Liver Research Center, Division of Gastroenterology, Department of Medicine, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA.
J Gastroenterol Hepatol. 2013 Oct;28(10):1660-8. doi: 10.1111/jgh.12291.
Alcohol-related liver disease (ALD) is mediated in part by insulin resistance. Attendant dysregulation of lipid metabolism increases accumulation of hepatic ceramides that worsen insulin resistance and compromise the structural and functional integrity of the liver. Insulin and insulin growth factor (IGF) stimulate aspartyl-asparaginyl-β-hydroxylase (AAH), which promotes cell motility needed for structural maintenance and remodeling of the liver. AAH mediates its effects by activating Notch, and in ALD, insulin/IGF signaling, AAH, and Notch are inhibited.
To test the hypothesis that in ALD, hepatic ceramide load contributes to impairments in insulin, AAH, and Notch signaling, control and chronic ethanol-fed adult Long-Evans rats were treated with myriocin, an inhibitor of serine palmitoyl transferase. Livers were used to assess steatohepatitis, insulin/IGF pathway activation, and expression of AAH-Notch signaling molecules.
Chronic ethanol-fed rats had steatohepatitis with increased ceramide levels; impairments in signaling through the insulin receptor, insulin receptor substrate, and Akt; and decreased expression of AAH, Notch, Jagged, Hairy-Enhancer of Split-1, hypoxia-inducible factor 1α, and proliferating cell nuclear antigen. Myriocin abrogated many of these adverse effects of ethanol, particularly hepatic ceramide accumulation, steatohepatitis, and impairments of insulin signaling through Akt, AAH, and Notch.
In ALD, the histopathology and impairments in insulin/IGF responsiveness can be substantially resolved by ceramide inhibitor treatments, even in the context of continued chronic ethanol exposure.
酒精相关性肝病(ALD)部分由胰岛素抵抗介导。随之而来的脂质代谢失调会增加肝Cer的积累,从而加剧胰岛素抵抗,并损害肝脏的结构和功能完整性。胰岛素和胰岛素生长因子(IGF)刺激天冬氨酰-天冬酰胺-β-羟化酶(AAH),促进肝脏结构维持和重塑所需的细胞迁移。AAH 通过激活 Notch 来发挥其作用,在 ALD 中,胰岛素/IGF 信号、AAH 和 Notch 受到抑制。
为了验证肝 Cer 负荷在 ALD 中导致胰岛素、AAH 和 Notch 信号受损的假设,我们用丝氨酸棕榈酰转移酶抑制剂——美罗昔康处理对照和慢性乙醇喂养的成年 Long-Evans 大鼠。利用肝脏评估脂肪性肝炎、胰岛素/IGF 通路激活和 AAH-Notch 信号分子的表达。
慢性乙醇喂养的大鼠发生脂肪性肝炎,Cer 水平升高;胰岛素受体、胰岛素受体底物和 Akt 的信号转导受损;AAH、Notch、Jagged、Hairy-Enhancer of Split-1、缺氧诱导因子 1α 和增殖细胞核抗原的表达降低。美罗昔康消除了乙醇的许多这些不利影响,特别是肝 Cer 积累、脂肪性肝炎和 Akt、AAH 和 Notch 中胰岛素信号的受损。
在 ALD 中,即使在持续慢性乙醇暴露的情况下,Cer 抑制剂治疗也可以显著缓解组织病理学和胰岛素/IGF 反应性的损害。