Abdel-Aziz G, Lebeau G, Rescan P Y, Clément B, Rissel M, Deugnier Y, Campion J P, Guillouzo A
INSERM U49, Unité de Recherches Hépatologiques, Hôpital Pontchaillou, Rennes, France.
Am J Pathol. 1990 Dec;137(6):1333-42.
The reversibility of hepatic fibrosis was investigated in an experimental model of extrahepatic cholestasis in the rat after common bile duct ligation for 2 weeks, followed by bilioduodenal anastomosis for 3 weeks. Bile duct ligation resulted in a transitory marked elevation in the serum concentration of 5'-nucleotidase, alkaline phosphatase, and bilirubin during the first 3 days. Then these levels decreased to threefold, twofold, and 100-fold the normal values, respectively, during the following 4 weeks. Histologic examination of the liver disclosed extensive bile duct proliferation and the formation of periportal fibrosis, with only slight inflammation and necrosis. The distribution of the major components of the hepatic extracellular matrix was analyzed 2 weeks after bile duct ligation, using the indirect immunoperoxidase method. Fibrous septa were found to be strongly stained for collagens I, pro-III, III and IV, fibronectin, and laminin. The most intense staining was found in enlarged periportal areas, collagen IV and laminin being particularly abundant around newly formed bile ducts. These changes paralleled high steady-state levels of alpha 1(I) and alpha 1(IV) collagen and B2 chain laminin mRNAs. Relief of the obstruction for 2 weeks resulted in a shift in the serum concentration of 5'-nucleotidase, alkaline phosphatase, and bilirubin toward normal values. A dramatic resorption of bile duct proliferations and periportal fibrosis were observed. Three weeks after bile duct repermeabilization, immunohistochemical study showed that the pattern of distribution of extracellular matrix components was almost normal, except for collagen IV, which remained abundant in the sinusoids when compared with the normal liver. In parallel, the steady-state B2-chain laminin mRNA level became lower than in cholestatic livers, whereas alpha 1(I) and alpha 1(IV) mRNAs were almost undetectable. These results show that hepatic fibrosis induced by experimental extrahepatic cholestasis in rat disappears in less than 3 weeks after relief of bile duct obstruction, suggesting that an active degradation of matrix protein occurs, except for collagen IV in the sinusoid.
在大鼠胆总管结扎2周后行胆肠吻合术3周的肝外胆汁淤积实验模型中,研究了肝纤维化的可逆性。胆总管结扎后第1个3天,血清5'-核苷酸酶、碱性磷酸酶和胆红素浓度出现短暂显著升高。随后,在接下来的4周内,这些水平分别降至正常值的3倍、2倍和100倍。肝脏组织学检查显示广泛的胆管增生和门周纤维化形成,仅有轻微炎症和坏死。胆管结扎2周后,采用间接免疫过氧化物酶法分析肝细胞外基质主要成分的分布。发现纤维间隔对I型、前III型、III型和IV型胶原、纤连蛋白和层粘连蛋白有强烈染色。在扩大的门周区域染色最强,IV型胶原和层粘连蛋白在新形成的胆管周围特别丰富。这些变化与α1(I)和α1(IV)胶原及层粘连蛋白B2链mRNA的高稳态水平平行。梗阻解除2周导致血清5'-核苷酸酶、碱性磷酸酶和胆红素浓度向正常值转变。观察到胆管增生和门周纤维化显著吸收。胆管再通3周后,免疫组织化学研究表明,细胞外基质成分的分布模式几乎正常,除了IV型胶原,与正常肝脏相比,其在肝血窦中仍很丰富。同时,层粘连蛋白B2链mRNA的稳态水平低于胆汁淤积性肝脏,而α1(I)和α1(IV)mRNA几乎检测不到。这些结果表明,大鼠实验性肝外胆汁淤积诱导的肝纤维化在胆管梗阻解除后不到3周内消失,提示除肝血窦中的IV型胶原外,基质蛋白发生了活跃降解。