Kato J, Kobune M, Kohgo Y, Sugawara N, Hisai H, Nakamura T, Sakamaki S, Sawada N, Niitsu Y
Fourth Department of Internal Medicine, Department of Public Health, Sapporo Medical University School of Medicine, Japan.
J Clin Invest. 1996 Aug 15;98(4):923-9. doi: 10.1172/JCI118875.
Several clinical studies have suggested that excess hepatic iron accumulation is a progressive factor in some liver diseases including chronic viral hepatitis and hemochromatosis. However, it is not known whether iron-induced hepatotoxicity may be directly involved in hepatitis, cirrhosis, and liver cancer. The Long-Evans Cinnamon (LEC) rat, which accumulates excess copper in the liver as in patients with Wilson's disease, is of a mutant strain displaying spontaneous hemolysis, hepatitis, and liver cancer. We found previously that LEC rats harbored an additional abnormality: accumulation of as much iron as copper in the liver. In the present study, we compared the occurrence of hepatitis and liver cancer in LEC rats fed an iron-deficient diet (ID) with those in rats fed a regular diet (RD). The RD group showed rapid increments of hepatic iron concentrations as the result of hemolysis, characteristics of fulminant hepatitis showing apoptosis, and a 53% mortality rate. However, no rats in the ID group died of fulminant hepatitis. Hepatic iron, especially "free" iron concentration and the extent of hepatic fibrosis in the ID group were far less than those of the RD group. At week 65, all rats in the RD group developed liver cancer, whereas none did in the ID group. These results suggest that the accumulation of iron, possibly by virtue of synergistic radical formation with copper, plays an essential role in the development of fulminant hepatitis, hepatic fibrosis, and subsequent hepatocarcinogenesis in LEC rats.
多项临床研究表明,肝脏铁过量蓄积是包括慢性病毒性肝炎和血色素沉着症在内的一些肝脏疾病的进展因素。然而,铁诱导的肝毒性是否直接参与肝炎、肝硬化和肝癌的发生尚不清楚。长 Evans 肉桂(LEC)大鼠会像威尔逊病患者一样在肝脏中蓄积过量铜,是一种表现出自发性溶血、肝炎和肝癌的突变品系。我们之前发现 LEC 大鼠还有另一种异常:肝脏中铁的蓄积量与铜一样多。在本研究中,我们比较了喂食缺铁饮食(ID)的 LEC 大鼠和喂食常规饮食(RD)的大鼠中肝炎和肝癌的发生情况。RD 组由于溶血导致肝脏铁浓度迅速升高,出现了以凋亡为特征的暴发性肝炎,死亡率为 53%。然而,ID 组没有大鼠死于暴发性肝炎。ID 组的肝脏铁,尤其是“游离”铁浓度和肝纤维化程度远低于 RD 组。在第 65 周时,RD 组的所有大鼠都患上了肝癌,而 ID 组无一发生。这些结果表明,铁的蓄积,可能是由于与铜协同形成自由基,在 LEC 大鼠暴发性肝炎、肝纤维化及随后的肝癌发生过程中起重要作用。