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靶向氧化应激:维生素C在预防电子束治疗后肝损伤中的潜力。

Targeting Oxidative Stress: The Potential of Vitamin C in Protecting against Liver Damage after Electron Beam Therapy.

作者信息

Demyashkin Grigory, Parshenkov Mikhail, Koryakin Sergey, Skovorodko Polina, Shchekin Vladimir, Yakimenko Vladislav, Uruskhanova Zhanna, Ugurchieva Dali, Pugacheva Ekaterina, Ivanov Sergey, Shegay Petr, Kaprin Andrey

机构信息

Department of Digital Oncomorphology, National Medical Research Centre of Radiology, 2nd Botkinsky Pass., 3, 125284 Moscow, Russia.

Laboratory of Histology and Immunohistochemistry, Institute of Translational Medicine and Biotechnology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya st., 8/2, 119048 Moscow, Russia.

出版信息

Biomedicines. 2024 Sep 26;12(10):2195. doi: 10.3390/biomedicines12102195.

Abstract

: Radiation-induced liver disease (RILD) is a severe complication arising from radiotherapy, particularly when treating abdominal malignancies such as hepatocellular carcinoma. The liver's critical role in systemic metabolism and its proximity to other abdominal organs make it highly susceptible to radiation-induced damage. This vulnerability significantly limits the maximum safe therapeutic dose of radiation, thereby constraining the overall efficacy of radiotherapy. Among the various modalities, electron beam therapy has gained attention due to its ability to precisely target tumors while minimizing exposure to surrounding healthy tissues. However, despite its advantages, the long-term impacts of electron beam exposure on liver tissue remain inadequately understood, particularly concerning chronic injury and fibrosis driven by sustained oxidative stress. : to investigate the molecular and cellular mechanisms underlying the radioprotective effects of vitamin C in a model of radiation-induced liver disease. Male Wistar rats (n = 120) were randomly assigned to four groups: control, fractionated local electron irradiation (30 Gy), pre-treatment with vitamin C before irradiation, and vitamin C alone. The study evaluated the effects of electron beam radiation and vitamin C on liver tissue through a comprehensive approach, including biochemical analysis of serum enzymes (ALT, AST, ALP, and bilirubin), cytokine levels (IL-1β, IL-6, IL-10, and TNF-α), and oxidative stress markers (MDA and SOD). Histological and morphometric analyses were conducted on liver tissue samples collected at 7, 30, 60, and 90 days, which involved standard staining techniques and advanced imaging, including light and electron microscopy. Gene expression of Bax, Bcl-2, and caspase-3 was analyzed using real-time PCR. The present study demonstrated that fractional local electron irradiation led to significant reductions in body weight and liver mass, as well as marked increases in biochemical markers of liver damage (ALT, AST, ALP, and bilirubin), inflammatory cytokines (IL-1β, IL-6, and TNF-α), and oxidative stress markers (MDA) in the irradiated group. These changes were accompanied by substantial histopathological alterations, including hepatocyte degeneration, fibrosis, and disrupted microvascular circulation. Pre-treatment with vitamin C partially mitigated these effects, reducing the severity of the liver damage, oxidative stress, and inflammation, and preserving a more favorable balance between hepatocyte proliferation and apoptosis. Overall, the results highlight the potential protective role of vitamin C in reducing radiation-induced liver injury, although the long-term benefits require further investigation. : The present study highlights vitamin C's potential as a radioprotective agent against electron beam-induced liver damage. It effectively reduced oxidative stress, apoptosis, and inflammation, particularly in preventing the progression of radiation-induced liver fibrosis. These findings suggest that vitamin C could enhance radiotherapy outcomes by minimizing liver damage, warranting further exploration into its broader clinical applications.

摘要

放射性肝病(RILD)是放疗引起的一种严重并发症,尤其是在治疗肝细胞癌等腹部恶性肿瘤时。肝脏在全身代谢中起关键作用,且与其他腹部器官相邻,这使其极易受到辐射损伤。这种易损性显著限制了辐射的最大安全治疗剂量,从而制约了放疗的整体疗效。在各种放疗方式中,电子束疗法因其能够精确靶向肿瘤同时使周围健康组织受照剂量最小化而受到关注。然而,尽管具有这些优势,电子束照射对肝组织的长期影响仍未得到充分了解,尤其是关于持续氧化应激驱动的慢性损伤和纤维化。:研究维生素C在放射性肝病模型中发挥辐射防护作用的分子和细胞机制。将120只雄性Wistar大鼠随机分为四组:对照组、分次局部电子照射组(30 Gy)、照射前用维生素C预处理组和单独使用维生素C组。该研究通过综合方法评估电子束辐射和维生素C对肝组织的影响,包括对血清酶(谷丙转氨酶、谷草转氨酶、碱性磷酸酶和胆红素)、细胞因子水平(白细胞介素-1β、白细胞介素-6、白细胞介素-10和肿瘤坏死因子-α)以及氧化应激标志物(丙二醛和超氧化物歧化酶)进行生化分析。对在第7天、30天、60天和90天采集的肝组织样本进行组织学和形态计量学分析,其中涉及标准染色技术和先进成像技术,包括光镜和电镜。使用实时聚合酶链反应分析Bax、Bcl-2和半胱天冬酶-3的基因表达。本研究表明,分次局部电子照射导致照射组体重和肝脏质量显著下降,以及肝损伤生化标志物(谷丙转氨酶、谷草转氨酶、碱性磷酸酶和胆红素)、炎性细胞因子(白细胞介素-1β、白细胞介素-6和肿瘤坏死因子-α)和氧化应激标志物(丙二醛)显著升高。这些变化伴随着大量组织病理学改变,包括肝细胞变性、纤维化和微血管循环紊乱。用维生素C预处理可部分减轻这些影响,降低肝损伤、氧化应激和炎症的严重程度,并在肝细胞增殖和凋亡之间维持更有利的平衡。总体而言,结果突出了维生素C在减轻辐射诱导的肝损伤方面的潜在保护作用,尽管其长期益处还需要进一步研究。:本研究突出了维生素C作为抗电子束诱导肝损伤辐射防护剂的潜力。它有效降低了氧化应激、细胞凋亡和炎症,特别是在预防辐射诱导的肝纤维化进展方面。这些发现表明,维生素C可通过使肝损伤最小化来提高放疗效果,值得进一步探索其更广泛的临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4258/11504655/a6e02b5b0b85/biomedicines-12-02195-g001.jpg

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