北京大学学报(医学版) ›› 2022, Vol. 54 ›› Issue (6): 1141-1150. doi: 10.19723/j.issn.1671-167X.2022.06.014
梁秀睿1,闪雪纯1,关晶1,张锐1,杨静1,张怡1,金佳琦1,张誉馨1,徐凡1,傅继华2,*()
Xiu-rui LIANG1,Xue-chun SHAN1,Jing GUAN1,Rui ZHANG1,Jing YANG1,Yi ZHANG1,Jia-qi JIN1,Yu-xin ZHANG1,Fan XU1,Ji-hua FU2,*()
摘要:
目的: 探讨5-羟色胺(5-hydroxytryptamine,5-HT)在2型糖尿病(type 2 diabetes mellitus,T2DM)引起肝脏炎症及纤维化时的作用。方法: 雄性C57BL/6J小鼠,通过高脂饲料喂养结合腹腔注射链脲佐菌素,建立T2DM模型;将已形成高血糖的小鼠继续用高脂饲料喂养9周或同时用5-HT2A受体(5-HT 2A receptor,5-HT2AR)拮抗剂盐酸沙格雷酯(sarpogrelate hydrochloride,SH)及5-HT合成抑制剂卡比多巴(carbidopa,CDP)分别或联合给药进行治疗。细胞实验用人肝星状细胞(hepatic stellate cells,HSCs)株LX-2,高浓度葡萄糖刺激或同时用SH、CDP或单胺氧化酶A(monoamine oxidase A,MAO-A)抑制剂氯吉兰(clorgyline,CGL)处理细胞,观察高糖诱导LX-2细胞肌成纤维细胞化时5-HT的作用。用苏木精-伊红(hematoxylin & eosin,HE)及马松(Masson)染色法检测肝组织切片病理变化,免疫组织化学及Western blot分析蛋白表达,ELISA或酶试剂法检测生化指标,荧光探针法检测细胞内活性氧(reactive oxygen species,ROS)含量。结果: T2DM小鼠肝脏的5-HT2AR、5-HT合成酶和MAO-A表达上调,且5-HT含量升高。SH和CDP治疗在降低肝脏5-HT含量及下调MAO-A表达的同时,可有效地改善肝脏病变:不仅改善肝功能及肝脂肪变性,还明显抑制肝脏ROS(H2O2)含量升高,改善氧化应激,并抑制转化生长因子β1(transforming growth factor β1,TGF-β1)的产生,以及炎症和纤维化的发生,且SH和CDP的作用呈协同效应。LX-2细胞研究表明,高糖可上调5-HT2AR、5-HT合成酶和MAO-A表达,升高细胞内5-HT含量,使细胞的ROS产生增多及肌成纤维细胞化,从而增加TGF-β1合成及炎症和纤维化因子的产生。通过SH拮抗5-HT2AR,高糖作用被明显抑制;通过CGL抑制线粒体5-HT降解,高糖作用被强烈抑制。SH还可抑制高糖诱导的5-HT合成酶及MAO-A表达上调。结论: 高糖诱导HSCs肌成纤维细胞化和TGF-β1产生,从而导致T2DM小鼠肝脏炎症及纤维化损伤,其病理机制可能是诱导了5-HT2AR表达上调,5-HT合成及降解增加,使线粒体的ROS产生增多,其中,5-HT2AR的作用是参与了对5-HT合成酶和MAO-A表达的调控。
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