Department of Molecular Genetics, Maastricht University, the Netherlands.
Hepatology. 2012 Sep;56(3):894-903. doi: 10.1002/hep.25660. Epub 2012 Jul 6.
Nonalcoholic steatohepatitis (NASH) is characterized by hepatic lipid accumulation combined with inflammation, which can ultimately progress into cirrhosis. Recently, we demonstrated that deletion of scavenger receptors (SRs) CD36 and SR-A in hematopoietic cells reduced hepatic inflammation. In addition to uptake of modified lipoproteins, CD36 and SR-A are also involved in other functions that can activate the inflammatory response. Therefore, the actual trigger for SR activation during NASH is unclear. Here, we hypothesized that hepatic inflammation is triggered by recognition of oxidized LDL (oxLDL) by Kupffer cells (KCs). To inhibit recognition of oxLDL by KCs, low-density lipoprotein receptor (Ldlr(-/-) ) mice were immunized with heat-inactivated pneumococci, which were shown to induce the production of anti-oxLDL immunoglobulin M (IgM) antibodies, due to molecular mimicry with oxLDL. The mice received a high-fat, high-cholesterol diet during the last 3 weeks to induce NASH. Immunization with pneumococci increased anti-oxLDL IgM levels and led to a reduction in hepatic inflammation, as shown by reduced macrophage, neutrophil, and T cell infiltration, and reduced gene expression of tumor necrosis factor (Tnf), interleukin-6 (Il-6), interleukin-1β (Il-1b), monocyte chemoattractant protein 1 (Mcp1), and fibrosis-related genes. In immunized mice, KCs were smaller and showed fewer cholesterol crystals compared with nonimmunized mice.
Antibodies to oxLDL play an important role in the pathogenesis of NASH. Therefore, the potential of phosphorylcholine-based vaccination strategies as a novel tool for the prevention and therapy of NASH should be tested in the future.
非酒精性脂肪性肝炎(NASH)的特征是肝内脂质堆积伴有炎症,最终可进展为肝硬化。最近,我们证实了造血细胞中清道夫受体(SRs)CD36 和 SR-A 的缺失可减少肝内炎症。除了摄取修饰的脂蛋白外,CD36 和 SR-A 还参与其他可激活炎症反应的功能。因此,NASH 期间 SR 激活的实际触发因素尚不清楚。在这里,我们假设肝内炎症是由库普弗细胞(KCs)识别氧化的 LDL(oxLDL)引发的。为了抑制 KCs 对 oxLDL 的识别,用加热灭活的肺炎球菌对低密度脂蛋白受体(Ldlr(-/-))小鼠进行免疫,由于与 oxLDL 的分子模拟,肺炎球菌诱导产生了抗 oxLDL 的免疫球蛋白 M(IgM)抗体。在最后 3 周,这些小鼠接受高脂肪、高胆固醇饮食以诱导 NASH。肺炎球菌免疫接种增加了抗 oxLDL IgM 水平,并减少了肝内炎症,表现为巨噬细胞、中性粒细胞和 T 细胞浸润减少,肿瘤坏死因子(Tnf)、白细胞介素-6(Il-6)、白细胞介素-1β(Il-1b)、单核细胞趋化蛋白 1(Mcp1)和纤维化相关基因的表达减少。与未免疫的小鼠相比,免疫小鼠的 KCs 更小,且胆固醇结晶更少。
oxLDL 的抗体在 NASH 的发病机制中起重要作用。因此,基于磷酸胆碱的疫苗接种策略作为 NASH 预防和治疗的新工具的潜力,未来应加以测试。