Abstract
目的
肝病变是溃疡性结肠炎(ulcerative colitis,UC)最常见的肠外表现,但其发生机制目前尚未完全阐明,目前普遍认为其发生与免疫激活、肠道菌易位肝、炎症因子风暴及胆汁酸循环紊乱有关。UC相关性肝疾病的发生使其临床治疗更为困难,探究UC肝损伤的发病机制对于UC相关性肝疾病的防治意义重大。谷胱甘肽(glutathione,GSH)具有清除自由基、参与肝解毒代谢及免疫防御等多种生理功能,GSH的合成及氧化还原能力共同决定GSH的抗氧化功能。肝GSH抗氧化功能缺陷与多种肝疾病的发生密切相关,但其是否参与并介导UC相关性肝损伤的发生目前尚不明晰。本研究旨在探究UC发生中GSH合成及还原功能变化特征及其分子机制。
方法
应用2,4,6-三硝基苯磺酸(2,4,6-trinitrobenzenesulfonic acid,TNBS)乙醇溶液(每只5 mg/0.8 mL,50%乙醇)灌注结肠制备UC大鼠模型,分别在TNBS灌注后第3、5和7天取材血清、肝及肠道组织,测定疾病活动指数、结肠组织髓过氧化物酶活性及结肠病理组织学评分以评价UC结肠的病变程度;以肝病理组织学评分、血清谷草转氨酶(AST)和谷丙转氨酶(ALT)水平为指标评估肝病变程度;并分别将UC造模7天组大鼠肝病理评分和血清AST水平与其结肠病变程度做Spearman相关分析以明确UC发生中肝病变与结肠病变的相关性。采用试剂盒动态测定UC造模后第3、5和7天组大鼠肝中GSH含量、GSH过氧化物酶(glutathione peroxidase,GSH-Px)及GSH还原酶(glutathione reductases,GR)活性;并应用蛋白质印迹法检测肝中GSH合成反应关键酶谷氨酰胺半胱氨酸连接酶(glutamine cysteine ligase,GCL)、GSH合成酶以及GSH-Px和GR蛋白质表达的变化。
结果
与正常对照组相比,UC造模后第3、5及7天组大鼠的疾病活动指数、结肠组织髓过氧化物酶活性及结肠病理组织学评分均显著高于正常对照组(均P<0.01);UC造模后第7天组大鼠的血清AST水平及肝病理组织评分均显著高于正常对照组(均P<0.05),且UC模型大鼠肝损伤程度与结肠病变程度呈显著正相关(P=0.000 1)。此外,与正常对照组相比,UC造模后第3天和第5天组大鼠肝组织中GSH总量、GSH-Px活性和GR活性均显著低于正常对照组(P<0.05或P<0.01),且UC造模后第3、5及7天组大鼠肝组织中GCL、GSH-Px和GR蛋白质表达量均显著低于正常对照组(P<0.05或P<0.01)。
结论
UC大鼠肝病变程度与结肠病变程度呈正相关,UC大鼠肝GSH合成减少及还原能力降低明显早于肝损伤的发生,调控肝GSH合成及还原反应的关键酶表达减少是导致GSH合成减少及还原能力降低的主要原因,提示GSH抗氧化功能缺陷参与并介导UC相关性肝损伤的发生。
Keywords: 溃疡性结肠炎, 肝损伤, 谷胱甘肽, 抗氧化
Abstract
Objective
Liver disease is the most common extra-intestinal manifestation of ulcerative colitis (UC), but the underlying pathogenesis is still not clarified. It is well accepted that the occurrence of UC-related liver disease has close correlation with immune activation, intestinal bacterial liver translocation, inflammatory cytokine storm, and the disturbance of bile acid circulation. The occurrence of UC-related liver disease makes the therapy difficult, therefor study on the pathogenesis of UC-related liver injury is of great significance for its prevention and treatment. Glutathione (GSH) shows multiple physiological activities, such as free radical scavenging, detoxification metabolism and immune defense. The synthesis and the oxidation-reduction all contribute to GSH antioxidant function. It is reported that the deficiency in hepatic GSH antioxidant function participates in multiple liver diseases, but whether it participates in the pathogenesis of UC-related liver injury is still not clear. This study aims to investigate the feature and underlying mechanism of GSH synthesis and oxidation-reduction function during the development of UC, which will provide useful information for the pathogenesis study on UC-related liver injury.
