Alcoholic liver disease

酒精性肝病
  • 文章类型: Journal Article
    许多观察性研究表明维生素D(VD)与酒精性肝病(ALD)之间存在关联。然而,随机对照试验(RCTs)证实这种相关性的足够证据很少,从而使这种关系的因果关系变得模棱两可。为了克服传统观测研究的不足,我们进行了双样本双向孟德尔随机化(MR)分析,以确定VD和ALD之间的因果关系.
    我们利用来自全基因组关联研究(GWAS)的VD和ALD的汇总统计数据集。我们选择了测量循环VD水平的遗传仪器(n=64,979),并从GWAS检索ALD统计数据,包括1,416例病例和217,376例健康对照,同时排除慢性肝病,如非酒精性脂肪性肝病,中毒性肝病,和病毒性肝炎。随后,使用逆方差加权(IVW)随机效应模型进行MR分析以获得效应估计。Cochran的Q统计量和MR-Egger回归截距分析用于评估多效性。使用MREgger进行敏感性分析,加权中位数,简单模式,和加权模式方法也进行了。使用留一分析来鉴定具有潜在作用的SNP。还进行了反向MR分析。
    在IVW中,我们的MR分析纳入了21个独立的SNP,循环VD水平对ALD没有因果关系[OR=0.624(0.336-1.160),p=0.136],ALD对循环VD没有因果关系[OR=0.997(0.986-1.008),p=0.555]。没有观察到异质性或多效性(p>0.05)。其他MR方法也与IVW结果一致。
    这项研究提供了遗传预测的循环维生素D水平与ALD之间的因果关系,并为ALD的遗传学提供了新的见解。
    UNASSIGNED: Numerous observational studies have presented an association between Vitamin D (VD) and Alcoholic Liver Disease (ALD). However, sufficient evidence from Randomized Controlled Trials (RCTs) substantiating this correlation is scarce, thus leaving the causality of this relationship ambiguous. To overcome the shortcomings of traditional observational studies, we performed a two-sample bidirectional Mendelian randomization (MR) analysis to ascertain the causal relationship between VD and ALD.
    UNASSIGNED: We utilized summary statistics datasets from Genome-Wide Association Studies (GWAS) for VD and ALD. We selected genetic instruments that measure circulating VD levels (n = 64,979), and retrieved ALD statistics from GWASs, inclusive of 1,416 cases and 217,376 healthy controls, while excluding chronic liver diseases such as nonalcoholic fatty liver disease, toxic liver disease, and viral hepatitis. Subsequent, MR analyses were performed to obtain effect estimates using inverse variance weighted (IVW) random effect models. Cochran\'s Q statistic and MR-Egger regression intercept analyses were used to assess pleiotropy. Sensitivity analyses using the MR Egger, weighted median, simple mode, and weighted mode methods were also performed. Leave-one-out analysis was used to identify SNPs with potential effect. Reverse MR analysis was also performed.
    UNASSIGNED: In IVW, our MR analysis incorporated 21 independent SNPs, circulating VD levels had no causal effect on ALD [OR = 0.624 (0.336-1.160), p = 0.136] and ALD had no causal effect on circulating VD [OR = 0.997 (0.986-1.008), p = 0.555]. No heterogeneity or pleiotropy was observed (p > 0.05). Other MR methods also agreed with IVW results.
    UNASSIGNED: This study provides the causal relationship between genetically predicted circulating Vitamin D levels and ALD and provides new insights into the genetics of ALD.
