Farrington Christian, Novak Don, Liu Chen, Haafiz Allah B
Hepatology and Liver Transplantation, Division of Pediatric Gastroenterology, Hepatology and Nutrition.
Clin Exp Gastroenterol. 2010;3:185-91. doi: 10.2147/CEG.S14220. Epub 2010 Dec 9.
Biliary atresia (BA) is the most common indication of liver transplantation in children. Pathogenesis of hepatic fibrosis, which is a prominent feature of BA, remains obscure. The purpose of this work was to determine the cellular sources of transforming growth factor beta-1 (TGFβ1) and establish the relationship between TGFβ1-producing cells and extracellular matrix producing myofibroblasts (MFBs) in advanced BA.
Trichrome staining and immunohistochemistry were carried out to determine the expression pattern of collagen and TGFβ1 protein in explant liver specimens from patients with BA. The intensities of portal and lobular TGFβ1 expressions were compared. Immunofluorescence technique was carried out to determine the relationship between α-smooth muscle actin (α-SMA)-positive-MFB and TGFβ1-positve cells.
Lobular TGFβ1 protein expression was significantly higher than portal (89 ± 6 versus 10 ± 1 arbitrary units, P ≤ 0.05), whereas no difference was noted in livers used as control (10 ± 1.6 versus 19 ± 5 arbitrary units, P = 0.11). TGFβ1 expression was more in the center of nodules versus MFB in surrounding fibrous septa. Contrary to TGFβ1 expression, α1-SMA was mostly expressed in the portal structures and the adjacent fibrous septa enacting lobulation of the parenchyma. The results obtained by coimmunofluorescence staining showed no colocalization of α-SMA and TGFβ1.
TGFβ1 protein expression is mostly localized to hepatocytes in advanced BA. These findings suggest a paracrine mechanisms of TGFβ1-driven fibrogenesis in advanced BA.
胆道闭锁(BA)是儿童肝移植最常见的适应症。肝纤维化是BA的一个突出特征,其发病机制仍不清楚。本研究的目的是确定转化生长因子β-1(TGFβ1)的细胞来源,并建立晚期BA中产生TGFβ1的细胞与产生细胞外基质的肌成纤维细胞(MFBs)之间的关系。
采用三色染色和免疫组织化学方法,检测BA患者肝外植体标本中胶原蛋白和TGFβ1蛋白的表达模式。比较门静脉和小叶中TGFβ1表达的强度。采用免疫荧光技术确定α平滑肌肌动蛋白(α-SMA)阳性MFB与TGFβ1阳性细胞之间的关系。
小叶TGFβ1蛋白表达明显高于门静脉(89±6对10±1任意单位,P≤0.05),而作为对照的肝脏中未观察到差异(10±1.6对19±5任意单位,P = 0.11)。与周围纤维间隔中的MFB相比,TGFβ1在结节中心的表达更多。与TGFβ1表达相反,α1-SMA主要表达于门静脉结构和相邻的纤维间隔中,这些纤维间隔形成了实质的小叶结构。共免疫荧光染色结果显示α-SMA和TGFβ1没有共定位。
在晚期BA中,TGFβ1蛋白表达主要定位于肝细胞。这些发现提示晚期BA中TGFβ1驱动的肝纤维化存在旁分泌机制。