酒精性脂肪性肝病(AFLD)的特征是由于乙醇的代谢而导致脂质在肝细胞中积累。该过程导致NAD+/NADH比率的降低和活性氧的产生。进行了系统评价和荟萃分析,以探讨氧化应激在AFLD中的作用。共纳入201份合格手稿,这表明AFLD动物表现出CYP2E1的表达升高,抗氧化酶的酶活性降低,转录因子Nrf2的水平降低,Nrf2在抗氧化酶的合成中起着关键作用。此外,AFLD动物表现出脂质过氧化标记物和羰基化蛋白水平升高,共同导致抗氧化防御减弱和氧化损伤增加。AFLD中的肝损伤得到明显更高的丙氨酸和天冬氨酸氨基转移酶活性的支持。此外,AFLD的动物血清和肝脏中的三酰甘油水平升高,可能是由于PPAR-α表达减少引起的脂肪酸代谢减少,负责脂肪酸氧化,和SREBP-1c的表达增加,参与脂肪酸合成。关于炎症,AFLD动物表现出高水平的促炎细胞因子,包括TNF-a,IL-1β,IL-6升高的氧化应激,伴随着炎症,导致细胞死亡标记的上调,例如caspase-3和增加的Bax/Bcl-2比率。总的来说,综述和荟萃分析的结果表明,乙醇代谢减少了抗氧化防御的重要标志物,同时增加了炎症和凋亡标志物,从而促进AFLD的发展。
Alcoholic Fatty Liver Disease (AFLD) is characterized by the accumulation of lipids in liver cells owing to the metabolism of ethanol. This process leads to a decrease in the NAD+/NADH ratio and the generation of reactive oxygen species. A systematic
review and meta-analysis were conducted to investigate the role of oxidative stress in AFLD. A total of 201 eligible manuscripts were included, which revealed that animals with AFLD exhibited elevated expression of CYP2E1, decreased enzymatic activity of antioxidant enzymes, and reduced levels of the transcription factor Nrf2, which plays a pivotal role in the synthesis of antioxidant enzymes. Furthermore, animals with AFLD exhibited increased levels of lipid peroxidation markers and carbonylated proteins, collectively contributing to a weakened antioxidant defense and increased oxidative damage. The liver damage in AFLD was supported by significantly higher activity of alanine and aspartate aminotransferase enzymes. Moreover, animals with AFLD had increased levels of triacylglycerol in the serum and liver, likely due to reduced fatty acid metabolism caused by decreased PPAR-α expression, which is responsible for fatty acid oxidation, and increased expression of SREBP-1c, which is involved in fatty acid synthesis. With regard to inflammation, animals with AFLD exhibited elevated levels of pro-inflammatory cytokines, including TNF-a, IL-1β, and IL-6. The heightened oxidative stress, along with inflammation, led to an upregulation of cell death markers, such as caspase-3, and an increased Bax/Bcl-2 ratio. Overall, the findings of the
review and meta-analysis indicate that ethanol metabolism reduces important markers of antioxidant defense while increasing inflammatory and apoptotic markers, thereby contributing to the development of AFLD.