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  • 文章类型: Journal Article
    背景:脂质代谢紊乱似乎是酒精性肝病(ALD)的早期特征之一,这可以通过组学分析来推测,包括肝脏转录组学和肠道微生物群。由葛根和李子干果实(PPC)组成的复合体,具有保肝作用,可以作为药物或功能性食品。PPC中缺乏非多糖化合物及其对肠道微生物群的调节作用表明有必要进行相关研究。
    方法:6组昆明种小鼠(对照,白酒受伤,水飞蓟宾,低,中等,和高)通过用白酒(14天)和PPC(相当于人的最大剂量为9g/kg)进行建模。分析肝脏转录组数据以预测基因注释,其次是肠道微生物群的验证,血清,组织染色,免疫组织化学,和西方印迹。采用液相色谱-质谱联用技术检测各组分。
    结果:PPC标准化血清ALT(40U/L),下调TLR4-NF-κB信号通路抑制TNF-α(90pg/mL)释放,改善了occludin的表达,claudin-4和ZO-1,并恢复了杂草科的丰富,拟杆菌和链球菌。
    结论:PPC可以通过调节肠道菌群,抗炎和肠屏障来缓解ALD,在开发功能性食品方面具有应用价值。
    BACKGROUND: Lipid metabolism disorder appears to be one of the early features of alcoholic liver disease (ALD), which can be speculated via omics analysis including liver transcriptomics and gut microbiota. A complex consisting of the roots of Pueraria lobata and dried fruits of Prunus mume (PPC), which possesses hepatoprotective effects, could serve as a drug or functional food. The lack of non-polysaccharide compounds in PPC with their moderation effects on gut microbiota suggests the necessity for a relevant study.
    METHODS: Six groups of Kunming mice (control, Baijiu injury, silybin, low, medium, and high) were modelled by gavage with Baijiu (for 14 days) and PPC (equivalent to a maximum dose of 9 g/kg in humans). The liver transcriptome data were analyzed to predict gene annotation, followed by the verification of gut microbiota, serum, tissue staining, immunohistochemistry, and Western blotting. Liquid chromatography-mass spectrometry was used to detect the components.
    RESULTS: PPC normalized serum ALT (40 U/L), down-regulated TLR4-NF-κB signaling pathway to inhibit the release of TNF-α (90 pg/mL), improved the expression of occludin, claudin-4, and ZO-1, and restored the abundance of Muribaculaceae, Bacteroides and Streptococcus.
    CONCLUSIONS: PPC can alleviate ALD by regulating the gut microbiota with an anti-inflammatory and intestinal barrier, and has an application value in developing functional foods.
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  • 文章类型: Journal Article
    由慢性乙型肝炎病毒(HBV)或丙型肝炎病毒(HCV)感染引起的代谢功能障碍相关脂肪性肝病(MAFLD)和病毒性肝炎是全球常见的肝病。过度饮酒和酒精性肝病(ALD)也是新出现的健康问题。因此,在临床实践中,我们可能会遇到与肝脏疾病的双重病因,如共存MAFLD/HBV,MAFLD/HCV,和MAFLD/ALD。在这次审查中,我们总结了流行病学,临床特征,MAFLD与共存HBV的相互作用,HCV,或者ALD.还讨论了MAFLD对慢性病毒性肝炎患者肝病进展和治疗结果的影响,以及关于双MAFLD和ALD的临床问题。
    Metabolic dysfunction-associated fatty liver disease (MAFLD) and viral hepatitis due to chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection are common liver diseases worldwide. Excessive alcohol consumption and alcoholic liver disease (ALD) are also emerging health problems. Therefore, in clinical practice, we may encounter subjects with dual etiology of liver diseases such as coexisting MAFLD/HBV, MAFLD/HCV, and MAFLD/ALD. In this review, we summarize the epidemiology, clinical features, and mutual interactions of MAFLD with coexisting HBV, HCV, or ALD. The impact of MAFLD on the progression of liver diseases and treatment outcomes in patients with chronic viral hepatitis and the clinical questions to be addressed regarding dual MAFLD and ALD are also discussed.
