Hepatic fibrosis

肝纤维化
  • 文章类型: Journal Article
    血吸虫病是由血吸虫侵染引起的人畜共患寄生虫病,吸虫的一个属。卵源外泌体中的microRNAs(miRNA)对于调节宿主的免疫反应和协调病理生理机制至关重要。尽管日本血吸虫分泌的外泌体含有丰富的miRNAs,这些miRNAs在血吸虫病肝纤维化发病机制中的具体作用尚待全面阐明。日本血吸虫卵外泌体分泌miRNA-30,一种新的miRNA。
    体外,通过用miRNA模拟物转染HSC来评估miRNA-30的效果。使用miRDB软件预测miRNA-30的靶基因生物特征。通过提高其在健康小鼠中的表达或通过施用表达miRNA-30或miRNA海绵的重组腺相关病毒血清型8载体抑制其在感染小鼠中的活性来评估miRNA-30在肝纤维化中的作用。
    这种新的miRNA可以激活肝星状细胞(HSC),肝纤维化的效应细胞,在体外,即,它显著增加纤维原因子Col1(α1),Col3(α1),和α-SMA在mRNA和蛋白质水平。此外,miRNA-30可能通过靶向宿主RORA基因激活HSC。此外,通过施用重组腺相关病毒载体以调节miRNA-30的表达水平进行体内实验。miRNA-30在健康小鼠中的过表达显著升高了Col1(α1)的表达,Col3(α1),和α-SMA在转录组和蛋白质组尺度上。这种过表达与肝羟脯氨酸含量的显着增加有关。相反,miRNA-30在感染小鼠体内的沉默导致肝肉芽肿的大小和胶原沉积的面积显著减少。因此,在体内,miRNA-30表达的调节可能在改善日本血吸虫小鼠肝纤维化的严重程度中起关键作用。
    研究结果表明,miRNA-30可能通过与宿主RORA的相互作用来增强血吸虫病诱导的肝纤维化。我们的研究可能会改善目前关于血吸虫病肝纤维化miRNA跨物种调控的理论框架。
    UNASSIGNED: Schistosomiasis is a zoonotic parasitic disorder induced by the infestation of schistosomes, a genus of trematodes. MicroRNAs (miRNAs) in egg-derived exosomes are crucial for modulating the host\'s immune responses and orchestrating the pathophysiological mechanisms. Although the exosomes secreted by S. japonicum contain abundant miRNAs, the specific roles of these miRNAs in the pathogenesis of schistosomiasis-induced hepatic fibrosis are yet to be comprehensively elucidated. The egg exosomes of S. japonicum secrete miRNA-30, a novel miRNA.
    UNASSIGNED: In vitro, the effect of miRNA-30 was evaluated by transfecting HSCs with miRNA mimics. The target gene biosignature for miRNA-30 was predicted using the miRDB software. The effect of miRNA-30 in hepatic fibrosis was evaluated by either elevating its expression in healthy mice or by inhibiting its activity in infected mice by administration of recombinant adeno-associated virus serotype eight vectors expressing miRNA-30 or miRNA sponges.
    UNASSIGNED: This novel miRNA can activate hepatic stellate cells (HSCs), the prinary effector cells of hepatic fibrosis, in vitro, i.e., it significantly increases the fibrogenic factors Col1(α1), Col3(α1), and α-SMA at both mRNA and protein levels. In addition, miRNA-30 may activate HSCs by targeting the host RORA gene. In addition, in vivo experiments were conducted by administering a recombinant adeno-associated viral vector to modulate the expression levels of miRNA-30. The overexpression of miRNA-30 in healthy mice significantly elevated the expression of Col1(α1), Col3(α1), and α-SMA at both the transcriptomic and proteomic scales. This overexpression was coupled with a pronounced augmentation in the hepatic hydroxyproline content. Conversely, the in vivo silencing of miRNA-30 in infected mice induced a considerable reduction in the size of hepatic granulomas and areas of collagen deposition. Hence, in vivo, modulation of miRNA-30 expression may play a pivotal role in ameliorating the severity of hepatic fibrosis in mice afflicted with S. japonica.
