Roychowdhury Sanjoy, McMullen Megan R, Pritchard Michele T, Hise Amy G, van Rooijen Nico, Medof M Edward, Stavitsky Abram B, Nagy Laura E
Department of Pathobiology, Cleveland Clinic Foundation, Cleveland, OH, USA.
Hepatology. 2009 Apr;49(4):1326-34. doi: 10.1002/hep.22776.
The innate immune system has been implicated in the pathogenesis of alcoholic liver disease. Although innate immunity is usually considered an early response to injury, previous work implicating innate immunity in ethanol-induced liver injury focuses primarily on long-term ethanol exposure. We investigated the early period of ethanol exposure to determine whether there were temporal associations between activation of innate immune responses and known correlates of liver injury. Female C57BL/6 mice were allowed free access to an ethanol-containing Lieber-DeCarli diet or were pair-fed a control diet. Within 4 days of ethanol exposure, we observed a striking spike in expression of hepatic proinflammatory cytokines-including tumor necrosis factor alpha (TNF-alpha), interleukin-6, and interferon-gamma-prior to hepatic triglyceride accumulation or increased plasma alanine aminotransferase activities, as well as before the induction of cytochrome P450 2E1 or oxidative stress. This early spike in inflammatory cytokines coincided with deposition of C3b-iC3b/C3c (C3b) in the liver. This deposition, resulting from the cleavage of the third component of the complement system (C3), is evidence for activation of complement in response to ethanol. C3(-/-) mice were protected from the early, ethanol-induced increase in hepatic TNF-alpha expression. Ethanol increased C3b deposition in mice deficient in C3a receptor or C5a receptor, as well as in wild-type mice depleted of hepatic macrophages; however, there was no increase in hepatic TNF-alpha in the absence of C3a receptor, C5a receptor, or hepatic macrophages. In contrast, the absence of Toll-like receptor 4 (TLR-4) had no effect on the early, ethanol-induced increase in either C3b or TNF-alpha.
We have identified a complement- and macrophage-dependent, but TLR-4 independent, phase in the pathogenesis of ethanol-induced liver injury.
固有免疫系统已被认为与酒精性肝病的发病机制有关。虽然固有免疫通常被认为是对损伤的早期反应,但先前有关固有免疫参与乙醇诱导的肝损伤的研究主要集中在长期乙醇暴露。我们研究了乙醇暴露的早期阶段,以确定固有免疫反应激活与已知肝损伤相关因素之间是否存在时间关联。雌性C57BL/6小鼠可以自由摄取含乙醇的Lieber-DeCarli饮食,或成对喂养对照饮食。在乙醇暴露的4天内,我们观察到肝脏促炎细胞因子(包括肿瘤坏死因子α(TNF-α)、白细胞介素-6和干扰素-γ)的表达急剧升高,这发生在肝脏甘油三酯积累或血浆丙氨酸转氨酶活性增加之前,以及细胞色素P450 2E1诱导或氧化应激之前。炎症细胞因子的这种早期升高与肝脏中C3b-iC3b/C3c(C3b)的沉积同时发生。这种由补体系统第三成分(C3)裂解产生的沉积是乙醇诱导补体激活的证据。C3(-/-)小鼠可免受乙醇早期诱导的肝脏TNF-α表达增加的影响。乙醇增加了缺乏C3a受体或C5a受体的小鼠以及肝巨噬细胞耗竭的野生型小鼠中C3b的沉积;然而,在没有C3a受体、C5a受体或肝巨噬细胞的情况下,肝脏TNF-α没有增加。相比之下,缺乏Toll样受体4(TLR-4)对乙醇早期诱导的C3b或TNF-α增加没有影响。
我们在乙醇诱导的肝损伤发病机制中确定了一个补体和巨噬细胞依赖性但TLR-4非依赖性的阶段。