微生物群诱导的脂质过氧化损伤了奥贝胆酸对非酒精性脂肪性肝炎的抗纤维化作用。

Microbiota-induced lipid peroxidation impairs obeticholic acid-mediated antifibrotic effect towards nonalcoholic steatohepatitis in mice.

机构信息

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China; Research Units of Infectious Disease and Microecology, Chinese Academy of Medical Sciences, Beijing, 100730, China.

出版信息

Redox Biol. 2023 Feb;59:102582. doi: 10.1016/j.redox.2022.102582. Epub 2022 Dec 22.

Abstract

Obeticholic acid (OCA) has been examined to treat non-alcoholic steatohepatitis (NASH), but has unsatisfactory antifibrotic effect and deficient responsive rate in recent phase III clinical trial. Using a prolonged western diet-feeding murine NASH model, we show that OCA-shaped gut microbiota induces lipid peroxidation and impairs its anti-fibrotic effect. Mechanically, Bacteroides enriched by OCA deconjugates tauro-conjugated bile acids to generate excessive chenodeoxycholic acid (CDCA), resulting in liver ROS accumulation. We further elucidate that OCA reduces triglycerides containing polyunsaturated fatty acid (PUFA-TGs) levels, whereas elevates free PUFAs and phosphatidylethanolamines containing PUFA (PUFA-PEs), which are susceptible to be oxidized to lipid peroxides (notably arachidonic acid (ARA)-derived 12-HHTrE), inducing hepatocyte ferroptosis and activating hepatic stellate cells (HSCs). Inhibiting lipid peroxidation with pentoxifylline (PTX) rescues anti-fibrotic effect of OCA, suggesting combination of OCA and lipid peroxidation inhibitor could be a potential antifibrotic pharmacological approach in clinical NASH-fibrosis.

摘要

鹅去氧胆酸 (OCA) 已被研究用于治疗非酒精性脂肪性肝炎 (NASH),但在最近的 III 期临床试验中其抗纤维化效果并不令人满意,应答率也较低。我们使用延长的西方饮食喂养的 NASH 小鼠模型表明,OCA 样肠道微生物群会诱导脂质过氧化,并损害其抗纤维化作用。在机制上,OCA 富集的拟杆菌可将牛磺胆酸共轭物去共轭生成过量的鹅去氧胆酸 (CDCA),导致肝脏 ROS 积累。我们进一步阐明,OCA 降低含有多不饱和脂肪酸 (PUFA) 的甘油三酯 (PUFA-TGs) 水平,而增加游离多不饱和脂肪酸和含有多不饱和脂肪酸的磷脂酰乙醇胺 (PUFA-PEs),它们容易被氧化成脂质过氧化物(特别是花生四烯酸 (ARA) 衍生的 12-HHTrE),诱导肝细胞铁死亡并激活肝星状细胞 (HSCs)。用己酮可可碱 (PTX) 抑制脂质过氧化可挽救 OCA 的抗纤维化作用,这表明 OCA 和脂质过氧化抑制剂的联合应用可能是临床 NASH 纤维化的一种潜在的抗纤维化药物治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1072/9830314/2f3d5d20316f/gr1.jpg

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