Bhushan Bharat, Walesky Chad, Manley Michael, Gallagher Tara, Borude Prachi, Edwards Genea, Monga Satdarshan P S, Apte Udayan
Department of Pharmacology, Toxicology, and Therapeutics, University of Kansas Medical Center, Kansas City, Kansas.
Department of Pathology and Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Am J Pathol. 2014 Nov;184(11):3013-25. doi: 10.1016/j.ajpath.2014.07.019. Epub 2014 Sep 2.
Acetaminophen (APAP) overdose results in acute liver failure and has limited treatment options. Previous studies show that stimulating liver regeneration is critical for survival after APAP overdose, but the mechanisms remain unclear. In this study, we identified major signaling pathways involved in liver regeneration after APAP-induced acute liver injury using a novel incremental dose model. Liver injury and regeneration were studied in C57BL/6 mice treated with either 300 mg/kg (APAP300) or 600 mg/kg (APAP600) APAP. Mice treated with APAP300 developed extensive liver injury and robust liver regeneration. In contrast, APAP600-treated mice exhibited significant liver injury but substantial inhibition of liver regeneration, resulting in sustained injury and decreased survival. The inhibition of liver regeneration in the APAP600 group was associated with cell cycle arrest and decreased cyclin D1 expression. Several known regenerative pathways, including the IL-6/STAT-3 and epidermal growth factor receptor/c-Met/mitogen-activated protein kinase pathways, were activated, even at APAP600, where regeneration was inhibited. However, canonical Wnt/β-catenin and NF-κB pathways were activated only in APAP300-treated mice, where liver regeneration was stimulated. Furthermore, overexpression of a stable form of β-catenin, where serine 45 is mutated to aspartic acid, in mice resulted in improved liver regeneration after APAP overdose. Taken together, our incremental dose model has identified a differential role of several signaling pathways in liver regeneration after APAP overdose and highlighted canonical Wnt signaling as a potential target for regenerative therapies for APAP-induced acute liver failure.
对乙酰氨基酚(APAP)过量会导致急性肝衰竭,且治疗选择有限。先前的研究表明,刺激肝脏再生对APAP过量后的存活至关重要,但其机制仍不清楚。在本研究中,我们使用一种新型递增剂量模型确定了APAP诱导的急性肝损伤后参与肝脏再生的主要信号通路。在接受300mg/kg(APAP300)或600mg/kg(APAP600)APAP治疗的C57BL/6小鼠中研究了肝损伤和再生情况。接受APAP300治疗的小鼠出现广泛的肝损伤和强劲的肝脏再生。相比之下,接受APAP600治疗的小鼠表现出明显的肝损伤,但肝脏再生受到显著抑制,导致持续性损伤和存活率降低。APAP600组肝脏再生的抑制与细胞周期停滞和细胞周期蛋白D1表达降低有关。即使在APAP600组(肝脏再生受到抑制),包括IL-6/STAT-3和表皮生长因子受体/c-Met/丝裂原活化蛋白激酶通路在内的几种已知再生通路也被激活。然而,经典的Wnt/β-连环蛋白和NF-κB通路仅在接受APAP300治疗(肝脏再生受到刺激)的小鼠中被激活。此外,在小鼠中过表达丝氨酸45突变为天冬氨酸的稳定形式的β-连环蛋白,可改善APAP过量后的肝脏再生。综上所述,我们的递增剂量模型确定了几种信号通路在APAP过量后肝脏再生中的不同作用,并突出了经典Wnt信号作为APAP诱导的急性肝衰竭再生治疗潜在靶点的地位。