Inhibiting effect of antisense oligonucleotides phosphorthioate on gene expression of TIMP-1 in rat liver fibrosis

Targeting collagen homeostasis for the treatment of liver fibrosis: Opportunities and challenges

Liver fibrosis is an excessive production, aberrant deposition, and deficit degradation of extracellular matrix (ECM). Patients with unresolved fibrosis ultimately undergo end-stage liver diseases. To date, the effective and safe strategy to cease fibrosis progression remains an unmet clinical need. Since collagens are the most abundant ECM protein which play an essential role in fibrogenesis, the suitable regulation of collagen homeostasis could be an effective strategy for the treatment of liver fibrosis. Therefore, this review provides a brief overview on the dysregulation of ECM homeostasis, focusing on collagens, in the pathogenesis of liver fibrosis. Most importantly, promising therapeutic mechanisms related to biosynthesis, deposition and extracellular interactions, and degradation of collagens, together with preclinical and clinical antifibrotic evidence of drugs affecting each target are orderly criticized. In addition, challenges for targeting collagen homeostasis in the treatment of liver fibrosis are discussed.

Gene expression inhibitors for the treatment of liver fibrosis: drugs under preclinical and early clinical investigation

INTRODUCTION

Liver fibrosis represents an unmet medical condition with growing incidence and only limited therapeutic options. Interfering with dysregulated gene expression was considered a specific treatment approach, and we are here reviewing the current options to modulate transcription and translation with small molecule inhibitors of involved enzymes, transcription factors or by using non-coding RNA molecules (RNA interference) or DNA antisense oligonucleotides. Despite promising results in preclinical models, only limited data are available from studies in humans.

AREAS COVERED

This expert opinion provides a general overview of how to interfere with gene expression (transcription and translation) and highlighting recent achievements in liver fibrosis.

EXPERT OPINION

Many compounds that were explored to modulate gene expression in liver fibrosis (models) were developed as anti-cancer agents. Their use in humans with impaired liver function is often impaired by the lack of specificity to inhibit only fibrosis-related genes in the liver and by associated general toxicity and narrow therapeutic windows. RNAi approaches show a higher degree of specificity and potentially less systemic toxicity. Clinical development in liver fibrosis requires close interaction between pharmaceutical companies and regulatory authorities to address topics like relevant (surrogate) endpoints to achieve meaningful readouts faster.

Antisense oligonucleotide is a promising intervention for liver diseases

As the body's critical metabolic organ, the liver plays an essential role in maintaining proper body homeostasis. However, as people's living standards have improved and the number of unhealthy lifestyles has increased, the liver has become overburdened. These have made liver disease one of the leading causes of death worldwide. Under the influence of adverse factors, liver disease progresses from simple steatosis to hepatitis, to liver fibrosis, and finally to cirrhosis and cancer, followed by increased mortality. Until now, there has been a lack of accepted effective treatments for liver disease. Based on current research, antisense oligonucleotide (ASO), as an alternative intervention for liver diseases, is expected to be an effective treatment due to its high efficiency, low toxicity, low dosage, strong specificity, and additional positive characteristics. In this review, we will first introduce the design, modification, delivery, and the mechanisms of ASO, and then summarize the application of ASO in liver disease treatment, including in non-alcoholic fatty liver disease (NAFLD), hepatitis, liver fibrosis, and liver cancer. Finally, we discuss challenges and perspectives on the transfer of ASO drugs into clinical use. This review provides a current and comprehensive understanding of the integrative and systematic functions of ASO for its use in liver disease.