    UNASSIGNED: The study results suggest that miRNA-30 may augment schistosomiasis-induced hepatic fibrosis through a probable interaction with the host RORA. Our study may improve the current theoretical framework regarding cross-species regulation by miRNAs of hepatic fibrosis in schistosomiasis.
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  • 文章类型: Journal Article
    引言慢性肝病进展导致肝纤维化/肝硬化。瞬时弹性成像用于分期肝纤维化,但腹水,肥胖,和操作员经验限制了其适用性。在这项研究中,我们比较了各种非侵入性血清指标在预测慢性肝病患者纤维化中的作用。材料与方法收集142例确诊的慢性肝病患者。通过瞬时弹性成像和相关血液检查定量测定肝脏硬度。我们比较了瞬时弹性成像和纤维化指数的肝脏硬度测量,即,天冬氨酸转氨酶(AST)与丙氨酸转氨酶(ALT)的比值(AAR),AST与血小板比率指数(APRI),纤维化指数(FI),纤维化-4(FIB-4)指数,年龄-血小板指数(API),Pohl得分,和纤维化肝硬化指数(FCI)与新型纤维化指数(NFI),预测肝纤维化阶段。结果F4期NFI的最佳截止值≥6670,敏感性为75.8%,特异性为81.8%,对于F3期≥2112,敏感性为63.6%,特异性为72.7%,F2期≥1334,敏感性为100%,特异性为56.3%.与预测纤维化分期的其他指标相比,NFI的曲线下面积最大。结论新型纤维化指数是预测慢性肝病患者纤维化分期的最佳指标。在预测F4阶段方面表现良好。
    Introduction Chronic liver disease progression leads to liver fibrosis/cirrhosis. Transient Elastography is used for staging liver fibrosis but ascites, obesity, and operator experience limit its applicability. In this study, we compared various non-invasive serum indices in predicting fibrosis in chronic liver disease patients. Materials and methods A total of 142 cases of confirmed Chronic Liver Disease were included. Quantitative determination of liver stiffness by Transient Elastography and relevant blood investigations was done. We compared the liver stiffness measurement by Transient Elastography and fibrosis indices, i.e., Aspartate Transaminase (AST) to Alanine Transaminase (ALT) Ratio (AAR), AST to Platelet Ratio Index (APRI), Fibrosis Index (FI), Fibrosis-4 (FIB-4) Index, Age-Platelet Index (API), Pohl score, and Fibrosis Cirrhosis Index (FCI) with Novel Fibrosis Index (NFI), to predict liver fibrosis stages. Results The optimum cutoff of NFI for the F4 stage was ≥ 6670 with a sensitivity of 75.8% and specificity of 81.8%, for the F3 stage was ≥ 2112 with a sensitivity of 63.6% and specificity of 72.7%, and for the F2 stage was ≥ 1334 with a sensitivity of 100% and specificity of 56.3%. The NFI had the maximum area under the curve compared to other indices in predicting fibrosis stages. Conclusion The Novel Fibrosis Index was the best in predicting fibrosis stages in Chronic Liver Disease patients, with good performance in predicting the F4 stage.