Methods
UC model was induced by 2,4,6-trinitrobenzenesulfonic acid (TNBS)-ethanol solution (5 mg/0.8 mL per rat, 50% ethanol) via intra-colonic administration in rats, and the samples of serum, liver, and colon tissue of rats were collected at the 3rd, 5th, and 7th days post TNBS. The severity degree of colitis was evaluated by measuring the disease activity index, colonic myeloperoxidase activity, and histopathological score, and the degree of liver injury was evaluated by histopathological score and the serum content of alanine aminotransferase. Spearman correlation analysis was also conducted between the degree of colonic lesions and index of hepatic histopathological score as well as serum aspartate aminotransferase level to clarify the correlation between liver injury and colitis. To evaluate the hepatic antioxidant function of GSH in UC rats, hepatic GSH content, enzyme activity of GSH peroxidase (GSH-Px), and GSH reductase (GR) were determined in rats at the 3rd, 5th, and 7th days post TNBS, and the protein expressions of glutamine cysteine ligase (GCL), GSH synthase, GSH-Px, and GR in the liver of UC rats were also examined by Western blotting.
Results
Compared with the control, the disease activity index, colonic myeloperoxidase activity, and histopathological score were all significantly increased at the 3rd, 5th, and 7th days post TNBS (all P<0.01), the serum aspartate aminotransferase level and hepatic histopathologic score were also obviously elevated at the 7th day post TNBS (all P<0.05). There was a significant positive correlation between the degree of liver injury and the severity of colonic lesions (P=0.000 1). Moreover, compared with the control, hepatic GSH content and the activity of GSH-Px and GR were all significantly decreased at the 3rd and 5th days post TNBS (P<0.05 or P<0.01), and the protein expressions of GCL, GSH-Px, and GR were all obviously down-regulated at the 3rd, 5th, and 7th days post TNBS (P<0.05 or P<0.01).
Conclusion
There is a significant positive correlation between the degree of liver injury and the severity of colonic lesions, and the occurrence of reduced hepatic GSH synthesis and decreased GSH reduction function is obviously earlier than that of the liver injury in UC rats. The reduced hepatic expression of enzymes that responsible for GSH synthesis and reduction may contribute to the deficiency of GSH synthesis and oxidation-reduction function, indicating that the deficiency in GSH antioxidant function may participate in the pathogenesis of UC related liver injury.