Transplantation of Human Amnion Epithelial Cells Improves Endometrial Regeneration in Rat Model of Intrauterine Adhesions

Intrauterine adhesions (IUAs) are characterized by the injury of endometrium due to curettage and/or endometritis. The loss of functional endometrium in uterine cavity usually results in hypomenorrhea, amenorrhea, infertility, and/or recurrent pregnancy loss. Recently, stem cell transplantation has been applied to promote the endometrial regeneration. Human amnion epithelial cells (hAECs) have been shown to have stem cell characteristics. In this study, we found that PKH26-labeled hAECs were mainly distributed in the basal layer of endometrium after transplantation, and hAEC transplantation, including uterine injection and tail vein injection, could increase pregnancy rate and the number of embryos in rat model of IUAs. Moreover, hAEC transplantation was demonstrated to increase the endometrial thickness, promote the proliferation of glands and blood vessels, and decrease fibrotic areas in the endometrium. The immunohistochemical and quantitative polymerase chain reaction analysis showed the upregulated expression of growth factors, such as basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1) after hAEC transplantation; and the downregulated expression of collagen type I alpha 1 (COL1A1), tissue inhibitor of metalloproteinase-1 (TIMP-1), and transforming growth factor-β (TGF-β), all of which are associated with the extracellular matrix (ECM) deposition after hAEC transplantation. The mRNA sequencing indicated that platelet-derived growth factor-C (PDGF-C), thrombospondin-1 (THBS1), connective tissue growth factor (CTGF), Wnt5a, and Snai2 were significantly modulated in treatment groups. These results indicate that hAEC transplantation promotes endometrial regeneration and the restoration of fertility in rat model of IUAs.

Isochlorogenic Acid A Attenuates the Progression of Liver Fibrosis Through Regulating HMGB1/TLR4/NF-κB Signaling Pathway

Liver fibrosis, a chronic damage process related to further progression of hepatic cirrhosis, has yet no truly effective treatment. Isochlorogenic acid A (ICQA), isolated from a traditional Chinese herbal medicine named Laggera alata (DC.) Sch.Bip. ex Oliv. (Asteraceae), is proved to exhibit anti-inflammatory, hepatoprotective and antiviral properties. However, the actions of ICQA on liver fibrosis are poorly understood. The purpose of this study was to evaluate the actions of ICQA on liver fibrosis and clarify the underlying mechanism. It was found that ICQA had significant protective actions on liver injury, inflammation as we as fibrosis in rats. Meanwhile, ICQA prevented hepatic stellate cells (HSC) activation, indicated by its inhibitory effect on the overexpression of α-smooth muscle actin (α-SMA). In addition, the reduced fibrosis was found to be associated with the decreased protein expression of high-mobility group box 1 (HMGB1) as well as toll like receptor (TLR) 4. Simultaneously, ICQA can suppress the cytoplasmic translocation of HMGB1 in rat liver. Further investigations indicated that ICQA treatment dramatically attenuated the nuclear translocation of the nuclear factor-kB (NF-κB) p65 and suppressed the hepatic expression of p−IκBα in rats with liver fibrosis. Taken together, our study indicated that ICQA could protect against CCl₄-induced liver fibrosis probably through suppressing the HMGB1/TLR4/NF-κB signaling pathways.

Targeting TGFβ Signaling to Address Fibrosis Using Antisense Oligonucleotides

Fibrosis results from the excessive accumulation of extracellular matrix in chronically injured tissue. The fibrotic process is governed by crosstalk between many signaling pathways. The search for an effective treatment is further complicated by the fact that there is a degree of tissue-specificity in the pathways involved, although the process is not completely understood for all tissues. A plethora of drugs have shown promise in pre-clinical models, which is not always borne out translationally in clinical trial. With the recent approvals of two antisense oligonucleotides for the treatment of the genetic diseases Duchenne muscular dystrophy and spinal muscular atrophy, we explore here the potential of antisense oligonucleotides to knockdown the expression of pro-fibrotic proteins. We give an overview of the generalized fibrotic process, concentrating on key players and highlight where antisense oligonucleotides have been used effectively in cellular and animal models of different fibrotic conditions. Consideration is given to the advantages antisense oligonucleotides would have as an anti-fibrotic therapy alongside factors that would need to be addressed to improve efficacy. A prospective outlook for the development of antisense oligonucleotides to target fibrosis is outlined.

