Liver Transplantation Center of First Affiliated Hospital and State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu Province 210029, People's Republic of China.
J Immunol. 2013 Aug 15;191(4):1835-44. doi: 10.4049/jimmunol.1203013. Epub 2013 Jul 10.
Liver fibrosis is a severe, life-threatening clinical condition resulting from nonresolving hepatitis of different origins. IL-17A is critical in inflammation, but its relation to liver fibrosis remains elusive. We find increased IL-17A expression in fibrotic livers from HBV-infected patients undergoing partial hepatectomy because of cirrhosis-related early-stage hepatocellular carcinoma in comparison with control nonfibrotic livers from uninfected patients with hepatic hemangioma. In fibrotic livers, IL-17A immunoreactivity localizes to the inflammatory infiltrate. In experimental carbon tetrachloride-induced liver fibrosis of IL-17RA-deficient mice, we observe reduced neutrophil influx, proinflammatory cytokines, hepatocellular necrosis, inflammation, and fibrosis as compared with control C57BL/6 mice. IL-17A is produced by neutrophils and T lymphocytes expressing the Th17 lineage-specific transcription factor Retinoic acid receptor-related orphan receptor γt. Furthermore, hepatic stellate cells (HSCs) isolated from naive C57BL/6 mice respond to IL-17A with increased IL-6, α-smooth muscle actin, collagen, and TGF-β mRNA expression, suggesting an IL-17A-driven fibrotic process. Pharmacologic ERK1/2 or p38 inhibition significantly attenuated IL-17A-induced HSC activation and collagen expression. In conclusion, IL-17A(+) Retinoic acid receptor-related orphan receptor γt(+) neutrophils and T cells are recruited into the injured liver driving a chronic, fibrotic hepatitis. IL-17A-dependent HSC activation may be critical for liver fibrosis. Thus, blockade of IL-17A could potentially benefit patients with chronic hepatitis and liver fibrosis.
肝纤维化是一种严重的、危及生命的临床病症,由不同病因导致的非持续性肝炎发展而来。IL-17A 在炎症中起着关键作用,但它与肝纤维化的关系仍不清楚。我们发现,与未感染的、患有肝血管瘤的患者的非纤维化肝脏相比,接受部分肝切除术治疗肝硬化相关早期肝细胞癌的 HBV 感染患者的纤维化肝脏中,IL-17A 的表达增加。在纤维化肝脏中,IL-17A 免疫反应定位于炎症浸润部位。在缺乏 IL-17RA 的实验性四氯化碳诱导的肝纤维化小鼠中,与对照的 C57BL/6 小鼠相比,我们观察到中性粒细胞浸润、促炎细胞因子、肝细胞坏死、炎症和纤维化减少。IL-17A 由表达 Th17 谱系特异性转录因子视黄酸受体相关孤儿受体 γt 的中性粒细胞和 T 淋巴细胞产生。此外,从幼稚的 C57BL/6 小鼠中分离出来的肝星状细胞(HSCs)对 IL-17A 作出反应,表现为 IL-6、α-平滑肌肌动蛋白、胶原和 TGF-β mRNA 表达增加,表明存在一个由 IL-17A 驱动的纤维化过程。ERK1/2 或 p38 的药理学抑制显著减弱了 IL-17A 诱导的 HSC 激活和胶原表达。总之,IL-17A(+)视黄酸受体相关孤儿受体 γt(+)中性粒细胞和 T 细胞被募集到受损的肝脏中,导致慢性、纤维化的肝炎。IL-17A 依赖性 HSC 激活可能对肝纤维化至关重要。因此,阻断 IL-17A 可能对慢性肝炎和肝纤维化患者有益。
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