通过动物模型深入了解自身免疫性胆管炎。
New insights into autoimmune cholangitis through animal models.
机构信息
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
出版信息
Dig Dis. 2010;28(1):99-104. doi: 10.1159/000282072. Epub 2010 May 7.
Improving our understanding of the pathogenesis of chronic immune-mediated cholangiopathies such as primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC), as well as the development of novel diagnostic, prognostic and therapeutic tools for these disorders critically depends on easily reproducible animal models. Recently, several spontaneous mouse models for PBC (not requiring previous manipulations for breakdown of immunotolerance) have been reported, including NOD.c3c4 and NOD.c3c4-derived mice, IL-2Ralpha(-/-) mice, dominant negative TGF-beta receptor II mice and Ae2(a,b)(-/-) mice. To date, no animal model exhibits all of the attributes of PSC. Rodent models induced by bacterial cell components or colitis may help to explain the strong association between PSC and inflammatory bowel disease. Other models include direct injury to biliary epithelia, peribiliary vascular endothelia or portal venous endothelia. Mice with targeted disruption of the Mdr2 (Abcb4) gene encoding a canalicular phospholipid flippase (Mdr2(-/-) mice) spontaneously develop sclerosing cholangitis with macroscopic and microscopic features of human PSC. Another example for a transporter involved in the pathogenesis of sclerosing cholangitis is the cystic fibrosis transmembrane conductance regulator (CFTR/ABCC7). Xenobiotics and drugs may also lead to bile duct injury and biliary fibrosis via direct toxic and indirect immune-mediated injury. Hydrophobic bile acids, such as lithocholic acid, cause bile duct injury and destructive cholangitis with periductal fibrosis resembling sclerosing cholangitis. These models have enhanced our understanding of the pathogenesis of PBC and PSC and will hopefully result in improved treatment of these disorders.
提高我们对慢性免疫介导性胆管病(如原发性胆汁性肝硬化(PBC)和原发性硬化性胆管炎(PSC))发病机制的理解,以及为这些疾病开发新的诊断、预后和治疗工具,关键取决于是否能够轻易复制动物模型。最近,已经报道了几种用于 PBC 的自发性小鼠模型(无需预先进行免疫耐受破坏操作),包括 NOD.c3c4 和 NOD.c3c4 衍生的小鼠、IL-2Ralpha(-/-) 小鼠、显性负 TGF-β受体 II 小鼠和 Ae2(a,b)(-/-) 小鼠。迄今为止,没有任何动物模型表现出 PSC 的所有特征。由细菌细胞成分或结肠炎诱导的啮齿动物模型可能有助于解释 PSC 与炎症性肠病之间的强关联。其他模型包括对胆管上皮、胆管周围血管内皮或门静脉内皮的直接损伤。靶向破坏编码胆管磷脂翻转酶(Mdr2(-/-) 小鼠)的 Mdr2 (Abcb4) 基因的小鼠会自发发生具有人 PSC 的宏观和微观特征的硬化性胆管炎。另一个与硬化性胆管炎发病机制相关的转运蛋白是囊性纤维化跨膜电导调节剂(CFTR/ABCC7)。外源性化学物质和药物也可能通过直接毒性和间接免疫介导的损伤导致胆管损伤和胆管纤维化。疏水性胆汁酸,如胆酸,会导致胆管损伤和破坏性胆管炎,伴有类似于硬化性胆管炎的胆管周围纤维化。这些模型增强了我们对 PBC 和 PSC 发病机制的理解,并有望改善这些疾病的治疗效果。