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超声弹性成像在 TβR1 shRNA 治疗对大鼠肝纤维化疗效监测中的应用。

Application of ultrasound elastography for monitoring the effects of TβR1 shRNA therapy on hepatic fibrosis in a rat model.

机构信息

Department of Ultrasound Diagnosis, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.

出版信息

PLoS One. 2021 Jun 28;16(6):e0253150. doi: 10.1371/journal.pone.0253150. eCollection 2021.

Abstract

BACKGROUND

To investigate the application of ultrasound elastography in monitoring the effects of the transforming growth factor (TGF)-β1 signaling pathway-targeted combination therapy for hepatic fibrosis.

METHODS

  1. Short hairpin RNA (shRNA) constructs targeted towards TβR1 were designed, synthesized, and packaged using an adeno-associated virus (AAV), and the effective target shRNA was selected based on transfection results. 2. Fifty rats were randomly allocated (n = 10 per group) to the (A) control group, (B) model group, (C) 0-week therapy group, (D) 4-week therapy group, and (E) combination therapy group. At weeks 2, 4, 6, 8, 10, and 12, acoustic radiation force impulse (ARFI) elastography was used to measure the liver stiffness, inner diameter of the portal vein diameter, and blood velocity; radio frequency ultrasound imaging was used to measure the abdominal aortic elasticity parameter and pulse wave velocity (PWV) of the rats. 3. At week 12, portal vein puncture was performed to measure the portal venous pressure, and rat liver specimens were obtained for the pathological measurement of the degree of hepatic fibrosis.

RESULTS

  1. An shRNA interference sequence targeted towards TβR1 was successfully designed, screened, and packaged using an AAV, and small-animal imaging results indicated expression of the specific shRNA in the liver. 2. At week 12, the ultrasound elastography results were significantly different between the experimental groups and the control group (p < 0.01); among the experimental groups, differences were significant between the therapy groups and the model group (p < 0.01). For groups C and E, the therapeutic effects on hepatic fibrosis in rats were significant, with the pathological results indicating a significant reduction in the degree of hepatic fibrosis (p < 0.01). The therapeutic effectiveness of group D was less than that of group C (p < 0.05). Significant differences existed between the portal venous pressure of the experimental groups and of the control group (p < 0.01). For the abdominal aortic elasticity parameter measured by radio frequency ultrasound imaging, differences existed between the values obtained from the experimental groups and from that of the control group (p < 0.05), while statistically significant differences were not found among the various experimental groups. 3. Continuous ultrasound examination results indicated that the elasticity value of group A was significantly different from those of the other groups after 2 weeks of model establishment (p < 0.01); after 6 weeks, the elasticity values of groups C and E were significantly different compared with those of groups B and D (p < 0.01). For the abdominal aortic elasticity parameter and pulse wave velocity (PWV), there were no significant differences among the various groups (p > 0.05).

CONCLUSION

CCl4-induced hepatic fibrosis can be treated through shRNA silencing of TβR1. Ultrasound ARFI elastography is superior to external force-assisted elastography as it can reflect the degree of fibrosis in moderate to severe hepatic fibrosis and the variations in the degree of fibrosis after treatment. Portal venous pressure was positively correlated with the degree of fibrosis; with early combination therapy, both the degree of fibrosis and portal venous pressure could be effectively reduced.

摘要

背景

探讨超声弹性成像在转化生长因子(TGF)-β1 信号通路靶向联合治疗肝纤维化中的应用。

方法

  1. 设计、合成并使用腺相关病毒(AAV)包装短发夹 RNA(shRNA)构建物靶向 TβR1,根据转染结果选择有效的靶向 shRNA。2. 将 50 只大鼠随机分为(n=10 只/组):(A)对照组、(B)模型组、(C)0 周治疗组、(D)4 周治疗组和(E)联合治疗组。在第 2、4、6、8、10 和 12 周,使用声辐射力脉冲(ARFI)弹性成像测量肝硬度、门静脉直径内径和血流速度;使用射频超声成像测量大鼠腹主动脉弹性参数和脉搏波速度(PWV)。3. 在第 12 周,进行门静脉穿刺以测量门静脉压力,并获取大鼠肝标本以测量肝纤维化程度的病理测量。

结果

  1. 成功设计、筛选和包装了靶向 TβR1 的 shRNA 干扰序列,并通过小动物成像结果表明该 shRNA 在肝脏中有特异性表达。2. 在第 12 周,实验组和对照组的超声弹性成像结果差异有统计学意义(p<0.01);实验组中,治疗组与模型组之间的差异有统计学意义(p<0.01)。对于 C 组和 E 组,对大鼠肝纤维化的治疗效果显著,病理结果表明肝纤维化程度显著降低(p<0.01)。D 组的治疗效果低于 C 组(p<0.05)。实验组和对照组之间的门静脉压力差异有统计学意义(p<0.01)。射频超声成像测量的腹主动脉弹性参数,实验组与对照组之间的差异有统计学意义(p<0.05),但各组之间无统计学差异。3. 连续超声检查结果表明,模型建立 2 周后,A 组的弹性值与其他组有显著差异(p<0.01);6 周后,C 组和 E 组的弹性值与 B 组和 D 组有显著差异(p<0.01)。对于腹主动脉弹性参数和脉搏波速度(PWV),各组之间无显著差异(p>0.05)。

结论

通过靶向沉默 TβR1 可以治疗 CCl4 诱导的肝纤维化。超声 ARFI 弹性成像优于外力辅助弹性成像,因为它可以反映中重度肝纤维化的纤维化程度以及治疗后纤维化程度的变化。门静脉压力与纤维化程度呈正相关;早期联合治疗可有效降低纤维化程度和门静脉压力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e737/8238185/a2d32f61e49e/pone.0253150.g001.jpg

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