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  • 文章类型: Journal Article
    通过更换和去除有缺陷或感染的细胞,程序性细胞死亡(PCD)有助于体内平衡维持和身体发育,它普遍存在于哺乳动物中,可以随时发生。除了凋亡,最近已经描述了更多新的PCD模式,比如坏死,焦亡,铁性凋亡,和自噬依赖性细胞死亡。PCD不仅调节多种生理过程,而且还参与了各种疾病的发病机制,包括代谢功能障碍相关的脂肪变性肝病(MASLD)。MASLD主要分为代谢功能障碍相关脂肪性肝炎(MASL)和代谢功能障碍相关脂肪性肝炎(MASH),后者推定进展为肝硬化和肝细胞癌。由于MASH的发病率增加和病因不明,它的管理仍然是一个巨大的挑战。最近,肝细胞PCD作为从MASL到MASH的病理进展的有效驱动因素而备受关注,一些药物已被证明对MASH的有益作用部分是通过调节肝细胞PCD的活性。本文综述了PCD不同发病方式的发病机制,阐明了MASLD中代谢紊乱如何诱导肝细胞PCD的潜在机制,以及肝细胞PCD如何促进MASH的炎症和纤维化进展,讨论了肝细胞中控制PCD执行的几种信号通路,并总结了一些潜在的MASH治疗药物,这些药物部分通过调节肝细胞PCD发挥其治疗作用。这些发现表明,肝细胞PCD推定代表了MASH干预的新治疗点。
    By replacing and removing defective or infected cells, programmed cell death (PCD) contributes to homeostasis maintenance and body development, which is ubiquitously present in mammals and can occur at any time. Besides apoptosis, more novel modalities of PCD have been described recently, such as necroptosis, pyroptosis, ferroptosis, and autophagy-dependent cell death. PCD not only regulates multiple physiological processes, but also participates in the pathogenesis of diverse disorders, including metabolic dysfunction-associated steatotic liver disease (MASLD). MASLD is mainly classified into metabolic dysfunction-associated steatotic liver (MASL) and metabolic dysfunction-associated steatohepatitis (MASH), and the latter putatively progresses to cirrhosis and hepatocellular carcinoma. Owing to increased incidence and obscure etiology of MASH, its management still remains a tremendous challenge. Recently, hepatocyte PCD has been attracted much attention as a potent driver of the pathological progression from MASL to MASH, and some pharmacological agents have been proved to exert their salutary effects on MASH partly via the regulation of the activity of hepatocyte PCD. The current review recapitulates the pathogenesis of different modalities of PCD, clarifies the mechanisms underlying how metabolic disorders in MASLD induce hepatocyte PCD and how hepatocyte PCD contributes to inflammatory and fibrotic progression of MASH, discusses several signaling pathways in hepatocytes governing the execution of PCD, and summarizes some potential pharmacological agents for MASH treatment which exert their therapeutic effects partly via the regulation of hepatocyte PCD. These findings indicate that hepatocyte PCD putatively represents a new therapeutic point of intervention for MASH.
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  • 文章类型: Journal Article
    肝纤维化是一种伤口愈合反应,其特征是细胞外基质蛋白的过度积累。本研究旨在探讨白藜芦醇对TGF-β/SMAD信号通路及相关生化指标的影响,凋亡,和肝再生苯巴比妥-CCl4诱导肝纤维化大鼠模型。
    该模型是通过苯巴比妥和CCl4(0.2-0.35ml/kg)创建的。向纤维化组和对照组施用白藜芦醇(lmg/kg/天)。进行免疫组织化学染色以评估αSMA,肝组织中的TGF-β1和PCNA。采用TUNEL法和Masson毛状体染色法测定细胞凋亡和胶原积累。AST,ALP,ALT,总蛋白质,测量总胆红素水平以确定生化状态。检测SMAD2、SMAD3、SMAD4和SMAD7的表达水平以确定TGF-β1相关的肝纤维化。
    纤维化对照组SMAD2、SMAD3和SMAD4mRNA表达水平升高,SMAD7mRNA表达水平降低。苯巴比妥-CCl4诱导的白藜芦醇处理组中SMAD7mRNA表达水平较高。增加的生化参数表明肝损伤,凋亡细胞数量增加,与其他组相比,纤维化组观察到中央静脉周围的胶原积累。结论白藜芦醇通过调节生化指标改善肝纤维化的不良反应,控制TGF-β1/SMAD信号,增强组织再生,减少肝细胞凋亡。
    白藜芦醇可以是预防苯巴比妥-CCl4诱导的肝纤维化中的肝损伤的有益选择。
    UNASSIGNED: Liver fibrosis is a wound healing response characterized by excessive accumulation of extracellular matrix proteins. This study aimed to investigate the effects of resveratrol treatment on the TGF-β/SMAD signaling pathway and related biochemical parameters, apoptosis, and liver regeneration phenobarbital-CCl4 induced hepatic fibrosis rat model.
    UNASSIGNED: This model was created through phenobarbital and CCl4 (0.2-0.35 ml/kg). Resveratrol (1 mg/kg/day) was administered to the fibrosis and control groups. Immunohistochemical staining was performed to evaluate αSMA, TGF-β1, and PCNA in liver tissue. The TUNEL method and Masson\'s Trichome staining were used to determine apoptosis and collagen accumulation. AST, ALP, ALT, total protein, and total bilirubin levels were measured to determine biochemical status. SMAD2, SMAD3, SMAD4, and SMAD7 expression levels were measured to determine TGF-β1 related hepatic fibrosis.
