胰腺炎病程早期,在肝脏和腹腔巨噬细胞中检测到TGF-β1的强表达。在脱氧胆酸钠诱导的胰腺炎中,血浆(9.2±0.8 ng/mL)、胰腺炎相关腹水(11.5±0.6 ng/mL)和肝脏匀浆(2.8±0.3 ng/g肝组织)中TGF-β1水平也升高。此外,胰腺炎大鼠肝脏的DNA片段量是假手术大鼠的290%±20%,血清丙氨酸氨基转移酶水平升高至248.2±67.0 IU/L。TGF-β1中和部分阻断了肝细胞细胞核上的阳性标记、DNA片段量的升高(假手术的205%±10%)以及血清丙氨酸氨基转移酶水平(144.2±14.9 IU/L)。另一方面,巨噬细胞清除导致血浆(4.8±1.2 ng/mL)或胰腺炎相关腹水中TGF-β1蛋白水平显著降低(8.0±1.0 ng/mL)。此外,巨噬细胞清除完全抑制了肝脏匀浆中TGF-β1蛋白水平的升高(1.5±0.4 ng/g肝组织),随后降低了肝细胞细胞核上的阳性标记量,减少了DNA片段量(假手术的120%±18%)以及血清丙氨酸氨基转移酶的升高(119.2±24.2 IU/L)。
在脱氧胆酸钠诱导的胰腺炎模型中,巨噬细胞通过凋亡导致胰腺炎所致肝细胞损伤,巨噬细胞源性TGF-β1是诱导肝细胞凋亡的主要因素之一。