Oz Helieh S, Im Hee-Jeong, Chen Theresa S, de Villiers Willem J S, McClain Craig J
Department of Internal Medicine, Digestive Diseases and Nutrition, University of Kentucky Medical Center, Lexington, KY 40536, USA.
J Biochem Mol Toxicol. 2006;20(1):39-47. doi: 10.1002/jbt.20109.
Nonalcoholic fatty liver (NAFL) and steatohepatitis (NASH) may accompany obesity, diabetes, parenteral nutrition, jejeuno-ileal bypass, and chronic inflammatory bowel disease. Currently there is no FDA approved and effective therapy available. We investigated the potential efficacy of those agents that stimulate glutathione (GSH) biosynthesis on the development of experimental steatohepatitis. Rats fed (ad libitum) amino acid based methionine-choline deficient (MCD) diet were further gavaged with (1) vehicle (MCD), (2) S-adenosylmethionine (SAMe), or (3) 2(RS)-n-propylthiazolidine-4(R)-carboxylic acid (PTCA).
MCD diet significantly reduced hematocrit, and this abnormality improved in the treated groups (p < 0.01). Serum transaminases were considerably elevated (AST: 5.8-fold; ALT: 3.22-fold) in MCD rats. However, administration of GSH-enhancing agents significantly suppressed these abnormal enzyme activities. MCD rats developed severe liver pathology manifested by fatty degeneration, inflammation, and necrosis, which significantly improved with therapy. Blood levels of GSH were significantly depleted in MCD rats but normalized in the treated groups. Finally, RT-PCR measurements showed a significant upregulation of genes involved in tissue remodeling and fibrosis (matrix metalloproteinases, collagen-alpha1), suppressor of cytokines signaling1, and the inflammatory cytokines (IL-1beta, IL-6, TNF-alpha, and TGF-beta) in the livers of rats fed MCD. GSH-enhancing therapies significantly attenuated the expression of deleterious proinflammatory and fibrogenic genes in this dietary model. This is the first report that oral administration of SAMe and PTCA provide protection against liver injury in this model and suggests therapeutic applications of these compounds in NASH patients.
非酒精性脂肪肝(NAFL)和脂肪性肝炎(NASH)可能伴随肥胖、糖尿病、肠外营养、空肠回肠旁路术以及慢性炎症性肠病。目前尚无美国食品药品监督管理局(FDA)批准的有效疗法。我们研究了那些刺激谷胱甘肽(GSH)生物合成的药物对实验性脂肪性肝炎发展的潜在疗效。给自由采食基于氨基酸的蛋氨酸 - 胆碱缺乏(MCD)饮食的大鼠进一步灌胃给予:(1)赋形剂(MCD组),(2)S - 腺苷甲硫氨酸(SAMe),或(3)2(RS) - 正丙基噻唑烷 - 4(R) - 羧酸(PTCA)。
MCD饮食显著降低了血细胞比容,而在治疗组中这种异常情况得到改善(p < 0.01)。MCD大鼠的血清转氨酶显著升高(天冬氨酸转氨酶:5.8倍;丙氨酸转氨酶:3.22倍)。然而,给予增强GSH的药物显著抑制了这些异常酶活性。MCD大鼠出现了以脂肪变性、炎症和坏死为特征的严重肝脏病理改变,治疗后显著改善。MCD大鼠的血液GSH水平显著降低,但在治疗组中恢复正常。最后,逆转录 - 聚合酶链反应(RT - PCR)测量显示,在喂食MCD饮食的大鼠肝脏中,参与组织重塑和纤维化的基因(基质金属蛋白酶、胶原 - α1)、细胞因子信号传导抑制因子1以及炎症细胞因子(白细胞介素 - 1β、白细胞介素 - 6、肿瘤坏死因子 - α和转化生长因子 - β)显著上调。在这个饮食模型中,增强GSH的疗法显著减弱了有害促炎和促纤维化基因的表达。这是第一份关于口服SAMe和PTCA在该模型中对肝损伤具有保护作用的报告,并提示了这些化合物在NASH患者中的治疗应用。