Reduction of hepatic fibrosis by overexpression of von Hippel-Lindau protein in experimental models of chronic liver disease

Hypoxia-inducible factor (HIF)-1α and HIF-2α play an important role in liver fibrosis. von Hippel–Lindau protein (VHL), a key mediator of HIF-α, regulates fibrosis in an organ- and cell-specific way. In this study, human liver samples were collected from hepatitis C-, alcoholic-, and cholestatic-associated fibrotic and healthy individuals. Two mouse models of liver fibrosis were established: bile duct ligation and carbon tetrachloride injection. We constructed adenovirus vectors to overexpress VHL, normoxia-active HIF-α, and lentiviral vectors to silence HIF-α. The results showed that liver sections from fibrosis patients had a lower level of VHL and higher levels of HIF-1α and HIF-2α compared with healthy sections, a finding which was confirmed in mice. Overexpression of VHL attenuated liver fibrosis, downregulated fibrogenic genes, and inhibited liver inflammation, apoptosis, and angiogenesis. Overexpression of VHL was more successful at inhibiting fibrosis compared with silencing HIF-1α plus HIF-2α. Normoxia-active HIF-1α or HIF-2α prevented the inhibitory effect of VHL on liver fibrosis, indicating that attenuating fibrosis via VHL is HIF-1α- and HIF-2α-dependent to some extent. In addition, overexpression of VHL inhibited mouse hepatic stellate cells activation and proliferation and promoted apoptosis. Taken together, VHL may be considered a new target to inhibit liver fibrosis.

Protective effect of the herbal medicine Gan‑fu‑kang against carbon tetrachloride‑induced liver fibrosis in rats

The aim of the present study was to investigate the effect of a herbal medicine formula, Gan-fu-kang (GFK), on the treatment of liver fibrosis in rats and the mechanisms via which it exerts its effect. Liver fibrosis was induced in rats by subcutaneous injection of carbon tetrachloride (CCl4) at 0.5 mg/kg body weight, twice a week for 8 weeks. The rats were randomly selected to receive saline or GFK at 31.25, 312.5 or 3,125 mg/kg body weight/day between weeks 9 and 20. An additional group of rats without CCl4 injection was used as the baseline. In the liver fibrosis model rats, an increase in plasma liver enzymes, fibrotic markers in serum and liver fibrosis, production of α-smooth muscle actin, matrix metalloproteinase-2 and tissue inhibitor of metalloproteinase-1, synthesis of collagen and activation of the Wnt/β-catenin signaling pathway were observed. GFK administration was found to significantly reduce these changes. Results of this study demonstrate that GFK has a protective and therapeutic effect on liver fibrosis induced by CCl4, which may be associated with its inhibitory activity on HSC proliferation and collagen synthesis, effectively downregulating Wnt/β-catenin signaling.

Serum levels of tissue inhibitor of metalloproteinase-1 are correlated with liver fibrosis in patients with chronic hepatitis B

OBJECTIVE

To investigate the relationship between tissue inhibitor of metalloproteinase-1 (TIMP-1) expression and the severity of liver fibrosis in chronic hepatitis B (CHB) patients, and to explore the diagnostic value of serum TIMP-1.

METHODS

A total of 159 CHB patients underwent liver biopsy for the analysis of liver fibrosis stages and inflammation. Serum TIMP-1 was determined by ELISA. Hyaluronic acid (HA), procollagen type III (PCIII), collagen type IV (CIV), laminin (LN), and FIB-4 index were determined and calculated, and diagnostic accuracy was analyzed using receiver operating characteristic (ROC) curve.

