Pi Aiwen, Jiang Kai, Ding Qinchao, Lai Shanglei, Yang Wenwen, Zhu Jinyan, Guo Rui, Fan Yibin, Chi Linfeng, Li Songtao
School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
School of Life Science, Zhejiang Chinese Medical University, Hangzhou, China.
Front Pharmacol. 2021 Sep 16;12:752148. doi: 10.3389/fphar.2021.752148. eCollection 2021.
Alcoholic liver disease (ALD) caused by chronic ethanol overconsumption is a common type of liver disease with a severe mortality burden throughout the world. The pathogenesis of ALD is complex, and no effective clinical treatment for the disease has advanced so far. Prolonged alcohol abstinence is the most effective therapy to attenuate the clinical course of ALD and even reverse liver damage. However, the molecular mechanisms involved in alcohol abstinence-improved recovery from alcoholic fatty liver remain unclear. This study aims to systematically evaluate the beneficial effect of alcohol abstinence on pathological changes in ALD. Using the Lieber-DeCarli mouse model of ALD, we analysed whether 1-week alcohol withdrawal reversed alcohol-induced detrimental alterations, including oxidative stress, liver injury, lipids metabolism, and hepatic inflammation, by detecting biomarkers and potential targets. Alcohol withdrawal ameliorated alcohol-induced hepatic steatosis by improving liver lipid metabolism reprogramming upregulating phosphorylated 5'-AMP -activated protein kinase (p-AMPK), peroxisome proliferator-activated receptor-α (PPAR-α), and carnitine palmitoyltransferase-1 (CPT-1), and downregulating fatty acid synthase (FAS) and diacylglycerol acyltransferase-2 (DGAT-2). The activities of antioxidant enzymes, including superoxide dismutase (SOD) and glutathione peroxidase (GSH-px), were significantly enhanced by alcohol withdrawal. Importantly, the abstinence recovered alcohol-fed induced liver injury, as evidenced by the improvements in haematoxylin and eosin (H&E) staining, plasma alanine aminotransferase (ALT) levels, and liver weight/body weight ratio. Alcohol-stimulated toll-like receptor 4/mitogen-activated protein kinases (TLR4/MAPKs) were significantly reversed by alcohol withdrawal, which might mechanistically contribute to the amelioration of liver injury. Accordingly, the hepatic inflammatory factor represented by tumour necrosis factor-alpha (TNF-α) was improved by alcohol abstinence. In summary, we reported that alcohol withdrawal effectively restored hepatic lipid metabolism and reversed liver injury and inflammation by improving metabolism reprogramming. These findings enhanced our understanding of the biological mechanisms involved in the beneficial role of alcohol abstinence as an effective treatment for ALD.
慢性乙醇过度摄入所致的酒精性肝病(ALD)是一种常见的肝脏疾病,在全球范围内具有严重的死亡负担。ALD的发病机制复杂,迄今为止尚未有有效的临床治疗方法取得进展。长期戒酒是减轻ALD临床病程甚至逆转肝损伤的最有效疗法。然而,戒酒改善酒精性脂肪肝恢复的分子机制仍不清楚。本研究旨在系统评估戒酒对ALD病理变化的有益作用。利用ALD的Lieber-DeCarli小鼠模型,我们通过检测生物标志物和潜在靶点,分析了1周戒酒是否能逆转酒精诱导的有害改变,包括氧化应激、肝损伤、脂质代谢和肝脏炎症。戒酒通过改善肝脏脂质代谢重编程,上调磷酸化的5'-AMP激活蛋白激酶(p-AMPK)、过氧化物酶体增殖物激活受体-α(PPAR-α)和肉碱棕榈酰转移酶-1(CPT-1),下调脂肪酸合酶(FAS)和二酰甘油酰基转移酶-2(DGAT-2),改善了酒精诱导的心肝脂肪变性。戒酒显著增强了包括超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-px)在内的抗氧化酶的活性。重要的是,戒酒恢复了酒精喂养诱导的肝损伤,苏木精和伊红(H&E)染色、血浆丙氨酸氨基转移酶(ALT)水平以及肝脏重量/体重比的改善证明了这一点。酒精刺激的Toll样受体4/丝裂原活化蛋白激酶(TLR4/MAPKs)被戒酒显著逆转,这可能在机制上有助于改善肝损伤。因此,表示为肿瘤坏死因子-α(TNF-α)的肝脏炎症因子通过戒酒得到改善。总之,我们报道戒酒通过改善代谢重编程有效恢复了肝脏脂质代谢,逆转了肝损伤和炎症。这些发现加深了我们对戒酒作为ALD有效治疗方法的有益作用所涉及的生物学机制的理解。