Departamento de Medicina, Universidad de Alcalá, Madrid, Spain.
Hepatology. 2012 Nov;56(5):1861-9. doi: 10.1002/hep.25854. Epub 2012 Sep 17.
Cirrhosis with ascites is associated with a high rate of gut bacterial translocation (GBT) and spontaneous bacterial infections of enteric origin. We addressed the activation state and role of intestinal dendritic cells (DCs) in experimental ascitic cirrhosis and their relationship with GBT. Cirrhosis with ascites was CCl(4) induced in rats. To examine their activation state and functions, DCs (CD103(+) RT1B(+) CD3(-) CD45RA(-) ) were isolated from the intestinal lamina propria and mesenteric lymph nodes (MLNs), and the following parameters were determined by flow cytometry: surface antigen expression; spontaneous or lipopolysaccharide-stimulated tumor necrosis factor alpha (TNF-α) production; and in vitro capacity to phagocytose latex beads and to migrate toward the chemokine (C-C motif) ligand 21. GBT was defined as the growth of bacteria in MLNs culture. Bacterial DNA (Bact-DNA) in MLNs was identified by polymerase chain reaction. In rats with Bact-DNA in MLNs without GBT, intestinal and MLNs CD103(+) -DCs showed features of activation, expansion of the proinflammatory CD4(+) -DC subpopulation, augmented TNF-α production, and increased phagocytic and migratory capacities. In contrast, in rats with GBT, CD103(+) -DCs showed the absence of an activated phenotype, lowered TNF-α production, and relatively deficient phagocytosis and migration capacities. The CD103(+) -DC of rats without Bact-DNA in MLNs or GBT were similar to controls. In cirrhotic rats, bowel decontamination with antibiotics eliminated Bact-DNA in MLNs and GBT, normalized the activation state and functions of CD103(+) -DCs, and increased their TNF-α production.
In experimental cirrhosis with ascites, continuous pressure of gut bacteria shapes the phenotypic and functional profile of intestinal DCs to produce effects that range from their activation and enhanced functions to their exhaustion and tolerance.
肝硬化伴腹水与肠道细菌易位(GBT)和自发性肠道来源的细菌感染发生率高有关。我们研究了实验性腹水性肝硬化中肠道树突状细胞(DC)的激活状态和作用及其与 GBT 的关系。在大鼠中用 CCl4 诱导肝硬化。为了检测其激活状态和功能,从肠固有层和肠系膜淋巴结(MLN)中分离 DC(CD103(+)RT1B(+)CD3(-)CD45RA(-)),并通过流式细胞术测定以下参数:表面抗原表达;自发性或脂多糖刺激肿瘤坏死因子-α(TNF-α)产生;以及体外吞噬乳胶珠和向趋化因子(C-C 基序)配体 21 迁移的能力。GBT 定义为 MLN 培养物中细菌的生长。通过聚合酶链反应鉴定 MLN 中的细菌 DNA(Bact-DNA)。在 MLN 中没有 GBT 但有 Bact-DNA 的大鼠中,肠道和 MLN CD103(+)-DC 表现出激活特征,促炎 CD4(+)-DC 亚群扩张,TNF-α 产生增加,吞噬和迁移能力增强。相比之下,在有 GBT 的大鼠中,CD103(+)-DC 表现出无激活表型,TNF-α 产生降低,吞噬和迁移能力相对不足。MLN 中无 Bact-DNA 或 GBT 的大鼠的 CD103(+)-DC 与对照组相似。在肝硬化大鼠中,用抗生素进行肠道去污可消除 MLN 和 GBT 中的 Bact-DNA,使 CD103(+)-DC 的激活状态和功能正常化,并增加其 TNF-α 产生。
在伴有腹水的实验性肝硬化中,肠道细菌的持续压力塑造了肠道 DC 的表型和功能特征,产生的影响从激活和增强功能到耗竭和耐受不等。