Accatino L, Pizarro M, Solís N, Koenig C S, Vollrath V, Chianale J
Departamento de Gastroenterología, Faculated de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile.
J Hepatol. 1996 Sep;25(3):349-61. doi: 10.1016/s0168-8278(96)80122-x.
BACKGROUND/AIMS: Release into bile of canalicular membrane enzymes, such as alkaline phosphatase and gamma-glutamyl transpeptidase, is significantly increased in rats subjected to experimental models of hepatocellular or obstructive cholestasis. This effect appears to be related to a greater susceptibility of these membrane intrinsic proteins to the solubilizing effects of secreted bile acids. It is not known whether canalicular membrane transport proteins, such as P-glycoprotein isoforms, involved in ATP-dependent xenobiotic biliary excretion and phospholipid secretion, are excreted into bile and whether this process is modified in cholestasis. The aims of this work have been to investigate in the rat: a) whether P-glycoproteins are normally excreted into bile, b) whether their excretion is modified in two experimental models of cholestasis, i.e., hepatocellular cholestasis induced by ethynylestradiol and obstructive cholestasis, and c) whether observed changes correlate with bile acid and phospholipid secretion and enzyme release into bile and with relative P-glycoprotein content in hepatic tissue and isolated and purified canalicular membranes.
P-glycoproteins in bile and hepatic tissue were identified and quantitated by Western-blotting and immunohistochemistry using the C219 MAb. Changes in total mdr mRNA were analyzed by Northern-blotting.
Like canalicular membrane enzymes, P-glycoproteins are normally excreted into bile. Ethynylestradiol-induced cholestasis was associated with a 4.9-fold increase in P-glycoprotein excretion compared with controls while, in contrast, the excretion of the carrier decreased markedly in obstructive cholestasis to 2% of control values. P-glycoprotein excretion per nmol of secreted bile acids increased 4.4-fold in ethynylestradiol-induced cholestasis but decreased to 2% of control values in obstructive cholestasis. Total mdr mRNA levels in hepatic tissue were markedly increased (3.4-fold) in rats subjected to obstructive cholestasis and moderately increased (1.6-fold) in the ethynylestradiol group, compared with controls. P-glycoprotein content in isolated canalicular membranes was slightly decreased by 15% in ethynylestradiol-induced cholestasis, while it increased 4.7-fold in obstructive cholestasis. Immunohistochemistry of rat livers showed that P-glycoprotein reaction at the canalicular domain of hepatocytes at acinar zone 1 was decreased in ethynylestradiol-treated rats and markedly increased in obstructive cholestasis.
Ethynylestradiol-induced cholestasis is associated with increased P-glycoprotein biliary excretion and decreased hepatic content. In contrast, obstructive cholestasis results in decreased P-glycoprotein biliary excretion and increased hepatic content. These results suggest that biliary P-glycoprotein excretion might be a modulating factor in canalicular membrane P-glycoprotein content. Increased P-glycoprotein release into bile in ethynylestradiol-treated rats is apparently not a consequence of cholestasis, but it might be a primary event and play a pathogenetic role in ethynylestradiol-induced cholestasis.
背景/目的:在肝细胞性或阻塞性胆汁淤积实验模型的大鼠中,胆小管膜酶如碱性磷酸酶和γ-谷氨酰转肽酶向胆汁中的释放显著增加。这种效应似乎与这些膜内在蛋白对分泌型胆汁酸溶解作用的更高敏感性有关。尚不清楚参与ATP依赖性外源性物质胆汁排泄和磷脂分泌的胆小管膜转运蛋白如P-糖蛋白同工型是否会排泄到胆汁中,以及该过程在胆汁淤积时是否会改变。本研究的目的是在大鼠中研究:a)P-糖蛋白是否正常排泄到胆汁中;b)在两种胆汁淤积实验模型中,即乙炔雌二醇诱导的肝细胞性胆汁淤积和阻塞性胆汁淤积中,它们的排泄是否改变;c)观察到的变化是否与胆汁酸和磷脂分泌、酶向胆汁中的释放以及肝组织、分离和纯化的胆小管膜中相对P-糖蛋白含量相关。
使用C219单克隆抗体通过蛋白质印迹法和免疫组织化学法鉴定并定量胆汁和肝组织中的P-糖蛋白。通过Northern印迹法分析总mdr mRNA的变化。
与胆小管膜酶一样,P-糖蛋白通常排泄到胆汁中。与对照组相比,乙炔雌二醇诱导的胆汁淤积使P-糖蛋白排泄增加4.9倍,而相反,在阻塞性胆汁淤积中载体的排泄显著降低至对照值的2%。在乙炔雌二醇诱导的胆汁淤积中,每纳摩尔分泌胆汁酸的P-糖蛋白排泄增加4.4倍,但在阻塞性胆汁淤积中降至对照值的2%。与对照组相比,阻塞性胆汁淤积大鼠肝组织中的总mdr mRNA水平显著升高(3.4倍),乙炔雌二醇组中度升高(1.6倍)。在乙炔雌二醇诱导的胆汁淤积中,分离的胆小管膜中的P-糖蛋白含量略有下降15%,而在阻塞性胆汁淤积中增加4.7倍。大鼠肝脏的免疫组织化学显示,在乙炔雌二醇处理的大鼠中,腺泡1区肝细胞胆小管区域的P-糖蛋白反应降低,而在阻塞性胆汁淤积中显著增加。
乙炔雌二醇诱导的胆汁淤积与P-糖蛋白胆汁排泄增加和肝脏含量降低有关。相反,阻塞性胆汁淤积导致P-糖蛋白胆汁排泄减少和肝脏含量增加。这些结果表明胆汁P-糖蛋白排泄可能是胆小管膜P-糖蛋白含量的调节因子。在乙炔雌二醇处理的大鼠中,P-糖蛋白向胆汁中的释放增加显然不是胆汁淤积的结果,而是可能是一个原发性事件,并在乙炔雌二醇诱导的胆汁淤积中起致病作用。