RESULTS

Serum levels of TIMP-1 were associated with the grade of liver inflammation in CHB patients (r = 0.695, P < 0.01), especially in those without fibrosis or with stage 1 fibrosis, and were also positively correlated with liver fibrosis in CHB patients (r = 0.854, P < 0.01), particularly in those with inflammation at grade 1, 2 and 3. The area under the ROC curve (AUROC) of serum TIMP-1 was 0.918 for significant liver fibrosis (≥stage 2), and a sensitivity of 89.4% and specificity of 83.6% were obtained with a cut-off value of ≥174.5 ng/mL of serum TIMP-1, which were higher than that of HA, CIV and FIB-4 index.

CONCLUSION

TIMP-1 is a valuable single biomarker for the evaluation of significant fibrosis in CHB patients.

TIMP-1 deficiency subverts cell-cycle dynamics in murine long-term HSCs

In addition to the well-recognized role in extracellular matrix remodeling, the tissue inhibitor of metalloproteinases-1 (TIMP-1) has been suggested to be involved in the regulation of numerous biologic functions, including cell proliferation and survival. We therefore hypothesized that TIMP-1 might be involved in the homeostatic regulation of HSCs, whose biologic behavior is the synthesis of both microenvironmental and intrinsic cues. We found that TIMP-1(-/-) mice have decreased BM cellularity and, consistent with this finding, TIMP-1(-/-) HSCs display reduced capability of long-term repopulation. Interestingly, the cell cycle distribution of TIMP-1(-/-) stem cells appears distorted, with a dysregulation at the level of the G(1) phase. TIMP-1(-/-) HSCs also display increased levels of p57, p21, and p53, suggesting that TIMP-1 could be intrinsically involved in the regulation of HSC cycling dynamics. Of note, TIMP-1(-/-) HSCs present decreased levels of CD44 glycoprotein, whose expression has been proven to be controlled by p53, the master regulator of the G(1)/S transition. Our findings establish a role for TIMP-1 in regulating HSC function, suggesting a novel mechanism presiding over stem cell quiescence in the framework of the BM milieu.

Inhibitory effect of antisense oligonucleotide targeting TIMP-2 on immune-induced liver fibrosis

INTRODUCTION

We previously reported that both experimental and human studies have shown the importance of TIMP-1 and TIMP-2 in the development of liver fibrosis, a disease mostly caused by HBV and HCV infection in China. Inhibiting the expression of TIMP-1 by an antisense oligonucleotide (ASON) can prevent liver fibrosis through decreasing the deposition of collagen I and III. Whether blocking the expression of TIMP-2 has the same effect on liver fibrosis is not clear.

MATERIALS AND METHODS

To interfere with this potentially effective target, we designed and synthesized two different ASON targeting TIMP-2, then mixed and transfected them by hydrodynamic injection into the rat livers with immune-induced liver fibrosis. We isolated HSCs from the HSA-induced rat model with liver fibrosis, and transfected them with ASON or sense oligonucleotide in vitro.

RESULTS

We observed that TIMP-2 ASON markedly reduced the expression of TIMP-2 by real-time PCR, Western blot, and enzyme linked immunosorbent assay. However, TIMP-2 ASON had little effect on alpha-SMA expression in vitro by Western blot. Inhibition of the expression of TIMP-2 by TIMP-2 ASON clearly decreased deposition of collagen I and IV, ameliorated liver pathology, and improved the liver function among the rats with immune-induced liver fibrosis.

CONCLUSION

The results suggested that TIMP-2 ASON could prevent the progression of liver fibrosis in this rat model. It is possible that this could form the basis for exploration of new liver anti-fibrosis drugs at a genetic level.

Potential therapeutic effects of a traditional Chinese formulation, BJ-JN, on liver fibrosis induced by carbon tetrachloride in rats

AIM OF THE STUDY

To evaluate the anti-fibrotic effects of BJ-JN (a traditional Chinese formulation) in CCl(4)-induced liver fibrosis in rats.

