Kojima Hideyuki, Sakurai Shinya, Uemura Masahito, Fukui Hiroshi, Morimoto Hiroyo, Tamagawa Yasuhiro
Third Department of Internal Medicine, Nara Medical University, Nara, Japan.
Alcohol Clin Exp Res. 2007 Jan;31(1 Suppl):S61-6. doi: 10.1111/j.1530-0277.2006.00288.x.
Oxidative stress plays a major role in the pathogenesis of nonalcoholic steatohepatitis (NASH). Mitochondrial abnormality may be associated with the onset and progression of NASH via excessive formation of mitochondrial reactive oxygen species. This study aimed to investigate the role of mitochondrial abnormality in NASH in relation to oxidative stress.
Twenty-six patients with NASH, 11 with simple steatosis, and 10 healthy volunteers underwent clinico-pathological analysis. The liver/spleen ratio, an index of the hepatic fat content, was evaluated with computed tomography. Plasma glutathione levels were measured as an antioxidative marker, and the urinary 8-isoprostane levels and 3-nitrotyrosine staining in the liver as an oxidative stress marker. Mitochondrial abnormality was estimated by serum levels of mitochondria aspartate transaminase (mAST) and the mitochondrial staining in the liver.
Urinary 8-isoprostane levels were higher in NASH than in the healthy volunteers, whereas plasma glutathione levels were similar in the 2 groups. In NASH, urinary 8-isoprostane levels positively correlated with alanine transaminase levels and negatively with the liver/spleen ratio. The 3-nitrotyrosine staining was more advanced in simple steatosis and NASH than in the normal liver, but was similar in simple steatosis and NASH. In contrast to the normal mAST levels in the healthy volunteers and simple steatosis, serum mAST levels were elevated in one-fourth of the NASH patients and positively correlated with urinary 8-isoprostane levels in NASH. Most cases of NASH showed diffuse or focal but intense mitochondrial staining in the liver in contrast to scattered staining in simple steatosis.
Our present study demonstrated that in NASH, the enhanced oxidative stress may be associated with hepatic inflammation and the degree of fat infiltration in the liver. However, simple steatosis and NASH were both exposed to oxidative stress, while NASH alone was associated with mitochondrial abnormality. These findings indicate that mitochondrial abnormality may play a role in the onset and progression of NASH in correlation with oxidative stress.
氧化应激在非酒精性脂肪性肝炎(NASH)的发病机制中起主要作用。线粒体异常可能通过线粒体活性氧的过度形成与NASH的发生和发展相关。本研究旨在探讨线粒体异常在NASH中与氧化应激相关的作用。
对26例NASH患者、11例单纯性脂肪变性患者和10名健康志愿者进行临床病理分析。用计算机断层扫描评估肝脏/脾脏比值,作为肝脏脂肪含量的指标。测量血浆谷胱甘肽水平作为抗氧化标志物,测量尿8-异前列腺素水平以及肝脏中3-硝基酪氨酸染色作为氧化应激标志物。通过血清线粒体天冬氨酸转氨酶(mAST)水平和肝脏中线粒体染色评估线粒体异常。
NASH患者尿8-异前列腺素水平高于健康志愿者,而两组血浆谷胱甘肽水平相似。在NASH中,尿8-异前列腺素水平与丙氨酸转氨酶水平呈正相关,与肝脏/脾脏比值呈负相关。单纯性脂肪变性和NASH中的3-硝基酪氨酸染色比正常肝脏更明显,但单纯性脂肪变性和NASH中的染色相似。与健康志愿者和单纯性脂肪变性患者的正常mAST水平相反,四分之一的NASH患者血清mAST水平升高,且与NASH患者尿8-异前列腺素水平呈正相关。与单纯性脂肪变性中散在的染色相比,大多数NASH病例在肝脏中表现为弥漫性或局灶性但强烈的线粒体染色。
我们目前的研究表明,在NASH中,氧化应激增强可能与肝脏炎症和肝脏脂肪浸润程度相关。然而,单纯性脂肪变性和NASH都受到氧化应激的影响,而只有NASH与线粒体异常相关。这些发现表明,线粒体异常可能在NASH的发生和发展中与氧化应激相关发挥作用。