15-deoxy-delta 12,14-prostaglandin J2 prevents inflammatory response and endothelial cell damage in rats with acute obstructive cholangitis

Shenfu Injection Attenuates Bile Duct Injury in Rats with Acute Obstructive Cholangitis

Background: We investigated the effect of Shenfu injection (SFI) in Wistar rats with acute obstructive cholangitis (AOC) and considered the possible molecular mechanisms of the effects. Methods: The 96 rats were divided randomly into three groups. In one group, the common bile duct was subjected to ligation (BDL), and 0.2 mL of saline was injected into the proximal bile ducts. To create AOC, again, the common bile duct was ligated, and 0.2 mL of lipopolysaccharide (LPS)) (2 mg/mL) was injected into the proximal ducts. In the Shenfu injection (SFI) group, the material (10 mg/kg) was injected into the tail vein 2 hours before induction of AOC. The hepatic histopathologic changes were observed under a light microscope. The endotoxin, tumor necrosis factor-α (TNF-α), alanine transaminase (ALT), and total bilirubin (TB) concentrations in the serum were measured at different time points (0, 4, 8, and 16 hours) after ligation. The expression of nuclear transcription factor-κB (NF-κB) and CD14 in Kupffer cells also was analyzed at different times by Western blotting. Results: The TNF-α, ALT, and TB concentrations in the serum and the expression of CD14 and NF-κB in Kupffer cells were significantly higher in the SFI group than in the BDL group, but all were significantly lower than in the AOC group. Compared with the AOC group, the edema of cholangiocytes was alleviated in the SFI group, and the infiltration of inflammatory cells around cholangiocytes was reduced. Conclusion: Shenfu injection significantly alleviated bile duct injury. The potential mechanism may be associated with inhibition of CD14 expression and prevention of NF-κB activation in Kupffer cells.

Protective Effects of Peroxiredoxin 4 (PRDX4) on Cholestatic Liver Injury

Accumulating evidence indicates that oxidative stress plays a critical role in initiating the progression of inflammatory and fibrotic liver diseases, including cholestatic hepatitis. Peroxiredoxin 4 (PRDX4) is a secretory antioxidase that protects against oxidative damage by scavenging reactive oxygen species (ROS) in both the intracellular compartments and extracellular space. In this study, we examined the in vivo net effects of PRDX4 overexpression in a murine model of cholestasis. To induce cholestatic liver injury, we subjected C57BL/6J wild-type (WT) or human PRDX4 (hPRDX4) transgenic (Tg) mice to sham or bile duct ligation (BDL) surgery for seven days. Our results showed that the liver necrosis area was significantly suppressed in Tg BDL mice with a reduction in the severity of liver injuries. Furthermore, PRDX4 overexpression markedly reduced local and systemic oxidative stress generated by BDL. In addition, suppression of inflammatory cell infiltration, reduced proliferation of hepatocytes and intrahepatic bile ducts, and less fibrosis were also found in the liver of Tg BDL mice, along with a reduced mortality rate after BDL surgery. Interestingly, the composition of the hepatic bile acids (BAs) was more beneficial for Tg BDL mice than for WT BDL mice, suggesting that PRDX4 overexpression may affect BA metabolism during cholestasis. These features indicate that PRDX4 plays an important role in protecting against liver injury following BDL and might be a promising therapeutic modality for cholestatic diseases.

SOCS1 regulates hepatic regenerative response and provides prognostic makers for acute obstructive cholangitis

Acute obstructive cholangitis (AOC) is a common and severe infectious diseases that occurs in an obstructed biliary system. The suppressors of cytokine signaling (SOCS) family include well-known negative regulators of cytokine receptor signaling. However, few studies have been conducted to determine their function in AOC. In this study, we showed that SOCS1 expression aberrantly changed and was associated with AOC prognosis in rat models. Decreased SOCS1 expression enhances regenerative response after biliary drainage (BD) resulting from AOC by upregulating hepatocyte growth factor (HGF) signaling. To detect SOCS1 expression in the liver less invasively and to predict the prognosis for AOC after BD, miR-221 and miR-222 were investigated. Ectopic SOCS1 expression indirectly decreases miR-221/222 expression through Met in vitro. An inverse correlation between SOCS1 expression and miR-221/222 expression in liver tissue or in serum was verified in rats. Serum from AOC patients showed that lower expression of circulating miR-221/222 after endoscopic nasobiliary drainage was associated with delayed restoration of liver function. Our results showed that SOCS1 regulates hepatic regenerative response, and indirectly detecting downstream molecules, such as miR-221/222, may provide prognostic makers for AOC.

Catheterization of the gallbladder: A novel mouse model of severe acute cholangitis

AIM

To establish a severe acute cholangitis (SAC) model in mice.