    UNASSIGNED: The SMAD2, SMAD3, and SMAD4 mRNA expression levels were increased and the SMAD7 mRNA expression level was decreased in the fibrosis control group. The SMAD7 mRNA expression level was higher in the phenobarbital-CCl4 induced resveratrol treated group. Increased biochemical parameters indicating hepatic damage, increased number of apoptotic cells, and collagen accumulation surrounding the central vein were observed in the fibrosis group compared with the other groups. It was concluded that administration of resveratrol ameliorates the adverse effects of hepatic fibrosis by regulating biochemical parameters, controlling TGF-β1/SMAD signaling, enhancing tissue regeneration, and reducing apoptosis in liver cells.
    UNASSIGNED: Resveratrol can be a beneficial option for the prevention of liver damage in a phenobarbital-CCl4 induced hepatic fibrosis.
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  • 文章类型: Journal Article
    2型糖尿病(T2DM)增加非酒精性脂肪性肝病(NAFLD)进展至晚期的风险,特别是在高脂肪饮食(HFD)。HFD诱导的肝纤维化可以通过氧化应激来标记,炎症,和激活肝星状细胞。Sirtuin1/2(SIRT1/2),NAD依赖性III类组蛋白脱乙酰酶,参与纤维化的减弱。在我们进行的研究中,TGF-β1激活的LX-2细胞,游离脂肪酸(FFA)处理的同时共培养(SCC)细胞,和HFD诱导的Zucker糖尿病脂肪(ZDF)大鼠肝纤维化,在代谢综合征研究中广泛使用的动物模型,用于评估SIRT1/2抑制剂Tenovin-1的保护作用。ZDF大鼠分为饮食,HFD,和HFD+Tenovin-1组。Tenovin-1减少肝损伤,抑制炎症细胞浸润,微/大泡脂肪变性和预防胶原沉积HFD喂养的大鼠。Tenovin-1降低血清生化指标,甘油三酯(TG)和丙二醛(MDA)水平,但增加谷胱甘肽,过氧化氢酶,和超氧化物歧化酶水平。Tenovin-1减轻促炎细胞因子IL-6,IL-1β,HFD大鼠的TNFα和纤维化生物标志物,TGF-β1激活的LX-2和FFA处理的SCC细胞。此外,Tenovin-1在HFD大鼠和FFA处理的SCC细胞中抑制SIRT1/2表达并抑制JNK-1和STAT3磷酸化。总之,Tenovin-1通过刺激抗氧化剂和抑制HFD条件下糖尿病大鼠的炎症细胞因子来减轻肝纤维化。
    Type 2 diabetes mellitus (T2DM) increases the risk of non-alcoholic fatty liver disease (NAFLD) progression to advanced stages, especially upon high-fat diet (HFD). HFD-induced hepatic fibrosis can be marked by oxidative stress, inflammation, and activation of hepatic stellate cells. Sirtuin 1/2 (SIRT1/2), NAD-dependent class III histone deacetylases, are involved in attenuation of fibrosis. In our conducted research, TGF-β1-activated LX-2 cells, free fatty acid (FFA)-treated simultaneous co-culture (SCC) cells, and HFD-induced hepatic fibrosis in Zucker diabetic fatty (ZDF) rats, a widely used animal model in the study of metabolic syndromes, were used to evaluate the protective effect of Tenovin-1, a SIRT1/2 inhibitor. ZDF rats were divided into chow diet, HFD, and HFD + Tenovin-1 groups. Tenovin-1 reduced hepatic damage, inhibited inflammatory cell infiltration, micro/ macro-vesicular steatosis and prevented collagen deposition HFD-fed rats. Tenovin-1 reduced serum biochemical parameters, triglyceride (TG) and malondialdehyde (MDA) levels but increased glutathione, catalase, and superoxide dismutase levels. Tenovin-1 mitigated proinflammatory cytokines IL-6, IL-1β, TNFα and fibrosis biomarkers in HFD rats, TGF-β1-activated LX-2 and FFA treated SCC cells. Additionally, Tenovin-1 suppressed SIRT1/2 expression and inhibited JNK-1 and STAT3 phosphorylation in HFD rats and FFA-treated SCC cells. In conclusion, Tenovin-1 attenuates hepatic fibrosis by stimulating antioxidants and inhibiting inflammatory cytokines under HFD conditions in diabetic rats.