Keywords: ulcerative colitis, liver injury, glutathione, antioxidant
溃疡性结肠炎(ulcerative colitis,UC)是一种主要累及结直肠黏膜的慢性非特异性炎症性疾病[1]。UC的主要病变是结直肠,但其同时可并发多种肠外疾病,肝病变是UC最常见的肠外表现之一[2]。研究[3]显示:UC患者肝病变的发生概率显著高于普通人群,40%的UC患者存在肝功能异常,并以肝炎(70%)、胆汁淤积(20%)、脂肪肝、肝硬化及肝癌等病变为主。UC相关性肝病变的发生使UC的临床治疗变得更加棘手,研究UC相关性肝病变的发病机制并寻求防治策略是目前亟待解决的问题。目前,UC相关性肝病的发生机制尚未完全阐明,研究[4]认为其发生与免疫激活、肠菌肝脏易位、炎症因子风暴、肝屏障功能障碍及胆汁酸循环紊乱等有关。随着国民生活方式的改变,UC已成为中国人群消化系统的常见疾病[5],探究UC相关性肝病的发病机制对于UC相关性肝病的防治意义重大。
谷胱甘肽(glutathione,GSH)是胞内小分子硫醇化合物,具有清除氧自由基、代谢解毒、参与免疫防御调节及抑制细胞坏死等生理功能[6]。GSH发挥功能的核心环节包括生物合成和氧化还原两大过程,其中氨酰胺半胱氨酸连接酶(glutamine cysteine ligase,GCL)和谷胱甘肽合成酶(glutathione synthetase,GS)是调控GSH合成的关键酶,而谷胱甘肽还原酶(glutathione reductases,GR)与谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)是调控GSH氧化还原反应的关键酶。GCL是GSH合成反应的限速酶,催化L-谷氨酸和L-半胱氨酸生产γ-氨酰胺半胱氨酸,后者在GS的催化下与甘氨酸结合生成GSH[7]。在GSH的氧化还原反应中,GSH-Px可催化还原型GSH变为氧化型GSH,进而使有毒的过氧化物还原成无毒的羟基化合物以减少细胞的氧化损伤;GR则可利用还原型NADPH将氧化型GSH催化生成还原型GSH以保证体内有效抗氧化活性物质的含量[8]。目前大量研究[9-10]显示:GSH的合成及代谢异常所致的GSH抗氧化功能缺陷与肝炎、胆汁淤积、原发性硬化性胆管炎及脂肪肝等多种肝病的发生密切相关。然而GSH合成和还原功能缺陷是否与UC相关性肝损伤的发生有关鲜有报道。
本研究应用2,4,6-三硝基苯磺酸(2,4,6-trinitrobenzenesulfonic acid,TNBS)诱导的UC大鼠模型,动态研究UC发生发展过程中肝病变与GSH合成及还原反应关键分子变化的相关性,旨在探究UC肝损伤的发生是否与GSH合成和还原功能缺陷有关,阐明UC肝损伤的发生机制,以期为UC相关性肝病的防治提供线索和依据。
1. 材料与方法
1.1. 材料
1.1.1. 动物
选取体重为220~240 g的SPF级雄性Wistar大鼠,由甘肃中医药大学实验动物中心提供[许可证号:SCYK(甘)2015-0005]。大鼠适应性饲养1周后开始实验,所有实验操作均遵照实验动物管理和使用的原则进行。
1.1.2. 试剂与药物
TNBS(92823)、多聚甲醛(PFA,P6148)、十六烷基三甲基溴化胺(H6269)及邻联二茴香胺(D3252)均购自美国Sigma公司;柳氮磺胺吡啶片(salazosulfapyridine,SASP,0.25 g,批号H31020840)购自上海福达制药有限公司;GR活性(A062)、GSH-Px活性(A005)、微量还原型GSH含量(A006-2-1)及GSH含量(A061-1)检测试剂盒均购自南京建成生物工程研究所;GCL抗体(ab190685)、GS抗体(ab133592)、GSH-Px抗体(ab108429)及GR抗体(ab124995)购自美国Abcam公司;ECL化学发光试剂盒(P0018FS)购自上海碧云天生物技术有限公司。戊巴比妥钠购自中国医药集团上海化学试剂公司。
1.1.3. 仪器
全自动生化分析仪(5831型)购自美国Beckman公司;病理图像分析系统(XB51-32H01)购自日本奥林巴斯公司;Thermo全自动酶标仪(MultiskanFC型)购自美国Thermo公司;电动匀浆机(DY89-1型)购自宁波新芝生物科技有限公司;精密电子天平(AL204型)购自美国梅特勒-托利多公司;高速低温离心机(3K15型)购自美国Sigma公司;免疫印迹电泳-转膜仪(1658001型)购自美国BioRad公司。
1.2. 方法
1.2.1. UC模型制备及评价
大鼠禁食12 h,以戊巴比妥钠(30 mg/kg,腹腔内注射)麻醉。通过导管向距肛门8 cm的结肠内缓慢注入TNBS乙醇溶液(每只5 mg/0.8 mL)以制备UC模型,对照组的大鼠于结肠灌注生理盐水作为对照。造模后每日记录大鼠体重及粪便形状,以体重变化率(<1%为0分,1%~5%为1分,6%~10%为2分,11%~15%为3分,>15%为4分)及粪便形状评分(正常为0分,成形软便为2分,软便不成形为3分,腹泻为4分)为指标计算病变活动指数(disease activity index,DAI)。最后以DAI、结肠组织髓过氧化物酶(myeloperoxidase,MPO)活性及结肠病理组织学评分[11]为指标评估UC模型。本实验已获得兰州大学医学伦理委员会批准(审批号:LDYYLL2017-37)。
