Järveläinen H A, Lukkari T A, Heinaro S, Sippel H, Lindros K O
National Public Health Institute, Alcohol Research Center, Helsinki, Finland.
J Hepatol. 2001 Jul;35(1):46-52. doi: 10.1016/s0168-8278(01)00050-2.
BACKGROUND/AIMS: Females are generally considered to be more susceptible to alcohol-induced liver injury than males. To elucidate whether gonadal hormones are involved, female rats were chronically treated with ethanol and with an antiestrogen.
Ethanol was administered in a low-carbohydrate liquid diet. Estrogen action was blocked by daily intubation of toremifene, a non-hepatotoxic second generation estrogen receptor antagonist.
The female rats consuming intoxicating amounts of ethanol diet for 6 weeks developed massive microvesicular/macrovesicular steatosis, frequent inflammatory foci and spotty necrosis. Serum alanine aminotransferase increased 7-fold. Toremifene treatment did not affect steatosis, but significantly reduced inflammation and necrosis. Ethanol increased the expression of CD14 and tumor necrosis factor- (TNF) alpha mRNA and also the production of TNF-alpha by isolated Kupffer cells, but toremifene had no significant counteracting effect. However, toremifene significantly alleviated both ethanol induction of the pro-oxidant enzyme CYP2E1 and ethanol reduction of the oxidant-protective enzyme Se-glutathione peroxidase.
The partial protection by toremifene against ethanol-induced liver lesions suggests a pathogenic contribution of estrogens, possibly associated with an oxygen radical mediated mechanism.
背景/目的:一般认为,女性比男性更容易受到酒精性肝损伤。为了阐明性腺激素是否参与其中,对雌性大鼠进行了乙醇和抗雌激素的长期治疗。
在低碳水化合物液体饮食中给予乙醇。通过每日灌胃托瑞米芬(一种无肝毒性的第二代雌激素受体拮抗剂)来阻断雌激素作用。
摄入致醉量乙醇饮食6周的雌性大鼠出现大量微泡/大泡性脂肪变性、频繁的炎症灶和点状坏死。血清丙氨酸转氨酶升高7倍。托瑞米芬治疗不影响脂肪变性,但显著减轻炎症和坏死。乙醇增加了CD14和肿瘤坏死因子-α(TNF-α)mRNA的表达,也增加了分离的库普弗细胞产生的TNF-α,但托瑞米芬没有显著的拮抗作用。然而托瑞米芬显著减轻了乙醇对促氧化酶CYP2E1的诱导以及乙醇对抗氧化保护酶硒谷胱甘肽过氧化物酶的降低作用。
托瑞米芬对乙醇诱导的肝脏病变具有部分保护作用,提示雌激素具有致病作用,可能与氧自由基介导的机制有关。