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  • 文章类型: Journal Article
    背景:肥胖已成为全球公共卫生的主要挑战。研究不同肥胖模式与非酒精性脂肪性肝病(NAFLD)风险之间的关联是有限的。这项研究旨在调查美国大量男性人群中不同肥胖模式与NAFLD风险之间的关系。
    方法:使用了2017年至2020年3月全国健康与营养检查调查(NHANES)的数据。使用受控的衰减参数(CAP)和肝脏硬度测量(LSM),用FibroScan评估肝脏脂肪变性和纤维化。脂肪变性被鉴定为具有248dB/m或更高的CAP值。腹部肥胖的定义是男性的腰围(WC)为102厘米或更高,女性的腰围为88厘米或更高。超重定义为24.0kg/m2及以上的体重指数(BMI)。一般肥胖的BMI为28.0kg/m2或更高。肥胖状态分为四种类型:超重,一般肥胖,腹部肥胖,和综合肥胖。多元逻辑回归,调整潜在的混杂因素,用于检查肥胖模式和NAFLD风险之间的联系。亚组分析进一步探讨了这些关联。
    结果:共纳入5,858名成年人。经过多变量调整后,与正常体重组相比,超重个体NAFLD的优势比(OR)[95%置信区间(CI)],一般肥胖,腹部肥胖,合并肥胖为6.90[3.74-12.70],2.84[2.38-3.39],3.02[2.02-4.51],和9.53[7.79-11.64],分别。亚组分析显示不同肥胖模式对NAFLD风险的影响在具有不同临床状况的个体中是稳定的。在完全调整的多元逻辑回归模型中,WC与NAFLD风险呈正相关(OR:1.48;95%CI:1.42-1.53;P<0.001)。WC还在接收机工作特性(ROC)分析中对NAFLD表现出很强的判别能力,实现0.802的曲线下面积(AUC)。
    结论:不同类型的肥胖是NAFLD的危险因素。WC的增加显著增加了NAFLD风险。应更加注意预防成人中不同类型的肥胖。
    BACKGROUND: Obesity has become a major global public health challenge. Studies examining the associations between different obesity patterns and the risk of nonalcoholic fatty liver disease (NAFLD) are limited. This study aimed to investigate the relationships between different obesity patterns and the risk of NAFLD in a large male population in the US.
    METHODS: Data from the 2017 to March 2020 National Health and Nutrition Examination Survey (NHANES) were utilized. Liver steatosis and fibrosis were assessed with FibroScan using the controlled attenuation parameter (CAP) and liver stiffness measurements (LSM). Steatosis was identified with a CAP value of 248 dB/m or higher. Abdominal obesity was defined by a waist circumference (WC) of 102 cm or more for males and 88 cm or more for females. Overweight was defined as a body mass index (BMI) of 24.0 kg/m2 and above. General obesity was identified with a BMI of 28.0 kg/m2 or higher. Obesity status was categorized into four types: overweight, general obesity, abdominal obesity, and combined obesity. Multivariate logistic regression, adjusting for potential confounders, was used to examine the link between obesity patterns and NAFLD risk. Subgroup analysis further explored these associations.
    RESULTS: A total of 5,858 adults were included. After multivariable adjustment, compared to the normal weight group, the odds ratios (ORs) [95% confidence interval (CI)] for NAFLD in individuals with overweight, general obesity, abdominal obesity, and combined obesity were 6.90 [3.74-12.70], 2.84 [2.38-3.39], 3.02 [2.02-4.51], and 9.53 [7.79-11.64], respectively. Subgroup analysis showed the effect of different obesity patterns on NAFLD risk was stable among individuals with different clinical conditions. In the fully adjusted multivariate logistic regression model, WC was positively associated with NAFLD risk (OR: 1.48; 95% CI: 1.42-1.53; P < 0.001). WC also demonstrated strong discriminatory ability for NAFLD in Receiver Operating Characteristic (ROC) analysis, achieving an Area Under the Curve (AUC) of 0.802.