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  • 文章类型: Published Erratum
    上述文章发表后,作者提请编辑部注意,在审查了他们的绘图软件的所有数字和数据之后,他们发现\'控制\'和\'DEX\'组中的图片。第904页上的4D被错误地导入到图。第905页上的6组装此图时,有效地替换图中的原始和正确放置的图像。图6D和E.的原始(和正确)版本。图6在下一页上示出。所有作者都同意本更正的出版,并感谢《国际分子医学杂志》的编辑让他们有机会发表这篇论文;此外,他们对造成的不便向《华尔街日报》的读者道歉。[国际分子医学杂志41:899-907,2018;DOI:10.3892/ijmm.2017.3297]。
    Following the publication of the above article, the authors drew to the attention of the Editorial Office that, after having reviewed all the figures and the data of their drawing software, they discovered that the pictures in the \'Control\' and \'DEX\' groups of Fig. 4D on p. 904 had been incorrectly imported into Fig. 6 on p. 905 when assembling this figure, effectively replacing the original and correctly placed images in Fig. 6D and E. The original (and correct) version of Fig. 6 is shown on the next page. All the authors agree with the publication of this Corrigendum, and express their gratitude to the Editor of International Journal of Molecular Medicine for allowing them the opportunity to publish this; furthermore, they apologize to the readership of the Journal for any inconvenience caused. [International Journal of Molecular Medicine 41: 899‑907, 2018; DOI: 10.3892/ijmm.2017.3297].
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  • 文章类型: Journal Article
    本研究旨在研究北五味子水提物(SSAE)对酒精性肝病(ALD)的关键化学成分和作用及其相关分子机制。
    本研究采用UPLC-Q-TOF-MS/MS来鉴定SSAE中的化学成分。通过口服白酒建立ALD大鼠模型。转录组测序,加权基因共表达网络构建分析(WGCNA),和网络药理学用于预测SSAE治疗ALD的关键成分和途径。酶联免疫吸附测定(ELISA),生化试剂盒,苏木精-伊红(HE)染色,蛋白质印迹(WB)分析,和免疫组织化学分析用于验证SSAE治疗ALD的作用机制。
    活性成分,如五味子甲,五味子A,发现五味子醇B调节PI3K/AKT/IKK信号通路。与模型组相比,SSAE组显示ALD模型大鼠肝组织细胞凝固和组织炎症的显著改善。此外,SSAE调节谷草转氨酶(AST)的水平,丙氨酸氨基转移酶(ALT),乙醇脱氢酶(ADH),血清中的醛脱氢酶(ALDH)(P<0.05);免疫印迹和免疫组织化学分析显示,AKT,IKK,NFκB,和FOXO1蛋白在肝组织中显著降低(P<0.05),而Bcl-2蛋白表达水平显著升高(P<0.05)。
    SSAE的活性成分是五味子A,五味子A,和五味子B,调节PI3K的磷酸化水平,AKT,IKK,和NFκB和FOXO1蛋白的表达,并上调ALD大鼠肝组织Bcl-2蛋白的表达。这些发现表明SSAE部分通过PI3K-AKT-IKK信号传导途径对抗ALD。本研究为今后ALD的研究和治疗以及新型天然保肝药物的开发提供了参考。
    UNASSIGNED: This study aimed to investigated the key chemical components and the effect of the aqueous extract of Schisandra sphenanthera (SSAE) on alcoholic liver disease (ALD) and the related molecular mechanism.
    UNASSIGNED: This study employed UPLC-Q-TOF-MS/MS to identify the chemical compositions in SSAE. ALD rat model was established through oral administration of white spirit. Transcriptome sequencing, weighted gene co-expression network construction analysis (WGCNA), and network pharmacology were used to predict key compositions and pathways targeted by SSAE for the treatment of ALD. Enzyme-linked immunosorbent assay (ELISA), biochemical kits, hematoxylin-eosin (HE) staining, Western blotting (WB) analysis, and immunohistochemical analysis were used to validate the mechanism of action of SSAE in treating ALD.
