Kiani Samira, Ebrahimkhani Mohammad R, Shariftabrizi Ahmad, Doratotaj Behzad, Payabvash Seyedmehdi, Riazi Kiarash, Dehghani Mehdi, Honar Hooman, Karoon Alaleh, Amanlou Massoud, Tavangar Seyed M, Dehpour Ahmad R
Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
J Gastroenterol Hepatol. 2007 Mar;22(3):406-13. doi: 10.1111/j.1440-1746.2006.04260.x.
Following bile duct ligation (BDL) endogenous opioids accumulate in plasma and play a role in the pathophysiology and manifestation of cholestasis. Evidence of centrally mediated induction of liver injury by exogenous opioid agonist administration, prompts the question of whether opioid receptor blockade by naltrexone can affect cholestasis-induced liver injury.
Cholestasis was induced by BDL and cholestatic and sham-operated rats received either naltrexone or saline for 7 consecutive days. On the 7th day, liver samples were collected for determining matrix metalloproteinase-2 (MMP-2) activity, S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) content and blood samples were obtained for measuring plasma nitrite/nitrate and liver enzyme activities.
Naltrexone-treated BDL animals had a significant reduction in plasma enzyme activity and nitrite/nitrate level. Liver SAM : SAH ratio and SAM level improved by naltrexone treatment in cholestatic animals compared to saline-treated BDL ones. Naltrexone treatment in BDL rats led to a decrease in the level of liver MMP-2 activity, which had already increased during cholestasis.
Opioid receptor blockade improved the degree of liver injury in cholestasis, as assessed by plasma enzyme and liver MMP-2 activities. The beneficial effect of naltrexone may be due to its ability to increase liver SAM level and restore the SAM : SAH ratio.
胆管结扎(BDL)后,内源性阿片类物质在血浆中蓄积,并在胆汁淤积的病理生理学和表现中发挥作用。外源性阿片类激动剂给药导致肝脏损伤由中枢介导的证据,引发了纳曲酮阻断阿片受体是否会影响胆汁淤积性肝损伤的问题。
通过BDL诱导胆汁淤积,胆管结扎和假手术大鼠连续7天接受纳曲酮或生理盐水治疗。在第7天,采集肝脏样本以测定基质金属蛋白酶-2(MMP-2)活性、S-腺苷甲硫氨酸(SAM)和S-腺苷同型半胱氨酸(SAH)含量,并采集血样以测量血浆亚硝酸盐/硝酸盐和肝酶活性。
纳曲酮治疗的BDL动物血浆酶活性和亚硝酸盐/硝酸盐水平显著降低。与生理盐水治疗的BDL动物相比,纳曲酮治疗可改善胆汁淤积动物肝脏的SAM:SAH比值和SAM水平。BDL大鼠接受纳曲酮治疗后,肝脏MMP-2活性水平降低,而在胆汁淤积期间该活性已经升高。
通过血浆酶和肝脏MMP-2活性评估,阿片受体阻断改善了胆汁淤积性肝损伤的程度。纳曲酮的有益作用可能归因于其增加肝脏SAM水平和恢复SAM:SAH比值的能力。