1.2.2. 实验设计及标本采集
UC模型组大鼠分别在TNBS给药后第3、5和7天进行取材,SASP组予UC大鼠灌胃给药SASP (300 mg/kg),每日1次,连续7 d,给药后次日取材。麻醉大鼠于腹主动脉取血,以3 000 r/min离心分离血清,用于测定肝生化指标。取肝及结肠组织,一部分放置于4%多聚甲醛中固定,用于病理组织学检查;剩余部分存放于-80 ℃冰箱,其中肝组织用于测定GSH含量、GSH酶活性及蛋白质表达,结肠组织用于测定MPO活性。
1.2.3. MPO活性检测
准确称取结肠组织,按1꞉9的比例(1 mg组织+0.5%十六烷基三甲基溴化胺9 mL)制备10%的组织匀浆,以10 000 r/min低温离心10 min后取上清液。上清液中加入含有0.0005%邻联二茴香胺及含0.1%过氧化氢的磷酸缓冲液(50 mmol/L,pH 6.0),在室温460 nm处连续测定2 min内光密度值,计算每分钟光密度值变化率,再以样品中蛋白质含量进行校正以计算MPO的活性[11]。
1.2.4. 肝病理组织学评分
肝组织经固定、脱水、石蜡包埋、切片及HE染色后行镜下病理组织学观察。根据文献[12]报道的方法,以各组大鼠肝组织学切片中细胞气球样变、汇管区炎症、脂肪变性及点状坏死等病变的轻重程度对肝组织进行病理组织学评分。
1.2.5. 肝生化指标检测
取0.5 mL血清标本送兰州大学第一医院检验科,根据说明书要求应用全自动生化分析仪测定血清谷草转氨酶(aspartate aminotransferase,AST)和谷丙转氨酶(alanine aminotransferase,ALT)含量以评估肝功能的变化。
1.2.6. 肝GSH含量及GR和GSH-Px酶活性测定
取大鼠肝组织,按照1꞉9的比例(1 mg组织+9 mL生理盐水)制备10%的肝组织匀浆。匀浆液经液氮冻融充分裂解细胞,再以2 500 r/min低温离心10 min,取上清液根据说明书要求配置样品反应溶液并进行加样反应。待样品反应完成后,立即按说明书要求用酶标仪在405 nm处进行检测。同时应用蛋白质检测试剂盒测定组织匀浆液中蛋白质浓度,最终实验结果以样品中蛋白质含量进行校正。
1.2.7. 蛋白质印迹法
应用蛋白质印迹法检测GSH合成关键酶GCL及GS的蛋白质表达。以肝组织(mg)꞉RIPA裂解液(μL)=1꞉9制备组织匀浆液,以10 000 r/min离心10 min,取上清液,再加入蛋白质上样缓冲液在95 ℃下变性,制备样品。取8 μL样本,行聚丙烯酰胺凝胶电泳,转入PDVF膜,用5%脱脂牛奶于室温下封闭1 h,再加入相应的一抗(anti-GCL,anti-GS,anti-GSH-Px及anti-GR,1꞉1 000稀释;anti-actin,1꞉2 000稀释),于4 ℃下摇床过夜。充分洗膜后加入二抗,于室温下孵育 1 h,再加入ECL试剂,在暗室压片曝光。扫描显影条带,用Image J软件计算灰度值,以内参照进行校正,定量统计蛋白质的表达量。
1.3. 统计学处理
采用SPSS 20.0软件进行统计分析,计量数据以均数±标准差( ±s)表示,两组间差异比较采用Student t检验。应用Spearman相关分析分别分析结肠炎评分与肝损伤评分、结肠DAI与血清AST水平的相关性。P<0.05为差异有统计学意义。
2. 结 果
2.1. UC模型评价
UC组大鼠出现不同程度的稀便、懒动、厌食及体重下降,DAI值及MPO活性均显著高于正常对照组(均P<0.01,表1)。病理组织学观察显示:正常组大鼠结肠黏膜完整,腺体排列整齐,无黏膜肿胀及炎细胞浸润;UC组大鼠结肠黏膜可见不同程度溃疡、水肿及大量炎细胞浸润。UC组大鼠病理组织学评分显著高于正常对照组(P<0.05),提示UC大鼠模型制备成功。与UC造模后7 d组相比,SASP组大鼠结肠黏膜溃疡减轻,炎症细胞浸润减少,DAI值、MPO及病理组织学评分显著低于UC组(均P<0.01)。
表1.
UC大鼠结肠病变活动指数、髓过氧化物酶活性 及组织学评分变化(n=6, ±s)
Table 1 Alteration of disease activity index, myeloperoxidase activity, and histological score in the colon of UC rats (n=6, ±s)
| Groups | Disease activity index | Myeloperoxidase activity/(U·mg-1) | Histological scores |
|---|---|---|---|
| Normal | 0.45±0.35 | 0.12±0.01 | 0.09±0.05 |
| UC-3 d | 3.00±0.89 ** | 0.29±0.06** | 1.03±0.15* |
| UC-5 d | 4.50±1.05** | 0.40±0.07** | 1.13±0.25* |
| UC-7 d | 3.82±1.17** | 0.36±0.06* | 1.04±0.29* |
| SASP-7 d | 2.54±0.84†† | 0.28±0.05†† | 0.74±0.15†† |
UC: Ulcerative colitis; SASP: Salazosulfapyridine. **P<0.01 vs the normal group; ††P<0.01 vsthe UC-7 d group.
