Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Institute of Translational Immunology, University Medical Center, Mainz, Germany.
Gastroenterology. 2014 Dec;147(6):1378-92. doi: 10.1053/j.gastro.2014.08.038. Epub 2014 Aug 28.
BACKGROUND & AIMS: Platelet-derived growth factor-β (PDGFB) is a mitogen for hepatic stellate cells (HSCs). We studied the cellular sources of PDGFB and the effects of a high-affinity monoclonal antibody against PDGFB (MOR8457) in mouse models of biliary fibrosis.
Cellular sources of PDGFB were identified using quantitative reverse-transcription polymerase chain reaction, biochemical, and immunohistologic methods. Mice with advanced biliary fibrosis, MDR2(Abcb4)-null mice, and C57Bl/6 (control) mice were placed on 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC)-supplemented diets and were given weekly intraperitoneal injections of MOR8457. Platelets were depleted from MDR2-null mice by injection of an antibody against CD41, or inhibited with diets containing low-dose aspirin. Liver tissues were collected and analyzed by quantitative reverse-transcription PCR and histologic and biochemical analyses.
Levels of PDGFB protein, but not messenger RNA, were increased in fibrotic livers of MDR2-null mice, compared with control mice. Platelet clusters were detected in the hepatic endothelium, in close proximity to HSCs, and were identified as a source of PDGFB protein in MDR2-null mice. Levels of the PDGFB were increased in serum samples from patients with early stages of liver fibrosis of various etiologies (F1-2, n = 16; P < .05), compared with nonfibrotic liver tissue (F0, n = 12). Depletion of platelets from MDR2-null mice normalized hepatic levels of PDGFB within 48 hours, reducing levels of a marker of HSC activation (α-smooth muscle actin) and expression of genes that promote fibrosis. Diets supplemented with low-dose aspirin reduced circulating serum and hepatic levels of PDGFB and significantly reduced progression of fibrosis in MDR2-null mice over 1 year. MOR8457 produced a dose-dependent decrease in liver fibrosis in MDR2-null mice, reducing collagen deposition by 45% and expression of fibrosis-associated genes by 50%, compared with mice given a control antibody. In vitro, platelets activated freshly isolated HSCs (induction of α-smooth muscle actin and fibrosis-associated genes) via a PDGFB-dependent mechanism. MOR8457 also reduced liver fibrosis in mice placed on DDC-supplemented diets.
Platelets produce PDGFB to activate HSC and promote fibrosis in MDR2-null mice and mice on DDC-supplemented diets. Antiplatelet therapy or selective inhibition of PDGFB might reduce biliary fibrosis in patients with liver disease.
血小板衍生生长因子-β(PDGFB)是肝星状细胞(HSCs)的有丝分裂原。我们研究了胆汁性纤维化小鼠模型中 PDGFB 的细胞来源以及高亲和力单克隆抗体 MOR8457 对其的影响。
使用定量逆转录聚合酶链反应、生化和免疫组织化学方法鉴定 PDGFB 的细胞来源。将患有晚期胆汁性纤维化的 MDR2(Abcb4)-/-小鼠、MDR2(Abcb4)+/+(对照)小鼠置于 3,5-二乙氧基羰基-1,4-二氢吡啶(DDC)补充饮食中,并每周给予 MOR8457 腹腔内注射。用抗 CD41 抗体从 MDR2(-/-)小鼠中耗竭血小板,或用含有低剂量阿司匹林的饮食抑制。通过定量逆转录 PCR 以及组织学和生化分析收集和分析肝组织。
与对照小鼠相比,MDR2(-/-)小鼠纤维化肝脏中的 PDGFB 蛋白水平(而非信使 RNA)增加。在肝内皮中检测到血小板簇,与 HSCs 接近,并被鉴定为 MDR2(-/-)小鼠 PDGFB 蛋白的来源。与无纤维化肝组织(F0,n=12)相比,来自各种病因早期肝纤维化患者的血清样本中 PDGFB 水平升高(F1-2,n=16;P<.05)。从 MDR2(-/-)小鼠中耗尽血小板可在 48 小时内使肝内 PDGFB 水平正常化,降低 HSC 活化标志物(α-平滑肌肌动蛋白)和促进纤维化的基因表达。补充低剂量阿司匹林的饮食可减少循环血清和肝内 PDGFB 水平,并在 1 年内显著减少 MDR2(-/-)小鼠的纤维化进展。MOR8457 使 MDR2(-/-)小鼠的肝纤维化呈剂量依赖性减少,与给予对照抗体的小鼠相比,胶原沉积减少 45%,纤维化相关基因表达减少 50%。在体外,血小板通过 PDGFB 依赖性机制激活新分离的 HSCs(诱导α-平滑肌肌动蛋白和纤维化相关基因)。MOR8457 还减少了补充 DDC 饮食的小鼠的肝纤维化。
血小板产生 PDGFB 以激活 HSC 并促进 MDR2(-/-)小鼠和补充 DDC 饮食的小鼠的纤维化。抗血小板治疗或 PDGFB 的选择性抑制可能会减少肝病患者的胆汁性纤维化。