Laviña B, Gracia-Sancho J, Rodríguez-Vilarrupla A, Chu Y, Heistad D D, Bosch J, García-Pagán J C
Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Barcelona, Spain.
Gut. 2009 Jan;58(1):118-25. doi: 10.1136/gut.2008.149880. Epub 2008 Oct 1.
Increased intrahepatic vascular tone in cirrhosis has been attributed to a decrease of hepatic nitric oxide (NO) secondary to disturbances in the post-translational regulation of the enzyme eNOS. NO scavenging by superoxide (O(2)(-)) further contributes to a reduction of NO bioavailability in cirrhotic livers.
To investigate whether removing increased O(2)(-) levels could be a new therapeutic strategy to increase intrahepatic NO, improve endothelial dysfunction and reduce portal pressure in cirrhotic rats with portal hypertension.
Adenoviral vectors expressing extracellular superoxide dismutase (SOD) (AdECSOD) or beta-galactosidase (Adbetagal) were injected intravenously in control and CCl(4)-induced cirrhotic rats. After 3 days, liver O(2)(-) levels were determined by dihydroethidium staining, NO bioavailability by hepatic cGMP levels, nitrotyrosinated proteins by immunohistochemistry and western blot, and endothelial function by responses to acetylcholine in perfused rat livers. Mean arterial pressure (MAP) and portal pressure were evaluated in vivo.
Transfection of cirrhotic livers with AdECSOD produced a significant reduction in O(2)(-) levels, a significant increase in hepatic cGMP, and a decrease in liver nitrotyrosinated proteins which were associated with a significant improvement in the endothelium-dependent vasodilatation to acetylcholine. In addition, in cirrhotic livers AdECSOD transfection produced a significant reduction in portal pressure (17.3 (SD 2) mm Hg vs 15 (SD 1.6) mm Hg; p<0.05) without significant changes in MAP. In control rats, AdECSOD transfection prevents the increase in portal perfusion pressure promoted by an ROS-generating system.
In cirrhotic rats, reduction of O(2)(-) by AdECSOD increases NO bioavailability, improves intrahepatic endothelial function and reduces portal pressure. These findings suggest that scavenging of O(2)(-) might be a new therapeutic strategy in the management of portal hypertension.
肝硬化时肝内血管张力增加归因于内皮型一氧化氮合酶(eNOS)翻译后调节紊乱导致肝内一氧化氮(NO)减少。超氧化物(O₂⁻)清除NO进一步导致肝硬化肝脏中NO生物利用度降低。
研究降低升高的O₂⁻水平是否可能成为一种新的治疗策略,以增加肝硬化门静脉高压大鼠肝内NO、改善内皮功能障碍并降低门静脉压力。
将表达细胞外超氧化物歧化酶(SOD)(AdECSOD)或β-半乳糖苷酶(Adbetagal)的腺病毒载体静脉注射到对照大鼠和四氯化碳诱导的肝硬化大鼠体内。3天后,通过二氢乙锭染色测定肝脏O₂⁻水平,通过肝cGMP水平测定NO生物利用度,通过免疫组织化学和蛋白质印迹法测定硝基酪氨酸化蛋白,通过灌注大鼠肝脏对乙酰胆碱的反应评估内皮功能。在体内评估平均动脉压(MAP)和门静脉压力。
用AdECSOD转染肝硬化肝脏可使O₂⁻水平显著降低,肝cGMP显著增加,肝脏硝基酪氨酸化蛋白减少,这与内皮依赖性血管舒张对乙酰胆碱的显著改善相关。此外,在肝硬化肝脏中,AdECSOD转染可使门静脉压力显著降低(17.3(标准差2)mmHg对15(标准差1.6)mmHg;p<0.05),而MAP无显著变化。在对照大鼠中,AdECSOD转染可防止由ROS生成系统促进的门静脉灌注压力升高。
在肝硬化大鼠中,AdECSOD降低O₂⁻可增加NO生物利用度,改善肝内内皮功能并降低门静脉压力。这些发现表明,清除O₂⁻可能是门静脉高压治疗的一种新策略。