Institute of Pharmacology, Center for Physiology and Pharmacology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Curr Opin Gastroenterol. 2012 May;28(3):239-43. doi: 10.1097/MOG.0b013e32835264d9.
Cholestatic liver diseases with bile duct injury and biliary fibrosis account for a significant percentage of patients with end-stage liver disease and undergoing liver transplantation. A number of different animal models have been established and have added substantially to our understanding of the molecular mechanisms underlying this group of chronic liver diseases. In the present review, we discuss recent findings and new insight derived from different animal models of biliary tract injury and fibrosis.
Cholangiocytes do not undergo epithelial to mesenchymal transition and do not contribute to the pool of biliary fibroblasts involved in extracellular matrix deposition. Rather cholangiocytes can acquire a reactive phenotype activating fibrogenesis through secretion of proinflammatory and profibrogenic mediators. Bile acid homeostasis is controlled by a gut-liver axis playing a crucial role in the adaptive response to bile duct injury and cholestasis. The nuclear factor-kappa B and hedgehog signaling pathways play a critical role in cholestatic liver injury and the emergence of liver cancer. Nuclear receptors are key mediators of adaptive response mechanisms in cholestasis and potential therapeutical targets.
Recent progress and mechanistic insights from mouse models have added to our understanding of the molecular mechanisms underlying cholestatic liver and biliary tract injury and pointed to new therapeutic options.
伴有胆管损伤和胆管纤维化的胆汁淤积性肝病在终末期肝病和肝移植患者中占有相当大的比例。已经建立了许多不同的动物模型,这些模型大大增加了我们对这组慢性肝病的分子机制的理解。在本综述中,我们讨论了不同胆管损伤和纤维化动物模型的最新发现和新见解。
胆管细胞不会经历上皮-间充质转化,也不会为参与细胞外基质沉积的胆管成纤维细胞池做出贡献。相反,胆管细胞可以通过分泌促炎和促纤维化介质获得反应性表型,激活纤维化。胆汁酸稳态受肠-肝轴的控制,在胆管损伤和胆汁淤积的适应性反应中起着至关重要的作用。核因子-κB 和 hedgehog 信号通路在胆汁淤积性肝损伤和肝癌的发生中起着关键作用。核受体是胆汁淤积适应性反应机制的关键介质,也是潜在的治疗靶点。
来自小鼠模型的最新进展和机制见解增加了我们对胆汁淤积性肝和胆管损伤的分子机制的理解,并指出了新的治疗选择。