    UNASSIGNED: Active ingredients such as schisandrin A, schisandrol A, and schisandrol B were found to regulate the PI3K/AKT/IKK signaling pathway. Compared to the model group, the SSAE group demonstrated significant improvements in cellular solidification and tissue inflammation in the liver tissues of ALD model rats. Additionally, SSAE regulated the levels of a spartate aminotransferase (AST), alanine aminotransferase (ALT), alcohol dehydrogenase (ADH), and aldehyde Dehydrogenase (ALDH) in serum (P < 0.05); Western blotting and immunohistochemical analyses showed that the expression levels of phosphorylated PI3K, AKT, IKK, NFκB, and FOXO1 proteins were significantly reduced in liver tissues (P < 0.05), whereas the expression level of Bcl-2 proteins was significantly increased (P < 0.05).
    UNASSIGNED: The active components of SSAE were schisandrin A, schisandrol A, and schisandrol B, which regulated the phosphorylation levels of PI3K, AKT, IKK, and NFκB and the expression of FOXO1 protein and upregulated the expression of Bcl-2 protein in the liver tissues of ALD rats. These findings indicate that SSAE acts against ALD partly through the PI3K-AKT-IKK signaling pathway. This study provided a reference for future research and treatment of ALD and the development of novel natural hepatoprotective drugs.
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  • 文章类型: Journal Article
    过度饮酒相关的酒精性肝病(ALD)的患病率正在上升,然而,治疗选择仍然有限。高酒精消耗和细胞色素P450(CYP)的氧化代谢可导致极高的活性氧水平,压倒细胞防御和伤害肝细胞。我们之前的研究表明,使用RNA干扰抑制Cyp2e1可以降低ALD的发生率。然而,CYP2E1以外的代偿机制有助于肝脏中的氧化应激。因此,我们将靶向Cyp2e1的三重siRNA脂质纳米颗粒(LNPs)与两种同工酶Cyp4a10和Cyp4a14偶联,以治疗早期(第1周)喂食Lieber-Decarli乙醇液体饮食12周的ALD小鼠模型,中间(第5周),和后期(第9周)阶段。三联siRNALNPs显著改善小鼠慢性酒精性肝损伤,早期治疗取得了最深远的效果。这些影响可以归因于氧化应激的减少和抗氧化基因表达的增加,包括Gsh-Px,Gsh-Rd,Sod1此外,我们观察到炎症的缓解,IL-1β的下调证明,Il-6,Tnf-α,和Tgf-β,和预防过度的脂质合成,Srebp1c表达的恢复证明,Acc,和Fas。最后,三联siRNA处理维持脂质氧化的正常代谢。简而言之,我们的研究通过检查靶向Cyp2e1,Cyp4a10和Cyp4a14的三重siRNALNP的治疗效果,检查了ALD临床干预的可能靶点.本研究中三个基因的体内敲除被认为是ALD的有希望的siRNA治疗方法。
    The prevalence of excessive drinking-related alcoholic liver disease (ALD) is rising, yet therapeutic options remain limited. High alcohol consumption and consequent oxidative metabolism by cytochrome P450 (CYP) can lead to extremely high levels of reactive oxygen species, which overwhelm cellular defenses and harm hepatocytes. Our previous investigations showed that inhibiting Cyp2e1 using RNA interference reduced the incidence of ALD. However, compensatory mechanisms other than CYP2E1 contribute to oxidative stress in the liver. Therefore, we coupled triple siRNA lipid nanoparticles (LNPs) targeting Cyp2e1 with two isoenzymes Cyp4a10 and Cyp4a14 to treat ALD mouse models fed with Lieber-Decarli ethanol liquid diet for 12 weeks at the early (1st week), middle (5th week), and late (9th week) stages. The administration of triple siRNA LNPs significantly ameliorated chronic alcoholic liver injury in mice, and early treatment achieved the most profound effects. These effects can be attributed to a reduction in oxidative stress and increased expression of antioxidant genes, including Gsh-Px, Gsh-Rd, and Sod1. Moreover, we observed the alleviation of inflammation, evidenced by the downregulation of Il-1β, Il-6, Tnf-α, and Tgf-β, and the prevention of excessive lipid synthesis, evidenced by the restoration of the expression of Srebp1c, Acc, and Fas. Finally, triple siRNA treatment maintained normal metabolism in lipid oxidation. In brief, our research examined the possible targets for clinical intervention in ALD by examining the therapeutic effects of triple siRNA LNPs targeting Cyp2e1, Cyp4a10, and Cyp4a14. The in vivo knockdown of the three genes in this study is suggested as a promising siRNA therapeutic approach for ALD.