    CONCLUSIONS: Different patterns of obesity are risk factors for NAFLD. An increase in WC significantly increased NAFLD risk. More attention should be paid to preventing different patterns of obesity among adults.
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  • 文章类型: Journal Article
    肝纤维化(HF)是肝脏结构和功能损害的病理过程,是慢性肝病进展的关键组成部分。没有特异性抗肝纤维化(抗HF)药物,和HF只能通过减轻原因来改善或预防。肝星状细胞(HSC)的自噬与HF的发展亲密相干。近年来,中医药在防治HF方面取得了良好的疗效。中药活性成分(AITCM)可通过不同途径调节HSC的自噬发挥抗HF作用,但是缺乏相关的评论。本文综述了AITCM调控HSCs自噬对HF,并讨论了HSCs自噬与HF的关系,指出了当前研究的问题和局限性,以期为中药靶向HSCs自噬的抗HF药物的开发提供参考。通过回顾PubMed中的文献,WebofScience,Embase,CNKI和其他数据库,我们发现HSCs自噬与HF之间的关系目前存在争议。HSCs自噬可以通过消耗脂滴(LD)为其激活提供能量来促进HF。然而,相比之下,诱导HSCs自噬可通过刺激其凋亡或衰老发挥抗HF作用,减少I型胶原蛋白的积累,抑制细胞外囊泡释放,降解促纤维化因子和其他机制。一些AITCM抑制HSCs自噬抵抗HF,最有希望的方向是瞄准LD。同时,其他人诱导HSC自噬抵抗HF,最有希望的方向是靶向HSCs凋亡。未来的研究需要集中在细胞靶向研究上,自噬靶向研究和体内验证研究,并探讨HSCs自噬对HF产生矛盾作用的原因。
    Hepatic fibrosis (HF) is a pathological process of structural and functional impairment of the liver and is a key component in the progression of chronic liver disease. There are no specific anti-hepatic fibrosis (anti-HF) drugs, and HF can only be improved or prevented by alleviating the cause. Autophagy of hepatic stellate cells (HSCs) is closely related to the development of HF. In recent years, traditional Chinese medicine (TCM) has achieved good therapeutic effects in the prevention and treatment of HF. Several active ingredients from TCM (AITCM) can regulate autophagy in HSCs to exert anti-HF effects through different pathways, but relevant reviews are lacking. This paper reviewed the research progress of AITCM regulating HSCs autophagy against HF, and also discussed the relationship between HSCs autophagy and HF, pointing out the problems and limitations of the current study, in order to provide references for the development of anti-HF drugs targeting HSCs autophagy in TCM. By reviewing the literature in PubMed, Web of Science, Embase, CNKI and other databases, we found that the relationship between autophagy of HSCs and HF is currently controversial. HSCs autophagy may promote HF by consuming lipid droplets (LDs) to provide energy for their activation. However, in contrast, inducing autophagy in HSCs can exert the anti-HF effect by stimulating their apoptosis or senescence, reducing type I collagen accumulation, inhibiting the extracellular vesicles release, degrading pro-fibrotic factors and other mechanisms. Some AITCM inhibit HSCs autophagy to resist HF, with the most promising direction being to target LDs. While, others induce HSCs autophagy to resist HF, with the most promising direction being to target HSCs apoptosis. Future research needs to focus on cell targeting research, autophagy targeting research and in vivo verification research, and to explore the reasons for the contradictory effects of HSCs autophagy on HF.