METHODS

Cholecystic catheterization was performed under the condition of bile duct ligation (BDL). Trans-cholecystic injection of lipopolysaccharide (LPS) was defined as the SAC animal model. Sham operation group, intraperitoneal injection of LPS without BDL group, intraperitoneal injection of LPS with BDL group and trans-cholecystic injection of normal saline with BDL group were defined as control groups. The survival rates and tissue injuries in liver, lungs and kidney were evaluated.

RESULTS

Mice in the SAC group showed a time-dependent mortality and much more severe tissue injuries in liver, lungs and kidney, compared with other groups. However, relieving biliary obstruction could effectively reduce mortality and attenuate liver injury in the SAC mouse model.

CONCLUSION

Trans-cholecystic injection of LPS under the condition of biliary obstruction could establish a repeatable and reversible mouse model of SAC.

Clinical effects of duodenoscopy, laparoscopy, and choledochoscopy combined with cholecystectomy and common bile duct exploration in treatment of acute obstructive suppurative cholangitis

AIM: To observe the clinical effects of duodenoscopy, laparoscopy, and choledochoscopy combined with cholecystectomy and common bile duct exploration in the treatment of acute obstructive suppurative cholangitis (AOSC).

METHODS: Ninety-six patients with AOSC treated at our hospital were randomly divided into either an observation group or a control group. Both groups underwent routine examination and treatment. The observation group additionally underwent endoscopic retrograde cholangiopancreatography (ERCP) + endoscopic naso-biliary drainage (ENBD) + endoscopic sphincteropapillotomy (EST) + laparoscopic cholecystectomy bile duct exploration (LCBDE) combination therapy, and the control group received open cholecystectomy and common bile duct exploration. Direct bilirubin, alanine aminotransferase, white blood cell count, serum albumin, and cholinesterase were compared between the two groups. Operative time, amount of intraoperative bleeding, time to anal exhaust, hospital stay, postoperative complications, residual stones, and incision infection were also compared.

RESULTS: Direct bilirubin, alanine transaminase, white blood cell count, albumin, and cholinesterase levels at postoperative week 1 were significantly better in the observation group than in the control group (6.63 µmol/L ± 1.82 µmol/L vs 11.34 µmol/L ± 2.8 µmol/L; 23.38 µmol/L ± 10.47 µmol/L vs 40.25 µmol/L ± 16.30 µmol/L; 6.53 × 10⁹/L ± 2.13 × 10⁹/L vs 9.65 × 10⁹/L ± 3.10 × 10⁹/L; 40.34 g/L ± 6.53 g/L vs 33.64 g/L ± 5.21 g/L; 7.10 U/L ± 1.82 U/L vs 4.93 U/L ± 1.63 U/L; P < 0.05). Operative time did not differ significantly between the two groups (128.34 min ± 12.58 min vs 118.58 min ± 11.67 min, P > 0.05). Blood loss, time to anal exhaust and hospital stay were significantly better in the observation group (54.20 mL ± 10.10 mL vs 252.50 mL ± 75.16 mL; 23.16 h ± 3.64 h vs 70.25 h ± 10.53 h; 5.50 d ± 1.13 d vs 15.50 d ± 4.38 d; P < 0.05). During 9 to 12 mo of follow-up, the rate of wound infection and residual stones was significantly lower in the observation group (6.25% vs 31.25%, P < 0.05).

CONCLUSION: ERCP + ENBD + EST + LCBDE combination therapy can effectively improve physiological indexes, reduce intraoperative bleeding, hospitalization time, and the incidence of complications, and improve the prognosis and quality of life in AOSC patients.

Aldo-keto reductase 1C3 is expressed in differentiated human epidermis, affects keratinocyte differentiation, and is upregulated in atopic dermatitis

Aldo-keto reductase 1C3 (AKR1C3) has been shown to mediate the metabolism of sex hormones and prostaglandin D(2) (PGD(2)), a lipid mediator that promotes skin inflammation in atopic dermatitis (AD). As both have a role in skin function and pathology, we first sought to investigate the expression pattern of AKR1C3 in normal human epidermis. Immunofluorescence revealed a strong expression of AKR1C3 in the differentiated suprabasal layers compared with the basal layer. Western blot analysis and quantitative PCR confirmed that AKR1C3 expression was also upregulated in differentiation-induced primary human keratinocytes (PHKs). To investigate the functional role of AKR1C3 during PHK differentiation, its expression and activity (measured as PGD(2) reduction to 9α,11β-PGF(2) by ELISA) were impaired by small interfering RNA or 2'-hydroxyflavanone, respectively. Cytokeratin 10 (K10) and loricrin expression were then examined by western blot analysis, thus revealing altered expression of these differentiation markers. Finally, following an observation that the AD-associated mediator, PGD(2), upregulated AKR1C3 expression in PHKs, we used immunofluorescence to examine AKR1C3 expression in AD and psoriasis lesions. AKR1C3 was found to be upregulated in AD but not in psoriasis lesions compared with non-lesional skin. Our work demonstrates a function for AKR1C3 in differentiation-associated gene regulation and also suggests a role in supporting inflammation in AD.