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  • 文章类型: Journal Article
    我们先前的临床代谢组学研究表明,能量代谢障碍是酒精性肝病(ALD)发展的潜在发病机制。补充烟酰胺(NAM),烟酰胺腺嘌呤二核苷酸(NAD+)的前体,可以恢复ALD的能量代谢稳态,因此可以作为治疗ALD的潜在治疗剂。在这个床边到长凳的研究中,NAM对ALD的保护作用通过使用NIAAA小鼠模型(慢性加暴饮暴食乙醇),并通过部分肝切除小鼠模型评估NAM的肝再生促进能力。我们的结果表明,NAM补充剂不仅可以保护肝脏免受酒精引起的损伤,而且可以改善酒精引起的线粒体结构和功能变化。但也通过增加肝脏NAD+含量促进部分肝切除术后小鼠的肝脏再生。这些发现表明,不结盟运动,维生素B3的水溶性形式,可以通过缓解酒精引起的能量代谢障碍来促进肝脏再生和改善肝功能。
    Our previous clinical metabolomics study illustrated that energy metabolism disorder is an underlying pathogenesis mechanism for the development of alcoholic liver disease (ALD). Supplementation of nicotinamide (NAM), the precursor of nicotinamide adenine dinucleotide (NAD+), may restore the energy metabolism homeostasis of ALD and thus serves as potential therapeutics to treat ALD. In this bedside-to-bench study, the protective effect of NAM against ALD was investigated by using the NIAAA mice model (chronic-plus-binge ethanol), and the liver regeneration boosting capability of NAM was evaluated by the partial hepatectomy mice model. Our results showed that NAM supplements not only protected the liver from alcohol-induced injury and improved alcohol-induced mitochondrial structure and function change, but also boosted liver regeneration in postpartial hepatectomy mice by increasing liver NAD+ content. These findings suggested that NAM, a water-soluble form of vitamin B3, can promote liver regeneration and improves liver function by alleviating alcohol-induced energy metabolism disorder.
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  • 文章类型: Journal Article
    目的:利用网络药理学和分子对接,该研究预测了大蒜中的活性化合物,并阐明了它们抑制酒精性肝病(ALD)发展的机制。ALD是一种全球慢性肝病,具有肝细胞癌进展的潜力。
    方法:通过筛选TCMSP,确定大蒜的主要活性成分和靶标。TCM-ID,和ETCM数据库。ALD疾病目标来自DisGeNet,GeneCards,和DiGSeE数据库,并通过交叉点确定大蒜的干预目标。使用STRING平台构建蛋白质相互作用网络,用R软件进行GO和KEGG途径富集分析。利用Cytoscape软件建立大蒜成分-疾病-目标网络。使用AutoDockVina软件通过分子对接模拟进行活性成分针对核心靶标的验证。使用从GEO数据库获得的ALD的人测序数据进行核心靶标的表达验证。
    结果:将大蒜药物靶标与ALD疾病靶标整合确定了83个靶标基因。通过酒精诱导的ALD小鼠模型的验证支持某些网络药理学发现,这表明大蒜可能通过减轻炎症反应和促进乙醇代谢来阻止疾病进展。
    结论:这项研究提供了对大蒜抑制ALD发展的潜在治疗机制的见解。确定的活性成分为进一步研究和开发ALD治疗提供了有希望的途径,强调植物药在肝病管理中的重要性。
    OBJECTIVE: Employing network pharmacology and molecular docking, the study predicts the active compounds in garlic and elucidates their mechanism in inhibiting the development of alcoholic liver disease (ALD). ALD is a global chronic liver disease with potential for hepatocellular carcinoma progression.
