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慢性乙型和丙型肝炎患者肝脏氧化性DNA损伤的比较

Comparison of hepatic oxidative DNA damage in patients with chronic hepatitis B and C.

作者信息

Fujita N, Sugimoto R, Ma N, Tanaka H, Iwasa M, Kobayashi Y, Kawanishi S, Watanabe S, Kaito M, Takei Y

机构信息

Department of Gastroenterology and Hepatology, Division of Clinical Medicine and Biomedical Science, Institute of Medical Sciences, Mie University Graduate School of Medicine, Mie, Japan.

出版信息

J Viral Hepat. 2008 Jul;15(7):498-507. doi: 10.1111/j.1365-2893.2008.00972.x. Epub 2008 Mar 6.

Abstract

8-Hydroxydeoxyguanosine (8-OHdG) is a promutagenic DNA lesion produced by hydroxyl radicals and is recognized as a useful marker in estimating DNA damage induced by oxidative stress. The aim of this study was to clarify the clinical significance of hepatic 8-OHdG levels in patients with chronic viral hepatitis. Hepatic 8-OHdG accumulation was investigated in patients with chronic hepatitis C (CH-C) (n = 77) and chronic hepatitis B (CH-B) (n = 34) by immunohistochemical staining of liver biopsy samples. 8-OHdG positive hepatocytes were significantly higher in patients with CH-C compared to CH-B (median 55.0 vs 18.8 cells/10(5) mum(2), P < 0.0001). The number of positive hepatocytes significantly increased with the elevation of serum aminotransferase levels, especially in CH-C patients (8-OHdG vs alanine aminotransferase (ALT)/aspartate aminotrasferase (AST) were r = 0.738/0.720 in CH-C and 0.506/0.515 in CH-B). 8-OHdG reactivity was strongly correlated with body and hepatic iron storage markers in CH-C (vs serum ferritin, r = 0.615; vs hepatic total iron score, r = 0.520; vs hepatic hepcidin mRNA levels, r = 0.571), although it was related to serum HBV-DNA titers (r = 0.540) and age of patients (r = -0.559) in CH-B. These results indicate that hepatic oxidative DNA damage is common in chronic viral hepatitis, in particular chronic HCV-infected patients, suggesting a possible link between chronic hepatic inflammation and hepatocarcinogenesis. The strong positive correlation between hepatic DNA damage and iron overload suggests that iron content is one of the most likely mediators of hepatic oxidative stress and iron reduction may be beneficial to reduce the incidence of hepatic cancer in CH-C patients.

摘要

8-羟基脱氧鸟苷(8-OHdG)是一种由羟基自由基产生的促突变DNA损伤,被认为是评估氧化应激诱导的DNA损伤的有用标志物。本研究的目的是阐明慢性病毒性肝炎患者肝脏8-OHdG水平的临床意义。通过对肝活检样本进行免疫组织化学染色,研究了丙型肝炎(CH-C)患者(n = 77)和乙型肝炎(CH-B)患者(n = 34)肝脏中8-OHdG的蓄积情况。与CH-B患者相比,CH-C患者中8-OHdG阳性肝细胞显著更高(中位数分别为55.0个/10⁵μm²和18.8个/10⁵μm²,P < 0.0001)。阳性肝细胞数量随血清转氨酶水平升高而显著增加,尤其是在CH-C患者中(CH-C中8-OHdG与丙氨酸转氨酶(ALT)/天冬氨酸转氨酶(AST)的相关系数r分别为0.738/0.720,CH-B中为0.506/0.515)。在CH-C中,8-OHdG反应性与身体和肝脏铁储存标志物密切相关(与血清铁蛋白,r = 0.615;与肝脏总铁评分,r = 0.520;与肝脏铁调素mRNA水平,r = 0.571),而在CH-B中,它与血清HBV-DNA滴度(r = 0.540)和患者年龄(r = -0.559)有关。这些结果表明,肝脏氧化性DNA损伤在慢性病毒性肝炎中很常见,尤其是在慢性丙型肝炎病毒感染患者中,提示慢性肝脏炎症与肝癌发生之间可能存在联系。肝脏DNA损伤与铁过载之间的强正相关表明,铁含量是肝脏氧化应激最可能的介质之一,降低铁含量可能有利于降低CH-C患者肝癌的发生率。

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