Lowes K N, Croager E J, Abraham L J, Olynyk J K, Yeoh G C T
Biochemistry and Molecular Biology, School of Biomedical and Chemical Sciences, The University of Western Australia, Crawley 6009, Australia.
Gut. 2003 Sep;52(9):1327-32. doi: 10.1136/gut.52.9.1327.
Bipotent liver progenitor (oval) cells with the ability to differentiate into hepatocytes and biliary epithelium have recently been identified in human subjects with hepatitis C. Animal studies suggest that members of the tumour necrosis factor family, including lymphotoxin beta (LT-beta), regulate oval cell proliferation in liver disease, but its role in human liver disease is unclear.
This study seeks to establish a role for LT-beta in hepatitis C related liver injury and to provide evidence that its increased expression is related to the presence of oval cells.
Liver biopsy specimens were obtained from patients with chronic hepatitis C virus (HCV) infection (n=20). Control liver samples (n=5) were obtained from liver resection or transplant surgery. LT-beta expression in liver biopsy specimens was studied using quantitative real time polymerase chain reaction and immunohistochemistry.
LT-beta mRNA levels were similar in control and HCV liver in the absence of fibrosis. In subjects with portal fibrosis, LT-beta mRNA levels were elevated 2.2-fold over control liver levels (p=0.04). In subjects with bridging fibrosis, LT-beta mRNA levels increased 4.4-fold over control liver levels (p=0.02). LT-beta mRNA levels in subjects with established cirrhosis were increased 3.3-fold compared with controls and 2.6-fold compared with mild liver damage (p=0.02). Immunohistochemical analysis established that LT-beta was expressed by oval cells, inflammatory cells, and small portal hepatocytes.
In chronic HCV infection, LT-beta expression is observed in multiple hepatic cell types, including oval cells. LT-beta expression is significantly increased when fibrosis or cirrhosis is present, suggesting a role for LT-beta in the pathogenesis of chronic hepatitis C and a possible role in oval cell mediated liver regeneration.
最近在丙型肝炎患者体内发现了具有分化为肝细胞和胆管上皮细胞能力的双能肝祖(卵圆)细胞。动物研究表明,肿瘤坏死因子家族成员,包括淋巴毒素β(LT-β),在肝病中调节卵圆细胞增殖,但其在人类肝病中的作用尚不清楚。
本研究旨在确定LT-β在丙型肝炎相关肝损伤中的作用,并提供证据表明其表达增加与卵圆细胞的存在有关。
从慢性丙型肝炎病毒(HCV)感染患者(n = 20)获取肝活检标本。对照肝样本(n = 5)取自肝切除或移植手术。使用定量实时聚合酶链反应和免疫组织化学研究肝活检标本中LT-β的表达。
在无纤维化的对照肝脏和HCV肝脏中,LT-β mRNA水平相似。在有门脉纤维化的受试者中,LT-β mRNA水平比对照肝脏水平升高2.2倍(p = 0.04)。在有桥接纤维化的受试者中,LT-β mRNA水平比对照肝脏水平增加4.4倍(p = 0.02)。与对照相比,已确诊肝硬化的受试者中LT-β mRNA水平增加3.3倍,与轻度肝损伤相比增加2.6倍(p = 0.02)。免疫组织化学分析证实,LT-β由卵圆细胞、炎性细胞和小的门脉区肝细胞表达。
在慢性HCV感染中,在包括卵圆细胞在内的多种肝细胞类型中观察到LT-β表达。当存在纤维化或肝硬化时,LT-β表达显著增加,提示LT-β在慢性丙型肝炎发病机制中起作用,并且在卵圆细胞介导的肝再生中可能起作用。