    METHODS: The main active ingredients and targets of garlic were identified through screening the TCMSP, TCM-ID, and ETCM databases. ALD disease targets were sourced from DisGeNET, GeneCards, and DiGSeE databases, and intervention targets for garlic were determined through intersections. Protein interaction networks were constructed using the STRING platform, and GO and KEGG pathway enrichment analyses were performed with R software. The garlic component-disease-target network was established using Cytoscape software. Validation of active ingredients against core targets was conducted through molecular docking simulations using AutoDock Vina software. Expression validation of core targets was carried out using human sequencing data of ALD obtained from the GEO database.
    RESULTS: Integration of garlic drug targets with ALD disease targets identified 83 target genes. Validation through an alcohol-induced ALD mouse model supported certain network pharmacology findings, suggesting that garlic may impede disease progression by mitigating the inflammatory response and promoting ethanol metabolism.
    CONCLUSIONS: This study provides insights into the potential therapeutic mechanisms of garlic in inhibiting ALD development. The identified active ingredients offer promising avenues for further investigation and development of treatments for ALD, emphasizing the importance of botanical remedies in liver disease management.
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  • 文章类型: Journal Article
    背景:APOH在脂质代谢和脂质在循环中的运输中起着至关重要的作用。先前的研究表明,APOH缺乏会导致小鼠模型中的脂肪肝和肠道微生物群失调。然而,APOH缺乏在酒精性肝病发病中的作用和潜在机制尚不清楚.
    方法:用C57BL/6WT和ApoH-/-小鼠构建长期酗酒模型。小鼠肝脏转录组,靶向胆汁酸代谢组,和16S肠道细菌分类群进行了测定和分析。分析开源人类肝脏转录组数据集。
    结果:酒精喂养的ApoH-/-小鼠表现出严重的肝性脂肪变性。肝脏RNAseq和RT-qPCR数据表明,APOH缺乏主要通过破坏从头脂肪生成影响肝脂质代谢,胆固醇处理,和胆汁酸代谢。有针对性的胆汁酸代谢组学测定表明胆汁酸成分发生了显着变化,包括酒精喂养的ApoH-/-小鼠肝脏中TCA和肠道中DCA的百分比增加。CA的浓度,NorCA,与对照小鼠相比,乙醇饮食的ApoH-/-小鼠的肝脏中的HCA更高(p<0.05)。此外,APOH缺乏改变了肠道菌群的组成,这与乙醇喂养小鼠模型中肝脏胆汁酸组成的变化有关。最后,来自人类ALD肝脏的开源转录水平数据强调了APOH下调和脂肪性肝炎之间的显着联系,以及胆汁酸代谢。
    结论:APOH缺乏通过破坏小鼠肠道菌群稳态和胆汁酸代谢,加重酒精诱导的肝脂肪变性。
    BACKGROUND: APOH plays an essential role in lipid metabolism and the transport of lipids in the circulation. Previous studies have shown that APOH deficiency causes fatty liver and gut microbiota dysbiosis in mouse models. However, the role and potential mechanisms of APOH deficiency in the pathogenesis of alcoholic liver disease remain unclear.
    METHODS: C57BL/6 WT and ApoH-/- mice were used to construct the binge-on-chronic alcohol feeding model. Mouse liver transcriptome, targeted bile acid metabolome, and 16S gut bacterial taxa were assayed and analyzed. Open-source human liver transcriptome dataset was analyzed.
    RESULTS: ApoH-/- mice fed with alcohol showed severe hepatic steatosis. Liver RNAseq and RT-qPCR data indicated that APOH deficiency predominantly impacts hepatic lipid metabolism by disrupting de novo lipogenesis, cholesterol processing, and bile acid metabolism. A targeted bile acid metabolomics assay indicated significant changes in bile acid composition, including increased percentages of TCA in the liver and DCA in the gut of alcohol-fed ApoH-/- mice. The concentrations of CA, NorCA, and HCA in the liver were higher in ApoH-/- mice on an ethanol diet compared to the control mice (p < 0.05). Additionally, APOH deficiency altered the composition of gut flora, which correlated with changes in the liver bile acid composition in the ethanol-feeding mouse model. Finally, open-source transcript-level data from human ALD livers highlighted a remarkable link between APOH downregulation and steatohepatitis, as well as bile acid metabolism.