2.2. UC大鼠肝病理组织学及生化指标变化
病理组织学检查结果显示:正常组大鼠肝组织中央静脉为中心肝细胞索排列整齐,肝细胞无肿胀坏死及炎症细胞浸润;UC-5 d组大鼠肝脏的中央静脉周围散在肝细胞气球样变,未见细胞坏死及炎症细胞浸润;UC-7 d组大鼠肝脏的中央静脉周围大量肝细胞气球样变,并可见散在肝细胞嗜酸性变及核固缩等细胞坏死表现;SASP组大鼠肝脏可见气球样变,少见细胞坏死(图1)。与正常组相比,UC造模后大鼠血清ALT和AST水平有逐渐升高趋势,UC-7 d组大鼠血清AST水平及肝病理组织学评分均显著高于正常对照组(均P<0.05)。与UC-7 d组相比,SASP组大鼠AST水平及肝病理组织学评分均明显降低(均P<0.05,表2)。
图1.
UC大鼠肝脏病理组织学改变(HE)
Figure 1 Pathological changes in the liver of UC rats (HE) Blue arrows indicate ballooning degeneration of hepatocytes and black arrows indicate eosinophilic changes and karyopyknosis of hepatocytes.
表2.
UC大鼠血清ALT和AST水平及肝脏病理组织学评分变化(n=6, ±s)
Table 2 Alteration of serum level of ALT, AST, and the histological score in the liver of UC rats (n=6, ±s)
| Groups | ALT/(U·L-1) | AST/(U·L-1) | Histological scores |
|---|---|---|---|
| Normal | 51.60±7.93 | 82.00±0.61 | 0.42±0.27 |
| UC-3 d | 59.83±8.03 | 96.33±19.9 | 0.47±0.24 |
| UC-5 d | 61.17±9.82 | 99.83±16.1 | 0.91±0.31 |
| UC-7 d | 63.67±7.12 | 115.17±15.8* | 2.72±0.27* |
| SASP-7 d | 61.02±7.31 | 94.72±10.2† | 1.84±0.28† |
UC: Ulcerative colitis; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; SASP: Salazosulfapyridine. *P<0.05 vs the normal group; †P<0.05 vs the UC-7 d group.
2.3. UC结肠病变程度与肝病变的相关性分析
UC-7 d组及SASP组大鼠结肠病理组织学评分与肝病理组织学评分呈显著正相关(P=0.000 1),Loess曲线拟合两者呈线性相关,回归方程为肝病变评分值=0.3603×结肠病理组织学评分值+0.1911,该模型R 2=0.820 5(图2A)。结肠DAI与血清AST水平呈显著正相关(P=0.000 2),Loess曲线拟合两者呈线性相关,回归方程为血清AST水平=9.009×结肠DAI+68.89,该模型R 2=0.7698(图2B)。
图2.
溃疡性结肠炎大鼠结肠病变与肝病变的相关性(n=12)
Figure 2 Correlation between colonic lesions and liver alteration in ulcerative colitis rats (n=12)
2.4. UC大鼠肝GSH含量及GSH-Px与GR酶活性的变化
与正常组相比,UC造模后3 d和5 d组大鼠肝GSH含量及GSH-Px活性均显著降低(P<0.05或P<0.01),UC-5 d组大鼠肝GR活性显著降低(P<0.05,表3)。
表3.
UC大鼠肝GSH含量及GSH-Px与GR酶活性的变化(n=6, ±s)
Table 3 Alteration of GSH content and enzyme activity of GSH-Px and GR in the liver of UC rats (n=6, ±s)
| Groups |
GSH/ (μmol·g Prot-1) |
GSH-Px/ (U·g Prot-1) |
GR/(U·g Prot-1) |
|---|---|---|---|
| Normal | 5.86±0.56 | 410.40±19.41 | 228.22±47.26 |
| UC-3 d | 4.05±0.31* | 329.34±11.48** | 195.27±31.28 |
| UC-5 d | 3.67±0.87* | 268.20±10.13** | 150.71±26.82* |
UC: Ulcerative colitis; GSH: Glutathione; GSH-Px: Glutathione peroxidase; GR: Glutathione reductases. *P<0.05,**P<0.01 vs the normal group.
