肝组织清道夫受体A在急性重症胆管炎时的表达与内毒素性肝损伤的关系  

Relation of endotoxic hepatic injury with expression of scavenger receptor A in liver tissue during severe acute cholangitis

作　　者：杨慷[1] 刘作金[1] 龚建平[1] 赵蕾[1] 涂兵[1] 

机构地区：[1]重庆医科大学附属第二医院肝胆外科,重庆市400010

出　　处：《世界华人消化杂志》2009年第2期141-145,共5页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;No.30500473~~

摘　　要：目的:研究急性重症型胆管炎(ACST)时大鼠内毒素性肝损伤与肝组织中清道夫受体A(SR-A)表达水平的关系.方法:Wistar大鼠随机分为2组,第1组(急性胆道感染组,AOC组),胆总管予以结扎并注入大肠杆菌O111B4建立ACST动物模型,第2组(胆总管结扎组,BDL组),结扎胆总管并注射等量生理盐水.于术后0、4、8、16、24h分别采用Western blot和RT-PCR检测肝组织中SR-A蛋白和基因表达水平;以鲎试验和ELISA测定血浆内毒素和白介素-6(IL-6);光镜观察肝组织病理变化并测定血浆ALT、TB含量.结果:在ACST时随着病程的延长、血浆内毒素浓度逐渐升高(0-24h:0.058±0.009,0.207±0.024,0.433±0.049,0.645±0.077,0.784±0.097,P<0.01),血浆IL-6、ALT和TB含量明显增加(均P<0.01),肝功能减损,同时肝细胞变性、坏死等病理改变逐渐加重,而AOC组SR-A在术后4h,表达已开始下降(P<0.01),随着病程延长其表达逐渐下降,至24h与BDL比较有明显显著性差异(蛋白:0.156±0.014vs0.809±0.107,P<0.01;mRNA:0.138±0.019vs0.578±0.068,P<0.01).结论:ACST时,内毒素性肝损伤与肝组织SR-A表达水平的进行性下调有关.随着枯否细胞清除内毒素的防御能力下降,肝组织内毒素性损伤进行性加重.AIM： To investigate the relationship of endotoxic hepatic injury with the expression of scavenger receptor A （SR-A） in liver tissue during acute cholangitis of severe type （ACST）. METHODS： A rat model of ACST was established by ligating choledochus and injecting escherichia coli O111B4 into Wistar rats. At 0, 4, 8, 16, 24 h after operation, the expressions of SR-A protein and mRNA in liver tissue were assayed by western blot and RT-PCR respectively; the levels of plasma endotoxin and interleukin-6 （IL-6） were measured using limulus test and ELISA. Pathological changes in liver tissue were detected by light microscopy, while ALT and TB were determined too. RESULTS： The plasma endotoxin levels in ACST were progressively increased with time （0-24 h： 0.058 ± 0.009, 0.207 ± 0.024, 0.433 ± 0.049, 0.645 ± 0.077, 0.784 ± 0.097, P 〈 0.01）. With elevated endotoxin, the levels of IL-6, ALT and TB were markedly increased; hepatic histopathological injury was gradually aggravated, while the SR-A expression was obviously decreased. There was significant difference between the expression of SR-A and expression of BLD at 24 h （protein： 0.156 ± 0.014 vs 0.809 ± 0.107, P 〈 0.01; mRNA： 0.138 ± 0.019 vs 0.578 ± 0.068, P 〈 0.01）. CONCLUSION： Endotoxic hepatic injury is related with the progressively decreased expression of SR-A in liver tissue during ACST. With the Kupffer cells abilities of clearing endotoxin down-regulated, endotoxic hepatic injury is gradually aggravated.

关 键 词：急性重症型胆管炎 清道夫受体A 内毒素性肝损伤 KUPFFER细胞 白介素-6 

分 类 号：R575.6[医药卫生—消化系统]