Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
J Surg Res. 2011 Sep;170(1):e47-55. doi: 10.1016/j.jss.2011.05.033. Epub 2011 Jun 15.
Obstructive jaundice is associated with bacterial translocation and inflammatory cytokine induction. It is unknown if toll-like receptors (TLRs) and their upstream molecule high mobility group box-1 (HMGB1) are involved in the pathogenetic mechanism and if glucocorticoid is effective in modulating the process.
A rat model of cholestasis by ligation of the extrahepatic bile duct (BDL) for 2 wk was created. TLRs, interferon regulatory factors (IRFs), IL-6, IL-8, antimicrobial peptide β-defensin, and cathelicidin, as well as HMGB1 expressions were studied by using real-time quantitative reverse transcription-polymerase chain reaction, immunohistochemistry, Western blotting, and enzyme-linked immunosorbent assay (ELISA). Glucocorticoid treatment was applied to a group of BDL rats.
Obstructive jaundice for 2 wk was associated with significant up-regulation of TLR1, 2, 4, 6, 7, and 9 mRNA expressions. There were significant increases of liver IRF5, IL-6, and β-defensin 1 mRNA levels in the BDL rats than in the sham and nonoperative control rats, which were associated with significant increase of immunoreactive IRF5 protein staining in the nucleus of Kupffer cells and neutrophils. Hepatic HMGB1 expression and release into serum were significantly elevated in the cholestatic rats than in the sham and control rats. Glucocorticoid treatment significantly decreased hepatic HMGB1 expression and release into serum, which was associated with significantly decreased hepatic TLR4 mRNA expression in the cholestatic rats.
The results indicate that obstructive jaundice may induce hepatic HMGB1 expression with activation of TLR4 and a number of downstream signaling molecules, which can be reversed by glucocorticoid administration.
阻塞性黄疸与细菌易位和炎症细胞因子诱导有关。目前尚不清楚 Toll 样受体 (TLR) 及其上游分子高迁移率族蛋白 1 (HMGB1) 是否参与发病机制,以及糖皮质激素是否能有效调节这一过程。
通过结扎胆总管 (BDL) 建立大鼠 2 周胆汁淤积模型。采用实时定量逆转录聚合酶链反应、免疫组织化学、Western blot 和酶联免疫吸附试验 (ELISA) 研究 TLRs、干扰素调节因子 (IRFs)、IL-6、IL-8、抗菌肽 β-防御素和 cathelicidin 以及 HMGB1 的表达。对一组 BDL 大鼠进行糖皮质激素治疗。
阻塞性黄疸 2 周与 TLR1、2、4、6、7 和 9 mRNA 表达的显著上调有关。BDL 大鼠肝 IRF5、IL-6 和 β-防御素 1 mRNA 水平显著升高,与库普弗细胞和中性粒细胞核中 IRF5 蛋白染色的显著增加有关。胆汁淤积大鼠肝 HMGB1 表达和释放到血清中的明显增加,与胆汁淤积大鼠肝 TLR4 mRNA 表达的明显降低有关。
这些结果表明,阻塞性黄疸可能通过激活 TLR4 和许多下游信号分子诱导肝 HMGB1 表达,糖皮质激素的应用可以逆转这种情况。