MATERIALS AND METHODS

BJ-JN (0.5, 1.0, 2.0 g/kg) was administrated via gavage once a day starting from the fifth weeks after the CCl(4) treatment for subsequent 9 weeks. Evaluated with liver and spleen index, serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), hyaluronic acid (HA), nitric oxide (NO), hepatic malondialdehyde (MDA) content and superoxide dismutase (SOD) activity, as well as with histopathologic changes of liver. The proliferation and collagen synthesis of primary hepatic stellate cells (HSCs) from normal, model and BJ-JN (2.0 g/kg) treatment rats were examined with (3)H-TdR and (3)H-Pro uptake assay, respectively.

RESULTS

BJ-JN (0.5, 1.0, 2.0 g/kg) effectively reduced the elevated levels of liver and spleen index, serum ALT, AST, NO, HA, and hepatic MDA contents, enhance the reduced hepatic SOD activity in CCl(4)-treated rats. The histopathological analysis suggested that BJ-JN obviously alleviated the degree of liver fibrosis induced by CCl(4). The proliferation and collagen synthesis of HSC isolated from BJ-JN (2.0 g/kg) treatment rats were remarkably inhibited.

CONCLUSIONS

Those results suggest BJ-JN has a protective and therapeutic effect on liver fibrosis induced by CCl(4), which might be associated with its anti-oxidative activity, inhibitory activity on HSC proliferation and collagen synthesis.

Gene therapy for hepatic fibrosis

Hepatic fibrosis is a common pathological process of chronic liver diseases, characterized by increased synthesis and relatively low degradation of extracellular matrix (ECM) resulting from their dynamic imbalance. Recent progress in molecular biology techniques has made it possible to treat hepatic fibrosis with gene therapy. At present, the commonly used method is to induce the expression of exogenous genes by transducing enough therapeutic genes into injured liver to delay or cure liver fibrosis.

Gene modulation for treating liver fibrosis

Despite tremendous progress in our understanding of fibrogenesis, injury stimuli process, inflammation, and hepatic stellate cell (HSC) activation, there is still no standard treatment for liver fibrosis. Delivery of small molecular weight drugs, proteins, and nucleic acids to specific liver cell types remains a challenge due to the overexpression of extracellular matrix (ECM) and consequent closure of sinusoidal gaps. In addition, activation of HSCs and subsequent release of inflammatory cytokines and infiltration of immune cells are other major obstacles to the treatment of liver fibrosis. To overcome these barriers, different therapeutic approaches are being investigated. Among them, the modulation of certain aberrant protein production is quite promising for treating liver fibrosis. In this review, we describe the mechanism of antisense, antigene, and RNA interference (RNAi) therapies and discuss how the backbone modification of oligonucleotides affects their in vivo stability, biodistribution, and bioactivity. Strategies for delivering these nucleic acids to specific cell types are discussed. This review critically addresses various insights developed with each individual strategy and for multipronged approaches, which will be helpful in achieving more effective outcomes.

Expression of MMPs and TIMPs in liver fibrosis - a systematic review with special emphasis on anti-fibrotic strategies

In liver tissue matrix metalloproteinases (MMPs) and their specific inhibitors (tissue inhibitors of metalloproteinases, TIMPs) play a pivotal role in both, fibrogenesis and fibrolysis. The current knowledge of the pathophysiology of liver fibrogenesis with special emphasis on MMPs and TIMPs is presented. A systematic literature search was conducted. All experimental models of liver fibrosis that evaluated a defined anti-fibrotic intervention in vivo or in vitro considering MMPs and TIMPs were selected. The methodological quality of all these publications has been critically appraised using an objective scoring system and the content has been summarized in a table.

Alpha-melanocyte-stimulating hormone gene therapy reverses carbon tetrachloride induced liver fibrosis in mice

BACKGROUND

Hepatic fibrosis represents a process of healing and scarring in response to chronic liver injury. Effective therapies are lacking. We have previously demonstrated that alpha-melanocyte-stimulating hormone (alpha-MSH) gene therapy protects against thioacetamide-induced acute liver failure in mice. Recent reports showed that collagen metabolism is a novel target of alpha-MSH. Therefore, the aim of this study is to investigate whether alpha-MSH gene therapy possesses anti-hepatic fibrogenic effect in mice.

