King Andrew, Houlihan Diarmaid D, Kavanagh Dean, Haldar Debashis, Luu Nguyet, Owen Andrew, Suresh Shankar, Than Nwe Ni, Reynolds Gary, Penny Jasmine, Sumption Henry, Ramachandran Prakash, Henderson Neil C, Kalia Neena, Frampton Jon, Adams David H, Newsome Philip N
Birmingham Liver Biomedical Research Unit, National Institute for Health Research, Centre for Liver Research, University of Birmingham, Birmingham, United Kingdom.
Birmingham Liver Biomedical Research Unit, National Institute for Health Research, Centre for Liver Research, University of Birmingham, Birmingham, United Kingdom.
Gastroenterology. 2017 Jul;153(1):233-248.e16. doi: 10.1053/j.gastro.2017.03.022. Epub 2017 Mar 28.
BACKGROUND & AIMS: There is growing interest in the use of bone marrow cells to treat liver fibrosis, however, little is known about their antifibrotic efficacy or the identity of their effector cell(s). Sphingosine-1-phosphate (S1P) mediates egress of immune cells from the lymphoid organs into the lymphatic vessels; we investigated its role in the response of hematopoietic stem cells (HSCs) to liver fibrosis in mice.
Purified (c-kit+/sca1+/lin-) HSCs were infused repeatedly into mice undergoing fibrotic liver injury. Chronic liver injury was induced in BoyJ mice by injection of carbon tetrachloride (CCl) or placement on a methionine-choline-deficient diet. Some mice were irradiated and given transplants of bone marrow cells from C57BL6 mice, with or without the S1P antagonist FTY720; we then studied HSC mobilization and localization. Migration of HSC lines was quantified in Transwell assays. Levels of S1P in liver, bone marrow, and lymph fluid were measured using an enzyme-linked immunosorbent assay. Liver tissues were collected and analyzed by immunohistochemical quantitative polymerase chain reaction and sphingosine kinase activity assays. We performed quantitative polymerase chain reaction analyses of the expression of sphingosine kinase 1 and 2, sphingosine-1-phosphate lyase 1, and sphingosine-1-phosphate phosphatase 1 in normal human liver and cirrhotic liver from patients with alcohol-related liver disease (n = 6).
Infusions of HSCs into mice with liver injury reduced liver scarring based on picrosirius red staining (49.7% reduction in mice given HSCs vs control mice; P < .001), and hepatic hydroxyproline content (328 mg/g in mice given HSCs vs 428 mg/g in control mice; P < .01). HSC infusion also reduced hepatic expression of α-smooth muscle actin (0.19 ± 0.007-fold compared with controls; P < .0001) and collagen type I α 1 chain (0.29 ± 0.17-fold compared with controls; P < .0001). These antifibrotic effects were maintained with infusion of lymphoid progenitors that lack myeloid potential and were associated with increased numbers of recipient neutrophils and macrophages in liver. In studies of HSC cell lines, we found HSCs to recruit monocytes, and this process to require C-C motif chemokine receptor 2. In fibrotic liver tissue from mice and patients, hepatic S1P levels increased owing to increased hepatic sphingosine kinase-1 expression, which contributed to a reduced liver:lymph S1P gradient and limited HSC egress from the liver. Mice given the S1P antagonist (FTY720) with HSCs had increased hepatic retention of HSCs (1697 ± 247 cells in mice given FTY720 vs 982 ± 110 cells in controls; P < .05), and further reductions in fibrosis.
In studies of mice with chronic liver injury, we showed the antifibrotic effects of repeated infusions of purified HSCs. We found that HSCs promote recruitment of endogenous macrophages and neutrophils. Strategies to reduce SIP signaling and increase retention of HSCs in the liver could increase their antifibrotic activities and be developed for treatment of patients with liver fibrosis.
骨髓细胞用于治疗肝纤维化越来越受到关注,然而,对其抗纤维化疗效或效应细胞的特性却知之甚少。1-磷酸鞘氨醇(S1P)介导免疫细胞从淋巴器官进入淋巴管;我们研究了其在小鼠造血干细胞(HSC)对肝纤维化反应中的作用。
将纯化的(c-kit+/sca1+/lin-)HSC反复注入遭受纤维化肝损伤的小鼠体内。通过注射四氯化碳(CCl)或给予蛋氨酸-胆碱缺乏饮食诱导BoyJ小鼠发生慢性肝损伤。一些小鼠接受照射并移植来自C57BL6小鼠的骨髓细胞,同时给予或不给予S1P拮抗剂FTY720;然后我们研究HSC的动员和定位。在Transwell实验中对HSC系的迁移进行定量。使用酶联免疫吸附测定法测量肝脏、骨髓和淋巴液中S1P的水平。收集肝脏组织并通过免疫组织化学定量聚合酶链反应和鞘氨醇激酶活性测定进行分析。我们对酒精性肝病患者(n = 6)的正常肝脏和肝硬化肝脏中鞘氨醇激酶1和2、1-磷酸鞘氨醇裂解酶1以及1-磷酸鞘氨醇磷酸酶1的表达进行了定量聚合酶链反应分析。
对肝损伤小鼠输注HSC可减少肝瘢痕形成,基于天狼星红染色显示(接受HSC的小鼠与对照小鼠相比减少49.7%;P <.001),肝羟脯氨酸含量也降低(接受HSC的小鼠为328 mg/g,对照小鼠为428 mg/g;P <.01)。输注HSC还降低了α-平滑肌肌动蛋白的肝脏表达(与对照相比为0.19 ± 0.007倍;P <.0001)和I型胶原α1链的表达(与对照相比为0.29 ± 0.17倍;P <.0001)。这些抗纤维化作用在输注缺乏髓系潜能的淋巴祖细胞时得以维持,并且与肝脏中受体中性粒细胞和巨噬细胞数量增加有关。在对HSC细胞系的研究中,我们发现HSC可招募单核细胞,且此过程需要C-C基序趋化因子受体2。在小鼠和患者的纤维化肝组织中,由于肝脏鞘氨醇激酶-1表达增加导致肝脏S1P水平升高,这导致肝脏与淋巴之间的S1P梯度降低,限制了HSC从肝脏中流出。给予S1P拮抗剂(FTY720)与HSC的小鼠肝脏中HSC的滞留增加(给予FTY720的小鼠为1697 ± 247个细胞,对照小鼠为982 ± 110个细胞;P <.05),并且纤维化进一步减轻。
在慢性肝损伤小鼠的研究中,我们展示了反复输注纯化HSC的抗纤维化作用。我们发现HSC可促进内源性巨噬细胞和中性粒细胞的招募。降低SIP信号传导并增加HSC在肝脏中滞留的策略可能会增强其抗纤维化活性,并可开发用于治疗肝纤维化患者。