Clinical Pharmacology and Gastroenterology Unit, São Francisco University Medical School, Bragança Paulista, SP, Brazil.
Liver Int. 2010 Apr;30(4):603-10. doi: 10.1111/j.1478-3231.2009.02200.x. Epub 2010 Jan 15.
Pro-inflammatory cytokines, such as tumour necrosis factor (TNF)-alpha, are known to be involved in the establishment of insulin resistance. Insulin resistance plays a key role in the development of obesity-related pathologies, such as type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). The state of chronic inflammation associated with obesity led us to hypothesize that TNF-alpha blockade may have an effect on experimentally obese animals.
We studied the effects of thalidomide, an immunosuppressant and anti-TNF-alpha drug, on hepatic alterations that were induced by a high-fat diet (HFD) in mice.
Obesity was induced in Swiss mice using a HFD for 12 weeks. Thalidomide-treated animals received thalidomide i.p. (100 mg/kg/day, 10 days). Glucose, aspartate aminotransferases and alanine aminotransferases levels were assessed in the blood. Insulin and glucose tolerance tests were performed. The liver was excised for histological, triglyceride, gene and protein expression analyses.
We found improvements in both the basal glucose blood levels and the response to insulin administration in the treated animals. The molecular analysis of insulin signalling revealed a restoration of the hepatic insulin receptor substrate (IRS)-1 and AKT phosphorylation. The hepatic expression of TNF-alpha was inhibited and the levels correlated with a significant reduction in the steatosis area. Other hepatic inflammatory markers, such as iNOS and suppressor of cytokine signalling (SOCS-3), were also reduced.
We suggest that immunosuppressant drugs that target TNF-alpha and that may also contribute to reductions in the inflammatory markers that are associated with obesity could be a therapeutic option in NAFLD and type 2 diabetes.
已知促炎细胞因子,如肿瘤坏死因子 (TNF)-α,参与胰岛素抵抗的形成。胰岛素抵抗在肥胖相关病理的发展中起着关键作用,如 2 型糖尿病和非酒精性脂肪性肝病 (NAFLD)。与肥胖相关的慢性炎症状态使我们假设 TNF-α 阻断可能对实验性肥胖动物有影响。
我们研究了沙利度胺(一种免疫抑制剂和抗 TNF-α药物)对高脂肪饮食 (HFD) 诱导的小鼠肝脏改变的影响。
用 HFD 诱导瑞士小鼠肥胖 12 周。沙利度胺治疗的动物接受腹腔内注射沙利度胺(100mg/kg/天,10 天)。检测血液中的葡萄糖、天冬氨酸转氨酶和丙氨酸转氨酶水平。进行胰岛素和葡萄糖耐量试验。切除肝脏进行组织学、甘油三酯、基因和蛋白质表达分析。
我们发现治疗组动物的基础血糖水平和胰岛素给药后的反应均有所改善。胰岛素信号的分子分析显示肝胰岛素受体底物 (IRS)-1 和 AKT 磷酸化得到恢复。肝 TNF-α 的表达受到抑制,其水平与脂肪变性面积的显著减少相关。其他肝脏炎症标志物,如 iNOS 和细胞因子信号转导抑制物 (SOCS-3),也有所降低。
我们认为,针对 TNF-α 的免疫抑制剂药物可能通过降低与肥胖相关的炎症标志物,成为治疗 NAFLD 和 2 型糖尿病的一种治疗选择。