2.5. UC对大鼠肝GSH合成酶表达的影响
与正常对照组相比,UC造模后3 d、5 d和7 d组大鼠肝组织中GCL蛋白表达均显著降低(均P<0.001),而SASP治疗组GCL表达较UC-7d组明显增加(P<0.05);各组GS表达未见明显变化(P>0.05,图3)。
图3.
UC大鼠肝组织GCL及GS蛋白质表达变化(n=3)
Figure 3 Alteration in the protein expression of GCL and GSS in the liver tissues of colitis rats (n=3)
UC: Ulcerative colitis; GCL: Glutamine cysteine ligase; GS: Glutathione synthetase. **P<0.001 vs the normal group; †P<0.05 vs the UC-7 d group.
2.6. UC大鼠肝GSH还原酶表达的变化
与正常对照组相比,UC造模后3 d、5 d和7 d组大鼠肝组织中GSH还原反应的关键酶GSH-Px蛋白表达量均明显降低(均P<0.001),SASP组GSH-Px表达较UC-7 d组明显增加(P<0.05);与正常对照组相比,UC造模后5 d和7 d组大鼠肝组织中GSH还原酶GR蛋白表达量明显降低(均P<0.001),SASP组GR表达较UC-7 d组明显增加(P<0.05,图4)。
图4.
UC大鼠肝脏GSH-Px与GR蛋白质表达变化(n=3)
Figure 4 Alteration in the protein expression of GSH-Px and GR in the liver of colitis rats (n=3)
UC: Ulcerative colitis; GSH-Px: Glutathione peroxidase; GR: Glutathione reductases. **P<0.001 vsthe normal group; †P<0.05 vs the UC-7 d group.
3. 讨 论
UC相关性肝疾病是阻碍UC临床治疗的重要因素。肝损害最终可进展为肝硬化和肝衰竭,因此肝损害是危害UC患者生命的严重并发症,对其发生机制及防治进行研究具有重要的临床意义。TNBS是目前常用于制备结肠炎动物模型的药物,结肠灌注TNBS诱发的结肠炎病理表现近似于人类UC,TNBS与结肠大分子物质结合形成全抗原引起肠黏膜免疫激活和炎症反应为其主要致炎机制[13]。TNBS单次给药诱发的UC模型在TNBS给药后3~5 d最为典型[14]。本研究证实:TNBS造模后3 d大鼠可出现明显UC表现,且以TNBS给药后5 d最为显著;TNBS造模后 7 d大鼠即可出现肝转氨酶升高及肝细胞坏死等肝损害表现。该发现与国内外学者[15-17]的研究结果相似。例如TNBS诱发的结肠炎可并发肝转氨酶升高[15],DSS诱发的急性UC模型存在肝炎症及损伤[16],DSS诱发的慢性UC模型可继发肝炎症和纤维化[17],均说明UC结肠病变可继发肝损伤。此外,本研究发现UC病变损伤程度与肝损伤程度之间具有显著正相关,该发现与临床中UC患者肝损伤发生率较高的研究[18]结果比较一致。
为明确UC大鼠肝损害发生前是否存在肝谷胱甘肽抗氧化系统异常,本研究动态观察肝转氨酶变化前各组大鼠肝GSH相关指标的变化,发现UC-3d及UC-5d组大鼠肝GSH含量及GSH-Px和GR酶活性显著降低,提示UC大鼠在肝细胞受损前已出现肝GSH含量减少及抗氧化功能的降低。值得关注的是,Vairetti等[8]在应用DSS诱导的UC肝损伤模型中,同样发现了肝GSH含量降低及谷胱甘肽超氧化物歧化酶和过氧化氢酶活性显著降低,进一步说明UC存在肝GSH抗氧化功能缺陷。此外,研究[19]报道在UC模型肝GSH降低的同时出现丙二醛升高,提示肝GSH含量减少及其保护功能缺陷在UC肝损伤发病中扮演了重要作用。
