Department of Pharmacology, Toxicology and Therapeutics, The University of Kansas Medical Center, 3901 Rainbow Blvd, MS-1018, Kansas City, KS 66160, USA.
Am J Pathol. 2010 Jan;176(1):177-86. doi: 10.2353/ajpath.2010.090672. Epub 2009 Dec 11.
Altered hepatic lipid homeostasis, hepatocellular injury, and inflammation are features of nonalcoholic steatohepatitis, which contributes significantly to liver-related morbidity and mortality in the Western population. A collection of inflammatory mediators have been implicated in the pathogenesis of steatohepatitis in mouse models. However, the pathways essential for coordination and amplification of hepatic inflammation and injury caused by steatosis are not completely understood. We tested the hypothesis that tissue factor (TF)-dependent thrombin generation and the thrombin receptor protease activated receptor-1 (PAR-1) contribute to liver inflammation induced by steatosis in mice. Wild-type C57Bl/6J mice fed a diet deficient in methionine and choline for 2 weeks manifested steatohepatitis characterized by increased serum alanine aminotransferase activity, macrovesicular hepatic steatosis, hepatic inflammatory gene expression, and lobular inflammation. Steatohepatitis progression was associated with thrombin generation and hepatic fibrin deposition. Coagulation cascade activation was significantly reduced in low TF mice, which express 1% of normal TF levels. Hepatic triglyceride accumulation was not affected in low TF mice or PAR-1-deficient mice. In contrast, biomarkers of hepatocellular injury, inflammatory gene induction, and hepatic accumulation of macrophages and neutrophils were greatly reduced by TF-deficiency and PAR-1-deficiency. The results suggest that TF-dependent thrombin generation and activation of PAR-1 amplify hepatic inflammation and injury during the pathogenesis of steatohepatitis.
肝内脂质稳态改变、肝细胞损伤和炎症是非酒精性脂肪性肝炎的特征,这是导致西方人群肝脏相关发病率和死亡率的主要原因。一系列炎症介质已被认为与小鼠模型中脂肪性肝炎的发病机制有关。然而,导致脂肪变性引起的肝炎症和损伤协调和放大的途径尚不完全清楚。我们检验了这样一个假设,即组织因子(TF)依赖性凝血酶生成和凝血酶受体蛋白酶激活受体-1(PAR-1)有助于肥胖小鼠的肝脏炎症。用缺乏蛋氨酸和胆碱的饮食喂养 2 周的野生型 C57Bl/6J 小鼠表现出非酒精性脂肪性肝炎,其特征为血清丙氨酸氨基转移酶活性增加、大泡性肝脂肪变性、肝炎症基因表达和肝小叶炎症。脂肪性肝炎的进展与凝血酶生成和肝纤维蛋白沉积有关。在 TF 水平低的小鼠中,凝血级联激活显著降低,其 TF 水平仅为正常水平的 1%。TF 水平低的小鼠或 PAR-1 缺陷型小鼠的肝甘油三酯积聚不受影响。相比之下,TF 缺陷和 PAR-1 缺陷大大降低了肝损伤生物标志物、炎症基因诱导以及巨噬细胞和中性粒细胞在肝内的蓄积。结果表明,TF 依赖性凝血酶生成和 PAR-1 的激活在脂肪性肝炎发病机制中放大了肝炎症和损伤。