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  • 文章类型: Journal Article
    代谢功能障碍相关的脂肪变性肝病(MASLD)的患病率,慢性肝病的主要病因,随着肥胖和以葡萄糖代谢受损和胰岛素信号传导受损为特征的相关代谢异常疾病的流行,如2型糖尿病(T2D)。MASLD可以定义为当完全超过肝脂质代谢时发生的肝细胞中脂质滴的过度积累。这种代谢脂质的不灵活性构成了MASLD发病机理的中心节点,并且经常与脂毒性物质的过度产生有关。细胞应激增加,和线粒体功能障碍。令人信服的证据表明,来自鞘脂代谢的脂质物种的积累,如神经酰胺,通过触发炎症和纤维化机制,在更严重等级的MASLD中观察到的结构和功能组织损伤显着。在这种情况下,MASLD可以进一步发展为代谢功能障碍相关脂肪性肝炎(MASH),代表了MASLD的高级形式,和肝纤维化。在这次审查中,我们讨论了鞘脂物种作为MASH驱动因素的作用以及该疾病的机制。此外,鉴于缺乏批准的疗法和治疗MASH的有限选择,我们讨论了通过调节鞘脂代谢来预防MASH和其他严重表现的治疗策略的可行性。
    The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), a leading cause of chronic liver disease, has increased worldwide along with the epidemics of obesity and related dysmetabolic conditions characterized by impaired glucose metabolism and insulin signaling, such as type 2 diabetes mellitus (T2D). MASLD can be defined as an excessive accumulation of lipid droplets in hepatocytes that occurs when the hepatic lipid metabolism is totally surpassed. This metabolic lipid inflexibility constitutes a central node in the pathogenesis of MASLD and is frequently linked to the overproduction of lipotoxic species, increased cellular stress, and mitochondrial dysfunction. A compelling body of evidence suggests that the accumulation of lipid species derived from sphingolipid metabolism, such as ceramides, contributes significantly to the structural and functional tissue damage observed in more severe grades of MASLD by triggering inflammatory and fibrogenic mechanisms. In this context, MASLD can further progress to metabolic dysfunction-associated steatohepatitis (MASH), which represents the advanced form of MASLD, and hepatic fibrosis. In this review, we discuss the role of sphingolipid species as drivers of MASH and the mechanisms involved in the disease. In addition, given the absence of approved therapies and the limited options for treating MASH, we discuss the feasibility of therapeutic strategies to protect against MASH and other severe manifestations by modulating sphingolipid metabolism.
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  • 文章类型: Journal Article
    流行病学发现表明,体脂分布的测量值可预测健康结果,而与体重指数(BMI)评估的整体体脂无关。本研究旨在评估2型糖尿病合并非酒精性脂肪性肝病患者整体和区域脂肪与肝脂肪变性和纤维化严重程度的关系。
    生物电阻抗分析和两个新开发的人体测量指标,即,身体形状指数(ABSI)和身体圆度指数(BRI),用来估计体内脂肪。根据纤维扫描参数,显著肝纤维化和严重脂肪变性定义为≥F2和>66%,分别。
    较高的总脂肪(比值比[OR]1.107,95%置信区间(CI)1.038-1.182,p=0.002),躯干脂肪(OR1.136,95%CI1.034-1.248,p=0.008)和腿部脂肪(OR1.381,95%CI1.139-1.674,p=0.001)与肝纤维化相关。然而,与全身脂肪(OR1.088,95%CI1.017-1.164,p=0.014)和腿部脂肪(OR1.317,95%CI1.066-1.628,p=0.011)相比,躯干脂肪与严重的肝脏脂肪变性无关.BRI的表现比躯干好,腿部和全身脂肪预测肝脂肪变性(OR2.186,95%CI1.370-3.487,p=0.001)和纤维化(OR2.132,95%CI1.419-3.204,p<0.001)。此外,躯干/腿部脂肪比和ABSI不是脂肪变性或纤维化的独立预测因子(p>0.05).
    BRI显示出比其他肥胖指标更高的预测能力来识别肝脏脂肪变性和僵硬度。此外,躯干肥胖程度较高,腿,和整体身体与发展肝纤维化的风险增加有关。虽然躯干脂肪与严重的肝脏脂肪变性没有相关性,腿部脂肪和总脂肪的增加与肝脏脂肪变性有关.
    UNASSIGNED: Epidemiologic findings suggest that measures of body fat distribution predict health outcomes independent of the overall body fat assessed by body mass index (BMI). This study aimed to evaluate the associations of overall and regional body fat with the severity of hepatic steatosis and fibrosis in type 2 diabetic patients with non-alcoholic fatty liver disease.
    UNASSIGNED: Bioelectric impedance analysis and two newly developed anthropometric indices, namely, A Body Shape Index (ABSI) and Body Roundness Index (BRI), were used to estimate the body fat. Based on fibroscan parameters, significant hepatic fibrosis and severe steatosis were defined as ≥F2 and >66%, respectively.
