Clinical Nutrition Center, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
JPEN J Parenter Enteral Nutr. 2012 Mar;36(2):219-25. doi: 10.1177/0148607111424412. Epub 2012 Jan 24.
The authors aimed to investigate the role of anti-tumor necrosis factor (TNF)-α monoclonal antibody treatment in a mouse model of parenteral nutrition-associated liver disease (PNALD).
C57BL/6J male mice (aged 6-8 weeks) were randomly assigned to 3 groups: parenteral nutrition (PN), PN with anti-TNF-α monoclonal antibody treatment (PN + mAb), and controls. A central venous catheter was inserted for intravenous infusion of a PN solution (PN and PN + mAb groups) or saline (controls) for 7 days. Liver pathology, hepatic biochemical indicators, and serum TNF-α concentrations were analyzed. Levels of hepatic bsep, mdr1a/mdr1b, mdr2, and mrp2 mRNA were also evaluated in each group.
The PN group showed significant increases in serum transaminase, direct bilirubin, and bile acids relative to the control group (P < .05). Histopathological changes in this group were consistent with early stage cholestasis. The pathological score and serum alanine aminotransferase, total bilirubin, and direct bilirubin levels were improved in the PN + mAb group relative to the PN group (P < .05). The PN group showed significantly lower hepatic bsep, mdr1a/mdr1b, mdr2, and mrp2 mRNA expression than the controls (P < .05), but these were significantly increased compared to the PN group (P < .05).
Infliximab administered at a single dose of 5 mg/kg body weight ameliorated the progression of PNALD and improved the expression of hepatic ABC transporter genes. Therefore, anti-TNF-α monoclonal antibody may be a beneficial therapy for patients with PNALD.
作者旨在研究抗肿瘤坏死因子(TNF)-α单克隆抗体治疗在肠外营养相关肝病(PNALD)小鼠模型中的作用。
将 6-8 周龄雄性 C57BL/6J 小鼠随机分为 3 组:肠外营养(PN)、肠外营养加抗 TNF-α单克隆抗体治疗(PN + mAb)和对照组。通过中心静脉导管向静脉内输注 PN 溶液(PN 和 PN + mAb 组)或生理盐水(对照组),持续 7 天。分析肝组织病理学、肝生化指标和血清 TNF-α浓度。还评估了各组肝 bsep、mdr1a/mdr1b、mdr2 和 mrp2mRNA 的水平。
PN 组与对照组相比,血清转氨酶、直接胆红素和胆汁酸显著升高(P <.05)。该组的组织病理学变化与早期胆汁淤积一致。与 PN 组相比,PN + mAb 组的病理评分和血清丙氨酸氨基转移酶、总胆红素和直接胆红素水平均有所改善(P <.05)。PN 组的肝 bsep、mdr1a/mdr1b、mdr2 和 mrp2mRNA 表达明显低于对照组(P <.05),但明显高于 PN 组(P <.05)。
单次给予 5mg/kg 体重的英夫利昔单抗可改善 PNALD 的进展,并改善肝 ABC 转运体基因的表达。因此,抗 TNF-α单克隆抗体可能是 PNALD 患者的一种有益治疗方法。