METHODS

Liver fibrosis was induced in mice by administering carbon tetrachloride (CCl4) continuously for 10 weeks. Alpha-MSH expression plasmid was delivered via electroporation after liver fibrosis had been established. Histopathology, reverse-transcription polymerase chain reaction (RT-PCR), immunoblotting, and gelatin zymography were used to investigate its possible mechanisms of action.

RESULTS

Alpha-MSH gene therapy reversed established liver fibrosis in CCl4-treated mice. RT-PCR revealed that alpha-MSH gene therapy attenuated the liver TGF-beta1, collagen alpha1, and cell adhesion molecule mRNA upregulation. Following gene transfer, both the activation of alpha-smooth muscle actin (alpha-SMA) and cyclooxygenase-2 (COX-2) was significantly attenuated. Further, alpha-MSH significantly increased matrix metalloproteinase (MMP) activity with tissue inhibitors of matrix metalloproteinase (TIMP) inactivation.

CONCLUSIONS

We have demonstrated that alpha-MSH gene therapy reversed established liver fibrosis in mice. It also prevented the upregulated fibrogenic and proinflammatory gene response after CCl4 administration. Its collagenolytic effect may be attributed to MMP and TIMP modulation. In summary, alpha-MSH gene therapy may be an effective therapeutic modality against liver fibrosis with potential clinical use.

Cytokine blockade inhibits hepatic tissue inhibitor of metalloproteinase-1 expression and up-regulates matrix metalloproteinase-9 in toxic liver injury

BACKGROUND

Tissue inhibitor of metalloproteinases (TIMP)-1, the most important endogenous inhibitor of matrix metalloproteinases, plays a pivotal role in the pathogenesis of liver fibrosis and may represent an effective therapeutic target in the design of antifibrotic strategies for chronic liver diseases.

METHODS

Intraperitoneal application of a single dose of either tumor necrosis factor (TNF)-alpha or interleukin (IL)-1beta in mice led to an enhanced expression of hepatic TIMP-1 after 4-16 h. Male Sprague-Dawley rats were treated with carbon tetrachloride (CCl4) in the presence and absence of specific TNF-alpha and IL-1beta inhibitors.

RESULTS

Real-time PCR revealed a significant increase of TIMP-1 mRNA in total rat liver 24 h after CCl4 injection. Repetitive injection of both, etanercept and anakinra, before and after CCl4 injection effectively inactivated TNF-alpha and IL-1beta. Anticytokine pretreatment reduced the increase of TIMP-1 expression after a single CCl4 injection by 50% and 75%, respectively. In contrast to CCl4-treated rats with and without TNF-alpha blockade, IL-1beta inactivation caused a sevenfold increase in matrix metalloproteinases-9 mRNA levels.

CONCLUSIONS

In conclusion, TIMP-1 expression is up-regulated in the early phase of toxic liver injury by proinflammatory cytokines such as TNF-alpha and IL-1beta in rodents. Pharmacological inactivation of these cytokines significantly reduces TIMP-1 gene expression. Our data provide a potential new antifibrotic approach.

Electroporative interleukin-10 gene transfer ameliorates carbon tetrachloride-induced murine liver fibrosis by MMP and TIMP modulation

AIM

Liver fibrosis represents a process of healing and scarring in response to chronic liver injury. Effective therapies for liver fibrosis are lacking. Interleukin-10 (IL-10) is a cytokine that downregulates pro-inflammatory responses and has a modulatory effect on hepatic fibrogenesis. The aim of this study was to investigate whether electroporative IL-10 gene therapy has a hepatic fibrolytic effect on mice.

