Department of Pediatrics, Takarazuka City Hospital, 4-5-1 Kohama-cho, Takarazuka 665-0827, Japan.
Mol Genet Metab. 2012 Nov;107(3):542-7. doi: 10.1016/j.ymgme.2012.08.004. Epub 2012 Aug 11.
The mechanisms of liver damage and steatosis in Wilson's disease (WD) presenting accumulation of copper generating oxidants remain unclear. Recent studies have shown that peroxisome proliferator-activated receptors (PPARs), in particular PPARs α and γ, regulate fat content of the liver together with the anti-oxidant and anti-inflammation systems. However, such PPARs have never been studied in WD.
We examined PPARs along with the liver damage and steatosis of WD using liver specimens from affected patients exhibiting mild liver damage (group I, n = 5), moderate or greater liver damage (group II, n = 10) and fulminant hepatic failure (group III, n = 5), and from asymptomatic carriers (group H, n = 4).
PPAR α expression was increased over the control levels in groups H and I but was decreased in groups II and III in parallel with the progression of liver damage (group H = I>II>III). PPAR γ expression was inversely increased (group H<I<II<III). Mn-dependent superoxide dismutase (Mn-SOD), CuZn-SOD, and catalase activities were decreased in the affected three groups, and were increased in group H. Among group II exhibiting substantial inter-individual variances in parameters, the severity of steatosis showed a significant positive correlation with PPAR γ expression (p<0.001) but not PPAR α expression. CuZn-SOD activity was positively correlated with PPARα expression (p<0.05) but not PPAR γ expression.
These results suggest that changes of PPARs γ and α are associated with the steatosis and the impairment of anti-oxidant system in the liver of WD.
Wilson 病(WD)患者体内铜的蓄积会导致肝损伤和脂肪变性,但铜生成氧化剂导致肝损伤和脂肪变性的确切机制仍不清楚。最近的研究表明,过氧化物酶体增殖物激活受体(PPARs),特别是 PPARα和 PPARγ,与抗氧化和抗炎系统一起调节肝脏的脂肪含量。然而,这些 PPARs 在 WD 中从未被研究过。
我们使用来自有轻度肝损伤(I 组,n=5)、中重度肝损伤或肝衰竭(II 组,n=10)和暴发性肝衰竭(III 组,n=5)的 WD 患者的肝组织以及无症状携带者(H 组,n=4)的肝组织,检查了 PPARs 与 WD 患者的肝损伤和脂肪变性的关系。
PPARα的表达在 H 组和 I 组中均高于对照组,但随着肝损伤的进展(H 组>I 组>II 组>III 组),在 II 组和 III 组中则降低。PPARγ的表达呈相反的增加趋势(H 组<I 组<II 组<III 组)。Mn 依赖性超氧化物歧化酶(Mn-SOD)、CuZn-SOD 和过氧化氢酶活性在受影响的三组中均降低,而在 H 组中则升高。在表现出明显个体间差异的 II 组中,脂肪变性的严重程度与 PPARγ的表达呈显著正相关(p<0.001),但与 PPARα的表达无关。CuZn-SOD 活性与 PPARα的表达呈正相关(p<0.05),但与 PPARγ的表达无关。
这些结果表明,PPARγ和 PPARα的变化与 WD 患者肝脏的脂肪变性和抗氧化系统的损伤有关。