Wengrower Dov, Zanninelli Giuliana, Latella Giovanni, Necozione Stefano, Metanes Issa, Israeli Eran, Lysy Joseph, Pines Mark, Papo Orit, Goldin Eran
Institute of Gastroenterlogy, Hadassah University Hospital, Jerusalem, Israel.
Can J Gastroenterol. 2012 Jan;26(1):33-9. doi: 10.1155/2012/628268.
Intestinal fibrosis is a challenging clinical condition in several fibrostenosing enteropathies, particularly Crohn's disease. Currently, no effective preventive measures or medical therapies are available for intestinal fibrosis. Fibrosis, due to an abnormal accumulation of extracellular matrix proteins, is a chronic and progressive process mediated by cell⁄matrix⁄cytokine and growth factor interactions, but may be a reversible phenomenon. Of the several molecules regulating fibrogenesis, transforming growth factor-beta 1 (TGF-b1) appears to play a pivotal role; it is strongly induced by the local activation of angiotensin II. The levels of both TGF-b1 and angiotensin II are elevated in fibrostenosing Crohn's disease.
To evaluate the in vivo effect of losartan - an angiotensin II receptor antagonist - on the course of chronic colitis-associated fibrosis and on TGF-b1 expression.
Colitis was induced by intrarectal instillation of trinitrobenzene sulphonic acid (TNBS) (15 mg⁄mL) while losartan was administered orally daily by gavage (7 mg⁄kg⁄day) for 21 days. Three groups of rats were evaluated: control (n=10); TNBS treated (n=10); and TNBS + losartan treated (n=10). Inflammation and fibrosis of the colon were evaluated by macro- and microscopic score analysis. Colonic TGF-b1 levels was measured using ELISA.
Twenty-one days after induction, losartan significantly improved the macro- and microscopic scores of fibrosis in the colonic wall and reduced TGF-b1 concentration.
Prophylactic oral administration of losartan reduces the colorectal fibrosis complicating the TNBS-induced chronic colitis, an effect that appears to be mediated by a downregulation of TGF-b1 expression.
肠道纤维化是几种纤维狭窄性肠病(尤其是克罗恩病)中具有挑战性的临床病症。目前,尚无针对肠道纤维化的有效预防措施或药物治疗方法。纤维化是由于细胞外基质蛋白异常积聚所致,是由细胞/基质/细胞因子和生长因子相互作用介导的慢性进行性过程,但可能是一种可逆现象。在几种调节纤维生成的分子中,转化生长因子-β1(TGF-β1)似乎起关键作用;它由血管紧张素II的局部激活强烈诱导。在纤维狭窄性克罗恩病中,TGF-β1和血管紧张素II的水平均升高。
评估血管紧张素II受体拮抗剂氯沙坦对慢性结肠炎相关纤维化病程及TGF-β1表达的体内作用。
通过直肠内注入三硝基苯磺酸(TNBS)(15mg/mL)诱导结肠炎,同时氯沙坦通过灌胃每日口服给药(7mg/kg/天),持续21天。评估三组大鼠:对照组(n = 10);TNBS处理组(n = 10);TNBS +氯沙坦处理组(n = 10)。通过宏观和微观评分分析评估结肠的炎症和纤维化。使用酶联免疫吸附测定法测量结肠TGF-β1水平。
诱导21天后,氯沙坦显著改善结肠壁纤维化的宏观和微观评分,并降低TGF-β1浓度。
预防性口服氯沙坦可减轻TNBS诱导的慢性结肠炎并发的结肠直肠纤维化,这一作用似乎是由TGF-β1表达下调介导的。