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[长期服用大黄素致肝损伤的胆汁酸代谢相关机制]

[Mechanism related to bile acids metabolism of liver injury induced by long-term administration of emodin].

作者信息

Tian Jing-Zhuo, Wang Lian-Mei, Yi Yan, Xian Zhong, Deng Nuo, Zhao Yong, Li Chun-Ying, Zhang Yu-Shi, Liu Su-Yan, Han Jia-Yin, Pan Chen, Liu Chen-Yue, Meng Jing, Liang Ai-Hua

机构信息

State Key Laboratory for Quality Ensurance and Sustainalbe Use of Dao-di Herbs, Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences Beijing 100700,China.

State Key Laboratory for Quality Ensurance and Sustainalbe Use of Dao-di Herbs, Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences Beijing 100700,China Qianhai Provincial Key Laboratory of Tibetan Medicine Pharmacology and Safety Evaluation,Northwest Institute of Plateau Biology, Chinese Academy of Sciences Xining 810008,China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2025 Jun;50(11):3079-3087. doi: 10.19540/j.cnki.cjcmm.20250103.704.

Abstract

Emodin is a hydroxyanthraquinone compound that is widely distributed and has multiple pharmacological activities, including anti-diarrheal, anti-inflammatory, and liver-protective effects. Research indicates that emodin may be one of the main components responsible for inducing hepatotoxicity. However, studies on the mechanisms of liver injury are relatively limited, particularly those related to bile acids(BAs) metabolism. This study aims to systematically investigate the effects of different dosages of emodin on BAs metabolism, providing a basis for the safe clinical use of traditional Chinese medicine(TCM)containing emodin. First, this study evaluated the safety of repeated administration of different dosages of emodin over a 5-week period, with a particular focus on its impact on the liver. Next, the composition and content of BAs in serum and liver were analyzed. Subsequently, qRT-PCR was used to detect the mRNA expression of nuclear receptors and transporters related to BAs metabolism. The results showed that 1 g·kg(-1) emodin induced hepatic damage, with bile duct hyperplasia as the primary pathological manifestation. It significantly increased the levels of various BAs in the serum and primary BAs(including taurine-conjugated and free BAs) in the liver. Additionally, it downregulated the mRNA expression of farnesoid X receptor(FXR), retinoid X receptor(RXR), and sodium taurocholate cotransporting polypeptide(NTCP), and upregulated the mRNA expression of cholesterol 7α-hydroxylase(CYP7A1) in the liver. Although 0.01 g·kg(-1) and 0.03 g·kg(-1) emodin did not induce obvious liver injury, they significantly increased the level of taurine-conjugated BAs in the liver, suggesting a potential interference with BAs homeostasis. In conclusion, 1 g·kg(-1) emodin may promote the production of primary BAs in the liver by affecting the FXR-RXR-CYP7A1 pathway, inhibit NTCP expression, and reduce BA reabsorption in the liver, resulting in BA accumulation in the peripheral blood. This disruption of BA homeostasis leads to liver injury. Even doses of emodin close to the clinical dose can also have a certain effect on the homeostasis of BAs. Therefore, when using traditional Chinese medicine or formulas containing emodin in clinical practice, it is necessary to regularly monitor liver function indicators and closely monitor the risk of drug-induced liver injury.

摘要

大黄素是一种羟基蒽醌化合物,分布广泛且具有多种药理活性,包括止泻、抗炎和保肝作用。研究表明,大黄素可能是导致肝毒性的主要成分之一。然而,关于肝损伤机制的研究相对有限,尤其是与胆汁酸(BAs)代谢相关的研究。本研究旨在系统地探究不同剂量大黄素对BAs代谢的影响,为含大黄素的中药安全临床应用提供依据。首先,本研究评估了连续5周重复给予不同剂量大黄素的安全性,特别关注其对肝脏的影响。其次,分析了血清和肝脏中BAs的组成和含量。随后,采用qRT-PCR检测与BAs代谢相关的核受体和转运体的mRNA表达。结果显示,1 g·kg⁻¹大黄素可诱导肝损伤,主要病理表现为胆管增生。它显著增加了血清中各种BAs的水平以及肝脏中初级BAs(包括牛磺酸结合型和游离型BAs)的水平。此外,它下调了肝脏中法尼酯X受体(FXR)、视黄醇X受体(RXR)和牛磺胆酸钠共转运多肽(NTCP)的mRNA表达,并上调了胆固醇7α-羟化酶(CYP7A1)的mRNA表达。虽然0.01 g·kg⁻¹和0.03 g·kg⁻¹大黄素未诱导明显的肝损伤,但它们显著增加了肝脏中牛磺酸结合型BAs的水平,提示可能对BAs稳态有潜在干扰。总之,1 g·kg⁻¹大黄素可能通过影响FXR-RXR-CYP7A1途径促进肝脏中初级BAs的产生,抑制NTCP表达,并减少肝脏中BA的重吸收,导致外周血中BA蓄积。这种BA稳态的破坏导致肝损伤。即使接近临床剂量的大黄素也会对BAs稳态产生一定影响。因此,临床使用含大黄素的中药或方剂时,有必要定期监测肝功能指标,并密切监测药物性肝损伤的风险。

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