Department of Critical Care Medicine, University of Pittsburgh Medical School, 3550 Terrace Street, Pittsburgh, PA 15261, USA.
Crit Care. 2012 Jan 16;16(1):R9. doi: 10.1186/cc11149.
Inflammation may critically affect mechanisms of liver injury in acetaminophen (APAP) hepatotoxicity. Kupffer cells (KC) play important roles in inflammation, and KC depletion confers protection at early time points after APAP treatment but can lead to more severe injury at a later time point. It is possible that some inflammatory factors might contribute to liver damage at an early injurious phase but facilitate liver regeneration at a late time point. Therefore, we tested this hypothesis by using ethyl pyruvate (EP), an anti-inflammatory agent, to treat APAP overdose for 24-48 hours.
C57BL/6 male mice were intraperitoneally injected with a single dose of APAP (350 mg/kg dissolved in 1 mL sterile saline). Following 2 hours of APAP challenge, the mice were given 0.5 mL EP (40 mg/kg) or saline treatment every 8 hours for a total of 24 or 48 hours.
Twenty-four hours after APAP challenge, compared to the saline-treated group, EP treatment significantly lowered serum transaminases (ALT/AST) and reduced liver injury seen in histopathology; however, at the 48-hour time point, compared to the saline therapy, EP therapy impaired hepatocyte regeneration and increased serum AST; this late detrimental effect was associated with reduced serum TNF-α concentration and decreased expression of cell cycle protein cyclin D1, two important factors in liver regeneration.
Inflammation likely contributes to liver damage at an early injurious phase but improves hepatocyte regeneration at a late time point, and prolonged anti-inflammation therapy at a late phase is not beneficial.
炎症可能会严重影响对乙酰氨基酚(APAP)肝毒性中肝损伤的机制。库普弗细胞(KC)在炎症中发挥重要作用,KC 耗竭在 APAP 治疗后早期给予保护,但在后期可能导致更严重的损伤。一些炎症因子可能在早期损伤阶段导致肝损伤,但在后期促进肝再生。因此,我们使用乙基丙酮酸(EP),一种抗炎剂,治疗 APAP 过量 24-48 小时,从而验证了这一假说。
C57BL/6 雄性小鼠腹腔注射单次剂量的 APAP(350mg/kg 溶解于 1ml 无菌生理盐水中)。APAP 挑战后 2 小时,给予小鼠 0.5ml EP(40mg/kg)或生理盐水治疗,每 8 小时一次,共 24 或 48 小时。
APAP 挑战后 24 小时,与生理盐水治疗组相比,EP 治疗显著降低了血清转氨酶(ALT/AST)并减轻了组织病理学检查中的肝损伤;然而,在 48 小时时,与生理盐水治疗相比,EP 治疗损害了肝细胞再生并增加了血清 AST;这种晚期有害作用与血清 TNF-α浓度降低和细胞周期蛋白 D1 表达减少有关,细胞周期蛋白 D1 是肝再生的两个重要因素。
炎症可能在早期损伤阶段导致肝损伤,但在晚期促进肝细胞再生,晚期延长抗炎治疗无益。