Namikawa Chikako, Shu-Ping Zhang, Vyselaar John Raynor, Nozaki Yasuko, Nemoto Yoshihisa, Ono Masafumi, Akisawa Naoaki, Saibara Toshiji, Hiroi Makoto, Enzan Hideaki, Onishi Saburo
Department of Gastroenterology and Hepatology, Kochi Medical School, Nankoku 783-8505 Japan.
J Hepatol. 2004 May;40(5):781-6. doi: 10.1016/j.jhep.2004.01.028.
BACKGROUND/AIMS: The pathogenesis of non-alcoholic steatohepatitis (NASH) is poorly understood. The aim of this study was to examine genetic influences on NASH pathogenesis.
Blood samples from 63 patients with biopsy-proven NASH and 150 healthy controls were analyzed by the polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Two functional polymorphisms were studied: the -493 G/T polymorphism in the promoter of microsomal triglyceride transfer protein (MTP) and the 1183 T/C polymorphism in the mitochondrial targeting sequence of manganese superoxide dismutase (MnSOD).
NASH patients had a much higher incidence of the MTP gene G allele (P=0.001) and of the G/G genotype (P=0.002) compared to the controls. Fat occupied more area in liver lobules and the stage of NASH was advanced in patients with the G/G-genotype than in patients with G/T-genotype (P=0.04). NASH patients also had a higher incidence of the MnSOD T/T genotype (P=0.016).
The G allele in the MTP promoter leads to decreased MTP transcription, less export of triglyceride from hepatocytes, and greater intracellular triglyceride accumulation. The T allele in MnSOD mitochondrial targeting sequence leads to less transport of MnSOD to the mitochondria. Therefore, functional polymorphisms in MTP and MnSOD may be involved in determining susceptibility of NASH.
背景/目的:非酒精性脂肪性肝炎(NASH)的发病机制尚不清楚。本研究旨在探讨基因对NASH发病机制的影响。
采用聚合酶链反应(PCR)和限制性片段长度多态性(RFLP)分析63例经活检证实的NASH患者和150例健康对照者的血样。研究了两个功能性多态性:微粒体甘油三酯转移蛋白(MTP)启动子中的-493G/T多态性和锰超氧化物歧化酶(MnSOD)线粒体靶向序列中的1183T/C多态性。
与对照组相比,NASH患者MTP基因G等位基因(P=0.001)和G/G基因型(P=0.002)的发生率要高得多。G/G基因型患者肝小叶内脂肪占据的面积更大,NASH分期比G/T基因型患者更严重(P=0.04)。NASH患者MnSOD T/T基因型的发生率也更高(P=0.016)。
MTP启动子中的G等位基因导致MTP转录减少,肝细胞内甘油三酯输出减少,细胞内甘油三酯蓄积增加。MnSOD线粒体靶向序列中的T等位基因导致MnSOD向线粒体的转运减少。因此,MTP和MnSOD中的功能性多态性可能参与决定NASH的易感性。