Department of Teaching and Research Sub-Direction, Hospital Regional de Alta Especialidad de Ciudad Victoria "Bicentenario 2010", Ciudad Victoria, Mexico.
Facultad de Medicina e Ingeniería en Sistemas Computacionales de Matamoros, Universidad Autónoma de Tamaulipas, Matamoros, Mexico.
Front Immunol. 2023 Aug 1;14:1178909. doi: 10.3389/fimmu.2023.1178909. eCollection 2023.
Brain death (BD) and steatosis are both risk factors for organ dysfunction or failure in liver transplantation (LT).
Here, we examine the role of interleukin 6 (IL- 6) and IL-10 in LT of both non-steatotic and steatotic liver recovered from donors after brain death (DBDs), as well as the molecular signaling pathways underlying the effects of such cytokines.
BD reduced IL-6 levels only in nonsteatotic grafts, and diminished IL-10 levels only in steatotic ones. In both graft types, BD increased IL-1β, which was associated with hepatic inflammation and damage. IL-6 administration reduced IL-1β only in non-steatotic grafts and protected them against damage and inflammation. Concordantly, IL-1β inhibition via treatment with an IL-1 receptor antagonist caused the same benefits in non-steatotic grafts. Treatment with IL-10 decreased IL-1β only in steatotic grafts and reduced injury and inflammation specifically in this graft type. Blockading the IL-1β effects also reduced damage and inflammation in steatotic grafts. Also, blockade of IL-1β action diminished hepatic cAMP in both types of livers, and this was associated with a reduction in liver injury and inflammation, then pointing to IL-1β regulating cAMP generation under LT and BD conditions. Additionally, the involvement of nitric oxide (NO) in the effects of interleukins was evaluated. Pharmacological inhibition of NO in LT from DBDs prompted even more evident reductions of IL-6 or IL-10 in non-steatotic and steatotic grafts, respectively. This exacerbated the already high levels of IL-1β seen in LT from DBDs, causing worse damage and inflammation in both graft types. The administration of NO donors to non-steatotic grafts potentiated the beneficial effects of endogenous NO, since it increased IL-6 levels, and reduced IL-1β, inflammation, and damage. However, treatment with NO donors in steatotic grafts did not modify IL-10 or IL-1β levels, but induced more injurious effects tan the induction of BD alone, characterized by increased nitrotyrosine, lipid peroxidation, inflammation, and hepatic damage.
Our study thus highlights the specificity of new signaling pathways in LT from DBDs: NO-IL-6-IL-1β in non-steatotic livers and NO-IL-10-IL-1β in steatotic ones. This opens up new therapeutic targets that could be useful in clinical LT.
脑死亡 (BD) 和脂肪变性都是肝移植 (LT) 中器官功能障碍或衰竭的风险因素。
在这里,我们研究了白细胞介素 6 (IL-6) 和白细胞介素 10 (IL-10) 在来自脑死亡供体 (DBD) 的非脂肪变性和脂肪变性肝脏 LT 中的作用,以及这些细胞因子作用背后的分子信号通路。
BD 仅降低非脂肪变性移植物中的 IL-6 水平,仅降低脂肪变性移植物中的 IL-10 水平。在这两种移植物类型中,BD 增加了 IL-1β,这与肝炎症和损伤有关。IL-6 给药仅在非脂肪变性移植物中降低 IL-1β,并保护其免受损伤和炎症。相应地,用白细胞介素 1 受体拮抗剂治疗抑制 IL-1β 可在非脂肪变性移植物中产生相同的益处。IL-10 处理仅降低脂肪变性移植物中的 IL-1β,并特异性减少这种移植物类型的损伤和炎症。阻断 IL-1β 的作用也可减少脂肪变性移植物的损伤和炎症。此外,阻断 IL-1β 作用还降低了两种类型肝脏中的肝 cAMP,这与肝损伤和炎症的减少有关,然后表明 IL-1β 在 LT 和 BD 条件下调节 cAMP 的产生。此外,还评估了白细胞介素作用中一氧化氮 (NO) 的参与。在 DBDs 的 LT 中,药理学抑制 NO 导致非脂肪变性和脂肪变性移植物中 IL-6 或 IL-10 的水平进一步明显降低。这加剧了 DBDs 的 LT 中已经很高的 IL-1β 水平,导致两种移植物类型的损伤和炎症更严重。将 NO 供体施用于非脂肪变性移植物可增强内源性 NO 的有益作用,因为它增加了 IL-6 水平,并降低了 IL-1β、炎症和损伤。然而,在脂肪变性移植物中用 NO 供体治疗并没有改变 IL-10 或 IL-1β 水平,但诱导的损伤作用大于单独诱导 BD,其特征为增加硝基酪氨酸、脂质过氧化、炎症和肝损伤。
因此,我们的研究强调了 DBDs 的 LT 中新信号通路的特异性:非脂肪变性肝脏中的 NO-IL-6-IL-1β 和脂肪变性肝脏中的 NO-IL-10-IL-1β。这为临床 LT 开辟了新的治疗靶点,可能具有有用性。