Pietrangelo A, Gualdi R, Casalgrandi G, Montosi G, Ventura E
Department of Internal Medicine, University of Modena, Italy.
J Clin Invest. 1995 Apr;95(4):1824-31. doi: 10.1172/JCI117861.
Hepatic fibrosis and cirrhosis are common findings in humans with hemochromatosis. In this study we investigated the molecular pathways of iron-induced hepatic fibrosis and evaluated the anti-fibrogenic effect of vitamin E. Male gerbils were treated with iron-dextran and fed a standard diet or a alpha-tocopherol enriched diet (250 mg/Kg diet). In gerbils on the standard diet at 6 wk after dosing with iron, in situ hybridization analysis documented a dramatic increase of signal for collagen mRNA around iron foci onto liver fat storing cells (FSC), as identified by immunocytochemistry with desmin antibody. After 4 mo, micronodular cirrhosis developed in these animals, with nonparenchymal cells surrounding hepatocyte nodules and expressing high level of TGF beta mRNA. In this group, in vivo labeling with [3H]-thymidine showed a marked proliferation of nonparenchymal cells, including FSC. In iron-dosed gerbils on the vitamin E-enriched diet for 4 mo, in spite of a severe liver iron burden, a normal lobular architecture was found, with a dramatic decrease of collagen mRNA accumulation and collagen deposition. At the molecular level, a total suppression of nonparenchymal cell proliferation was appreciable, although expression of collagen and TGF beta mRNAs was still present into microscopic iron-filled nonparenchymal cell aggregates scattered throughout the hepatic lobule. In conclusion, our study shows that anti-oxidant treatment during experimental hepatic fibrosis arrests fibrogenesis and completely prevents iron induced hepatic cirrhosis mainly through inhibition of nonparenchymal cell proliferation induced by iron.
肝纤维化和肝硬化是血色素沉着症患者的常见表现。在本研究中,我们调查了铁诱导肝纤维化的分子途径,并评估了维生素E的抗纤维化作用。雄性沙鼠接受右旋糖酐铁治疗,并喂食标准饮食或富含α-生育酚的饮食(250毫克/千克饮食)。在用铁给药6周后,喂食标准饮食的沙鼠,原位杂交分析显示,在用结蛋白抗体免疫细胞化学鉴定的肝脏脂肪储存细胞(FSC)周围的铁灶周围,胶原蛋白mRNA信号显著增加。4个月后,这些动物出现小结节性肝硬化,肝结节周围的非实质细胞表达高水平的TGF-β mRNA。在该组中,用[3H] - 胸腺嘧啶核苷进行体内标记显示非实质细胞显著增殖,包括FSC。在喂食富含维生素E饮食4个月的铁给药沙鼠中,尽管肝脏铁负荷严重,但发现小叶结构正常,胶原蛋白mRNA积累和胶原蛋白沉积显著减少。在分子水平上,虽然在整个肝小叶中散在的微小铁填充非实质细胞聚集体中仍存在胶原蛋白和TGF-β mRNA的表达,但非实质细胞增殖被完全抑制。总之,我们的研究表明,实验性肝纤维化期间的抗氧化治疗可阻止纤维化形成,并主要通过抑制铁诱导的非实质细胞增殖来完全预防铁诱导的肝硬化。