Department of Endocrinology, Fundación Investigación Biomédica del Hospital Infantil Universitario Niño Jesús, Instituto de Investigación Biomédica la Princesa, Madrid, Spain.
UGC Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain.
Br J Pharmacol. 2020 Jul;177(14):3309-3326. doi: 10.1111/bph.15051. Epub 2020 Apr 15.
Protective mechanisms of the endogenous cannabinoid system against drug-induced liver injury (DILI) are actively being investigated regarding the differential regulatory role of the cannabinoid CB and CB receptors in liver fibrogenesis and inflammation.
The 2-arachidonoylglycerol (2-AG)-related signalling receptors and enzymatic machinery, and inflammatory/fibrogenic factors were investigated in the liver of a mouse model of hepatotoxicity induced by acute and repeated overdoses (750 mg·kg ·day ) of paracetamol (acetaminophen), previously treated with selective CB (ACEA) and CB (JWH015) agonists (10 mg·kg ), or lacking CB and CB receptors.
Acute paracetamol increased the expression of CB , ABHD6 and COX-2, while repeated paracetamol increased that of CB and COX-2 and decreased that of DAGLβ. Both acute paracetamol and repeated paracetamol decreased the liver content of acylglycerols (2-AG, 2-LG and 2-OG). Human liver samples from a patient suffering APAP hepatotoxicity confirmed CB and CB increments. Acute paracetamol-exposed CB KO mice had higher expression of the fibrogenic αSMA and the cytokine IL-6 and lower apoptotic cleaved caspase 3. CB deficiency enhanced the repeated APAP-induced increases in αSMA and cleaved caspase 3 and blocked those of CYP2E1, TNF-α, the chemokine CCL2 and the circulating γ-glutamyltransferase (γGT). Although JWH015 reduced the expression of αSMA and TNF-α in acute paracetamol, ACEA increased the expression of cleaved caspase 3 and CCL2 in repeated paracetamol.
The differential role of CB versus CB receptors on inflammatory/fibrogenic factors related to paracetamol-induced hepatotoxicity should be considered for designing alternative therapies against DILI.
内源性大麻素系统对药物性肝损伤(DILI)的保护机制正受到积极研究,研究方向为大麻素 CB1 和 CB2 受体在肝纤维化和炎症中的差异调节作用。
在急性和重复过量(750mg·kg·day)扑热息痛(醋氨酚)诱导的肝毒性小鼠模型中,研究了 2-花生四烯酸甘油(2-AG)相关信号转导受体和酶机制以及炎症/纤维化因子。此前,该模型已用选择性 CB(ACEA)和 CB(JWH015)激动剂(10mg·kg)预处理,或缺乏 CB 和 CB 受体。
急性扑热息痛增加了 CB1、ABHD6 和 COX-2 的表达,而重复扑热息痛增加了 CB1 和 COX-2 的表达,降低了 DAGLβ 的表达。急性扑热息痛和重复扑热息痛均降低了肝酰基甘油(2-AG、2-LG 和 2-OG)含量。来自扑热息痛肝毒性患者的人肝样本证实了 CB 和 CB2 的增加。急性扑热息痛暴露的 CB1 基因敲除(KO)小鼠αSMA 和细胞因子 IL-6 的表达更高,而凋亡 cleaved caspase 3 的表达更低。CB 缺乏增强了重复 APAP 诱导的αSMA 和 cleaved caspase 3 的增加,并阻断了 CYP2E1、TNF-α、趋化因子 CCL2 和循环γ-谷氨酰转移酶(γGT)的增加。虽然 JWH015 降低了急性扑热息痛中αSMA 和 TNF-α的表达,但 ACEA 增加了重复扑热息痛中 cleaved caspase 3 和 CCL2 的表达。
在设计针对 DILI 的替代疗法时,应考虑 CB1 受体与 CB2 受体在与扑热息痛诱导的肝毒性相关的炎症/纤维化因子中的差异作用。