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2 型免疫在代谢性疾病中具有保护作用,但与 TGF-β 协同作用会加剧 NAFLD。

Type 2 immunity is protective in metabolic disease but exacerbates NAFLD collaboratively with TGF-β.

机构信息

Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.

Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.

出版信息

Sci Transl Med. 2017 Jun 28;9(396). doi: 10.1126/scitranslmed.aal3694.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is now the most common progressive liver disease in developed countries and is the second leading indication for liver transplantation due to the extensive fibrosis it causes. NAFLD progression is thought to be tied to chronic low-level type 1 inflammation originating in the adipose tissue during obesity; however, the specific immunological mechanisms regulating the progression of NAFLD-associated fibrosis in the liver are unclear. To investigate the immunopathogenesis of NAFLD more completely, we investigated adipose dysfunction, nonalcoholic steatohepatitis (NASH), and fibrosis in mice that develop polarized type 1 or type 2 immune responses. Unexpectedly, obese interleukin-10 (IL-10)/IL-4-deficient mice (type 1-polarized) were highly resistant to NASH. This protection was associated with an increased hepatic interferon-γ (IFN-γ) signature. Conversely, IFN-γ-deficient mice progressed rapidly to NASH with evidence of fibrosis dependent on transforming growth factor-β (TGF-β) and IL-13 signaling. Unlike increasing type 1 inflammation and the marked loss of eosinophils seen in expanding adipose tissue, progression of NASH was associated with increasing eosinophilic type 2 liver inflammation in mice and human patient biopsies. Finally, simultaneous inhibition of TGF-β and IL-13 signaling attenuated the fibrotic machinery more completely than TGF-β alone in NAFLD-associated fibrosis. Thus, although type 2 immunity maintains healthy metabolic signaling in adipose tissues, it exacerbates the progression of NAFLD collaboratively with TGF-β in the liver.

摘要

非酒精性脂肪性肝病 (NAFLD) 现在是发达国家最常见的进行性肝病,也是由于其广泛纤维化导致的肝移植的第二大指征。NAFLD 的进展被认为与肥胖时脂肪组织中慢性低度 1 型炎症有关;然而,调节肝内与 NAFLD 相关纤维化进展的特定免疫机制尚不清楚。为了更全面地研究 NAFLD 的免疫发病机制,我们研究了在发展出极化 1 型或 2 型免疫反应的小鼠中脂肪组织功能障碍、非酒精性脂肪性肝炎 (NASH) 和纤维化。出乎意料的是,肥胖白细胞介素-10 (IL-10)/IL-4 缺陷型小鼠 (1 型极化) 对 NASH 具有高度抗性。这种保护与肝内干扰素-γ (IFN-γ) 特征增加有关。相反,IFN-γ 缺陷型小鼠迅速进展为 NASH,并伴有依赖转化生长因子-β (TGF-β) 和 IL-13 信号的纤维化。与在扩张的脂肪组织中观察到的 1 型炎症增加和嗜酸性粒细胞的明显丢失不同,NASH 的进展与嗜酸性粒细胞 2 型肝炎症的增加相关,无论是在小鼠还是人类患者的活检中均如此。最后,与 TGF-β 单独抑制相比,TGF-β 和 IL-13 信号的同时抑制在 NAFLD 相关纤维化中更完全地抑制了纤维化机制。因此,尽管 2 型免疫在脂肪组织中维持健康的代谢信号,但它与 TGF-β 一起协同加剧了 NAFLD 的进展。

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