Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China.
Transplantation. 2022 Jul 1;106(7):1351-1364. doi: 10.1097/TP.0000000000004156. Epub 2022 May 11.
Hepatic ischemia-reperfusion (I/R) injury is the main factor affecting the morbidity and mortality associated with perioperative complications of liver transplantation and major hepatectomy. AXL is a member of the TYRO3, AXL, MERTK family and is involved in immune and apoptosis processes in multiple organs. However, the role of AXL in hepatic I/R injury remains to be elucidated.
Mice pretreated with rmGas6 or R428 and mice tail vein injected with adeno-associated virus knockdown suppressor of cytokine signaling protein-1 (SOCS-1) underwent liver I/R surgery to detect the function of activated AXL in vivo. Primary hepatocytes undergo hypoxic reoxygenation injury in vitro.
AXL expression was significantly upregulated, and phosphorylated-AXL was substantially downregulated in liver transplantation patients and hepatic I/R surgery mice. A mouse model of hepatic I/R injury showed that AXL activation reduced liver inflammation and liver cells apoptosis. The inhibition of AXL activation (AXL-specific inhibitor R428) aggravated hepatic I/R injury, resulted in larger areas of liver injury, aggravated inflammatory response, and increased apoptosis of liver cells. In addition, activated AXL promotes the expression level of SOCS-1 and inhibits toll-like receptor 4 and its downstream signaling pathways. Finally, SOCS-1 was knocked down with an adeno-associated virus, and activated AXL failed to protect against hepatic I/R injury.
AXL activation protects the liver from I/R injury by upregulating SOCS-1 and inhibiting the toll-like receptor 4/myeloid differentiation factor-88/nuclear factor kappa-B signaling axis. Targeting AXL may be a new therapeutic option for ameliorating hepatic I/R injury.
肝缺血再灌注(I/R)损伤是影响肝移植和大肝切除围手术期并发症发病率和死亡率的主要因素。AXL 是 TYRO3、AXL、MERTK 家族的一员,参与多个器官的免疫和细胞凋亡过程。然而,AXL 在肝 I/R 损伤中的作用仍有待阐明。
用 rmGas6 或 R428 预处理小鼠,并通过尾静脉注射腺相关病毒敲低细胞因子信号转导蛋白 1(SOCS-1)的抑制剂,在体内检测激活的 AXL 的功能。原代肝细胞在体外经历低氧复氧损伤。
肝移植患者和肝 I/R 手术小鼠的肝组织中 AXL 表达明显上调,磷酸化-AXL 显著下调。肝 I/R 损伤的小鼠模型显示,AXL 激活可减轻肝炎症和肝细胞凋亡。AXL 激活的抑制(AXL 特异性抑制剂 R428)加重肝 I/R 损伤,导致更大的肝损伤面积,加重炎症反应,增加肝细胞凋亡。此外,激活的 AXL 促进 SOCS-1 的表达水平,并抑制 Toll 样受体 4 及其下游信号通路。最后,用腺相关病毒敲低 SOCS-1,激活的 AXL 未能防止肝 I/R 损伤。
AXL 激活通过上调 SOCS-1 并抑制 Toll 样受体 4/髓样分化因子-88/核因子 kappa-B 信号轴来保护肝脏免受 I/R 损伤。靶向 AXL 可能是改善肝 I/R 损伤的一种新的治疗选择。