    UNASSIGNED: Higher total body fat (odds ratio [OR] 1.107, 95% confidence intervals (CI) 1.038-1.182, p = 0.002), trunk fat (OR 1.136, 95% CI 1.034-1.248, p = 0.008) and leg fat (OR 1.381, 95% CI 1.139-1.674, p = 0.001) were associated with liver fibrosis. However, in contrast to the total body fat (OR 1.088, 95% CI 1.017-1.164, p = 0.014) and leg fat (OR 1.317, 95% CI 1.066-1.628, p = 0.011), the trunk fat was not associated with severe hepatic steatosis. BRI performed better than trunk, leg and total body fat in predicting hepatic steatosis (OR 2.186, 95% CI 1.370-3.487, p = 0.001) and fibrosis (OR 2.132, 95% CI 1.419-3.204, p < 0.001). Moreover, the trunk to leg fat ratio and ABSI were not independent predictors of either steatosis or fibrosis (p > 0.05).
    UNASSIGNED: BRI revealed a superior predictive ability for identifying the degree of hepatic steatosis and stiffness than other obesity indices. Additionally, higher levels of adiposity in the trunk, legs, and overall body were linked to an increased risk of developing liver fibrosis. Although trunk fat did not show an association with severe hepatic steatosis, an increase in leg and total fat was related to liver steatosis.
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  • 文章类型: Journal Article
    代谢功能障碍相关的脂肪变性肝病(MASLD)的特征是肝实质中脂肪球的大量沉积,可能会进展为肝硬化和肝细胞癌。这里,我们评估了一个大鼠模型,以研究MASLD谱的分子发病机制并筛选治疗药物。SHRSP5/Dmcr大鼠喂食高脂肪和胆固醇(HFC)饮食12周,并评估脂肪变性(MASLD)的发展,脂肪性肝炎,纤维化和肝硬化。一组动物在4号结束时被处死,6th,实验开始的第8周和第12周,以及接受正常饮食的对照大鼠。收集血液和肝脏样品用于生化和组织病理学评估。对α-SMA和I型胶原进行免疫组织化学染色。组织病理学检查在第4周显示脂肪变性,在第6周伴有进行性纤维化的脂肪性肝炎,晚期纤维化与桥接在第8周和肝硬化在第12周。生化标记和染色α-SMA和I型胶原证明了脂肪变性进展为脂肪性肝炎,肝纤维化和肝硬化的逐步方式。饲喂正常饮食的对照动物没有显示任何生化或组织病理学改变。本研究的结果清楚地表明,HFC饮食诱导的脂肪变性模型,脂肪性肝炎,肝纤维化和肝硬化是可行的,快速和适当的动物模型,以研究MASLD谱的分子发病机理并筛选有效的治疗剂。
    Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by intense deposition of fat globules in the hepatic parenchyma that could potentially progress to liver cirrhosis and hepatocellular carcinoma. Here, we evaluated a rat model to study the molecular pathogenesis of the spectrum of MASLD and to screen therapeutic agents. SHRSP5/Dmcr rats were fed a high-fat and cholesterol (HFC) diet for a period of 12 weeks and evaluated for the development of steatosis (MASLD), steatohepatitis, fibrosis and cirrhosis. A group of animals were sacrificed at the end of the 4th, 6th, 8th and 12th weeks from the beginning of the experiment, along with the control rats that received normal diet. Blood and liver samples were collected for biochemical and histopathological evaluations. Immunohistochemical staining was performed for α-SMA and Collagen Type I. Histopathological examinations demonstrated steatosis at the 4th week, steatohepatitis with progressive fibrosis at the 6th week, advanced fibrosis with bridging at the 8th week and cirrhosis at the 12th week. Biochemical markers and staining for α-SMA and Collagen Type I demonstrated the progression of steatosis to steatohepatitis, hepatic fibrosis and liver cirrhosis in a stepwise manner. Control animals fed a normal diet did not show any biochemical or histopathological alterations. The results of the present study clearly demonstrated that the HFC diet-induced model of steatosis, steatohepatitis, hepatic fibrosis and cirrhosis is a feasible, quick and appropriate animal model to study the molecular pathogenesis of the spectrum of MASLD and to screen potent therapeutic agents.
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