    CONCLUSIONS: APOH deficiency aggravates alcohol induced hepatic steatosis through the disruption of gut microbiota homeostasis and bile acid metabolism in mice.
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  • 文章类型: Journal Article
    目的:酒精相关性肝炎(AH)患者死亡率高。酒精通过诱导肠道菌群失调加剧肝脏损伤,细菌移位和炎症,其特征是循环和肝中性粒细胞数量增加。
    方法:在本研究中,我们进行了串联质量标签(TMT)蛋白质组学来分析对照(n=19)的粪便中的蛋白质,来自多中心队列(InTeam)的酒精使用障碍(AUD;n=20)和AH(n=80)患者.为了识别不成比例的蛋白质组,我们使用Reactome通路分析和基因本体论进行了过度表达分析,以确定影响最显著的蛋白质.通过ELISA在AH患者(n=70)的粪便样本中验证了粪便生物标志物及其预后效果。他们在第二个独立的多中心队列(AlcHepNet)中招募。
    结果:对照组之间的粪便蛋白质组总体上有显著差异,AUD和AH患者(主成分分析p=0.001,通过Bray-Curtis方法计算的差异指数)。在所有三组中显示显着差异并根据酒精相关肝病的严重程度显示出进行性增加的蛋白质主要位于中性粒细胞颗粒中。过度表达和Reactome分析证实,差异调节的蛋白质是中性粒细胞和中性粒细胞脱颗粒途径中颗粒的一部分。髓过氧化物酶(MPO),中性粒细胞颗粒的标记蛋白,与疾病严重程度相关,并预测60天死亡率。使用独立的验证队列,我们证实粪便MPO水平可以预测60天的短期生存率.
    结论:我们发现AH患者与中性粒细胞脱颗粒相关的粪便蛋白丰度增加,这是短期生存的预测,并可以作为预后的非侵入性标志物。
    OBJECTIVE: Patients with alcohol-associated hepatitis (AH) have a high mortality. Alcohol exacerbates liver damage by inducing gut dysbiosis, bacterial translocation and inflammation, which is characterised by increased numbers of circulating and hepatic neutrophils.
    METHODS: In this study, we performed tandem mass tag (TMT) proteomics to analyse proteins in the faeces of controls (n=19), patients with alcohol-use disorder (AUD; n=20) and AH (n=80) from a multicentre cohort (InTeam). To identify protein groups that are disproportionately represented, we conducted over-representation analysis using Reactome pathway analysis and Gene Ontology to determine the proteins with the most significant impact. A faecal biomarker and its prognostic effect were validated by ELISA in faecal samples from patients with AH (n=70), who were recruited in a second and independent multicentre cohort (AlcHepNet).
    RESULTS: Faecal proteomic profiles were overall significantly different between controls, patients with AUD and AH (principal component analysis p=0.001, dissimilarity index calculated by the method of Bray-Curtis). Proteins that showed notable differences across all three groups and displayed a progressive increase in accordance with the severity of alcohol-associated liver disease were predominantly those located in neutrophil granules. Over-representation and Reactome analyses confirmed that differentially regulated proteins are part of granules in neutrophils and the neutrophil degranulation pathway. Myeloperoxidase (MPO), the marker protein of neutrophil granules, correlates with disease severity and predicts 60-day mortality. Using an independent validation cohort, we confirmed that faecal MPO levels can predict short-term survival at 60 days.
    CONCLUSIONS: We found an increased abundance of faecal proteins linked to neutrophil degranulation in patients with AH, which is predictive of short-term survival and could serve as a prognostic non-invasive marker.
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