Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Vascular Medicine Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Hepatology. 2020 May;71(5):1732-1749. doi: 10.1002/hep.30927. Epub 2019 Dec 31.
The Wnt/β-catenin signaling pathway has a well-described role in liver pathobiology. Its suppression was recently shown to decrease bile acid (BA) synthesis, thus preventing the development of cholestatic liver injury and fibrosis after bile duct ligation (BDL).
To generalize these observations, we suppressed β-catenin in Mdr2 knockout (KO) mice, which develop sclerosing cholangitis due to regurgitation of BA from leaky ducts. When β-catenin was knocked down (KD) in KO for 2 weeks, hepatic and biliary injury were exacerbated in comparison to KO given placebo, as shown by serum biochemistry, ductular reaction, inflammation, and fibrosis. Simultaneously, KO/KD livers displayed increased oxidative stress and senescence and an impaired regenerative response. Although the total liver BA levels were similar between KO/KD and KO, there was significant dysregulation of BA transporters and BA detoxification/synthesis enzymes in KO/KD compared with KO alone. Multiphoton intravital microscopy revealed a mixing of blood and bile in the sinusoids, and validated the presence of increased serum BA in KO/KD mice. Although hepatocyte junctions were intact, KO/KD livers had significant canalicular defects, which resulted from loss of hepatocyte polarity. Thus, in contrast to the protective effect of β-catenin KD in BDL model, β-catenin KD in Mdr2 KO aggravated rather than alleviated injury by interfering with expression of BA transporters, hepatocyte polarity, canalicular structure, and the regenerative response.
The resulting imbalance between ongoing injury and restitution led to worsening of the Mdr2 KO phenotype, suggesting caution in targeting β-catenin globally for all cholestatic conditions.
Wnt/β-catenin 信号通路在肝脏病理生物学中具有明确的作用。最近的研究表明,抑制该通路可减少胆汁酸(BA)的合成,从而防止胆管结扎(BDL)后胆汁淤积性肝损伤和纤维化的发展。
为了推广这些观察结果,我们在 Mdr2 敲除(KO)小鼠中抑制β-catenin,这些小鼠由于漏胆管中 BA 的反流而发生硬化性胆管炎。当 KO 中的β-catenin 被敲低(KD)2 周时,与给予安慰剂的 KO 相比,肝和胆管损伤加剧,表现为血清生化、胆管反应、炎症和纤维化。同时,KO/KD 肝脏显示出增加的氧化应激和衰老以及受损的再生反应。尽管 KO/KD 和 KO 的总肝 BA 水平相似,但 KO/KD 中 BA 转运体和 BA 解毒/合成酶的表达显著失调。多光子活体显微镜显示窦内血液和胆汁混合,并验证了 KO/KD 小鼠血清 BA 增加。尽管肝细胞连接完整,但 KO/KD 肝脏的胆管缺陷明显,这是由于肝细胞极性丧失所致。因此,与 BDL 模型中β-catenin KD 的保护作用相反,β-catenin KD 在 Mdr2 KO 中通过干扰 BA 转运体、肝细胞极性、胆管结构和再生反应的表达,加重而不是缓解损伤。
持续损伤和修复之间的不平衡导致 Mdr2 KO 表型恶化,这表明在所有胆汁淤积性疾病中靶向β-catenin 时应谨慎。