已知GSH是一种三肽含硫化合物,其合成主要受GCL和GS的调控,GCL是GSH合成的限速酶,GCL表达减少会使GSH合成受阻并导致GSH含量降低[20]。本研究继续对GCL和GS蛋白质表达量进行研究,发现UC-3 d及UC-5 d组大鼠肝GCL表达明显降低,推测GCL表达降低致其合成减少可能是UC大鼠肝GSH含量降低的主要原因。GR可使氧化型GSH发生还原反应,维持GSH还原状态并防止细胞氧化损伤;GSH-Px可特异性催化GSH对过氧化氢的还原反应,从而保护细胞膜免受氧自由基的攻击;二者催化GSH的氧化还原反应在GSH抗细胞损伤中发挥重要作用[21]。本研究发现UC-3 d及UC-5 d组大鼠肝GR和GSH-Px的蛋白质表达也明显降低,该变化与GR和GSH-Px酶活性降低的实验结果一致,说明UC大鼠肝氧化还原能力降低与肝GR和GSH-Px的蛋白质表达减少有关。由此可见,GSH合成酶GCL、氧化还原反应关键酶GR和GSH-Px表达降低是导致UC大鼠肝GSH合成减少及还原功能降低的主要原因。
核因子E2相关因子2(nuclear factor E2-related factor 2,Nrf2)是调控GSH功能的关键转录因子,Nrf2基因敲除的大鼠体内GCL、GR、GSH-Px及S转移酶的mRNA表达均显著减少[22],说明Nrf2可调控GSH合成及抗氧化功能。此外,一项基于DSS诱导的UC肝损伤模型研究[19]发现肝Nrf2表达降低可导致UC肝GSH抗氧化系统异常,说明Nrf2表达减少可能是导致UC模型肝GSH抗氧化功能缺陷的主要原因。Nrf2主要表达于肝、肾、心及脾脏细胞,约调控250个基因表达,其功能涉及抗氧化蛋白、解毒酶及药物转运蛋白等[23],可见Nrf2是维持细胞内氧化还原稳态的关键调节分子。目前,在UC模型中肝Nrf2表达降低的原因尚不明晰,已知Keap1及Cul3可负调控Nrf2功能,且促炎因子及内毒素等也可使Nrf2表达降低[24-25]。鉴于在UC疾病进程中可出现肠道及血清中促炎因子及内毒素水平增高[26],故推测:促炎因子及内毒素可能通过下调Nrf2的表达而引发UC肝GSH合成及还原功能缺陷。后续本课题组将对该问题进行进一步研究。
本研究动态研究了UC发生发展过程中肝GSH合成及还原功能变化,初步阐释了UC大鼠肝GSH抗氧化功能缺陷的主要原因,但本研究仍存在一些问题值得后期深入研究:1)UC肠道病变是否会引起合成GSH的原料氨基酸吸收不足并影响GSH含量?2)UC大鼠外源性补充GSH是否可逆转肝损伤发生?因此,本课题组拟后期进一步观察UC大鼠肝中合成GSH的原料氨基酸含量的变化,并通过GSH干预观察UC肝损伤程度变化,以更深入的实验研究丰富本研究结论。
近年来,我国UC发病率逐年增高,导致UC相关性肝损害发生率不断增加,阐明UC肝损伤发生机制并进行防治策略研究刻不容缓。本研究发现在UC模型中肝GSH合成及还原功能缺陷与UC相关性肝损伤发生有关,调控肝GSH合成及氧化还原反应的关键酶表达的减少是导致GSH含量降低及还原能力缺陷的主要原因。可见,以调控GSH合成及还原反应为靶点的治疗策略有望为UC肝损伤的治疗提供新思路。
基金资助
国家自然科学基金(81770657);中央高校基本科研项目(lzujbky-2018-56);兰州大学大学生创新创业计划及兰州大学第一临床医学院“卓越计划”(20190060147)。
This work was supported by the National Natural Science Foundation (81770657), the Fundamental Research Funds for the Central Universities (lzujbky-2018-56), College Student Innovation and Entrepreneurship Action Plan of Lanzhou University, and the “Excellence Project” in First Clinical Medicine College of Lanzhou University (20190060147), China.
利益冲突声明
作者声称无任何利益冲突。
作者贡献
王亮亮 细胞和分子生物学实验及文章撰写;韩茹月、臧凯宏 动物实验及样品处理;袁沛 数据的统计分析;秦红岩 课题设计、实验统筹及文章修改。
原文网址
http://xbyxb.csu.edu.cn/xbwk/fileup/PDF/202203271.pdf
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