METHODS

Hepatic fibrosis was induced by administering carbon tetrachloride (CCl4) for 10 weeks in mice. The human IL-10 expression plasmid was delivered via electroporation after hepatic fibrosis was established. Histopathology, reverse transcription polymerase chain reaction (RT-PCR), immunoblotting, and gelatin zymography were used to investigate the possible mechanisms of action of IL-10.

RESULTS

Human IL-10 gene therapy reversed CCl4-induced liver fibrosis in mice. RT-PCR revealed that IL-10 gene therapy attenuated liver TGF-beta1, collagen alpha1, fibronectin, and cell adhesion molecule mRNA upregulation. Following gene transfer, both the activation of alpha-smooth muscle actin and cyclooxygenase-2 were significantly attenuated. Furthermore, IL-10 significantly inhibited matrix metalloproteinase-2 (MMP-2) and tissue inhibitors of matrix metalloproteinase (TIMP) activation after CCl4 intoxication.

CONCLUSIONS

We demonstrated that IL-10 gene therapy attenuated CCl4-induced liver fibrosis in mice. IL-10 prevented upregulated fibrogenic and pro-inflammatory gene responses. Its collagenolytic effect may be attributed to MMP and TIMP modulation. IL-10 gene therapy may be an effective therapeutic modality against liver fibrosis with potential clinical use.

Electroporative alpha-MSH gene transfer attenuates thioacetamide-induced murine hepatic fibrosis by MMP and TIMP modulation

Hepatic fibrosis represents a process of healing and scarring in response to chronic liver injury. alpha-Melanocyte-stimulating hormone (alpha-MSH) is a 13-amino-acid peptide with potent anti-inflammatory effects. We have previously demonstrated that alpha-MSH gene therapy protects against thioacetamide (TAA)-induced acute liver failure. Therefore, the aim of this study is to investigate whether alpha-MSH gene therapy possesses antihepatic fibrogenic effect. Liver fibrosis was induced by long-term TAA administration in mice. alpha-Melanocyte-stimulating hormone expression plasmid was delivered via electroporation after liver fibrosis was established. Our results showed that alpha-MSH gene therapy attenuated liver fibrosis in TAA-treated mice. Reverse transcription polymerase chain reaction revealed that alpha-MSH gene therapy attenuated the liver transforming growth factor-beta1, collagen alpha1 and cell adhesion molecule mRNA upregulation. Following gene transfer, the expression of alpha-smooth muscle actin and cyclooxygenase-2 were both significantly attenuated. Further, alpha-MSH significantly increased matrix metalloproteinase (MMP), while tissue inhibitors of matrix metalloproteinase (TIMPs) were inactivated. In summary, alpha-MSH gene therapy reversed established liver fibrosis in mice and prevented the upregulated fibrogenic and pro-inflammatory gene responses after TAA administration. Its collagenolytic effect might be attributed to MMP and TIMP modulation. Hence, alpha-MSH gene therapy may be an effective therapeutic modality against liver fibrosis with potential clinical use.

Inhibition of hepatic fibrogenesis by matrix metalloproteinase‐9 mutants in mice

Tissue inhibitor of metalloproteinases-1 (TIMP-1) plays a crucial role in the pathogenesis of hepatic fibrosis and thus may represent an important therapeutic target in the design of anti-fibrotic strategies for chronic liver disease. We present an innovative therapy based on the assignment of inactivated enzymes acting as scavengers for TIMP-1. Hepatic fibrosis was induced in BALB/c mice by repetitive intraperitoneal CCl4 injection. The animals were treated with proteolytic inactive matrix metalloproteinase-9 mutants (E402Q, H401A, E402H/H411E) using adenovirus-mediated gene transfer. Application of these MMP-9 mutants inhibited fibrogenesis, which was indicated by decreasing portal and periportal accumulation of collagen. Total hydroxyproline of liver tissue, the morphometric stage of fibrosis as well as mRNA expression of marker proteins for hepatic fibrosis in livers of E402Q- and H401A-treated mice were significantly reduced. MMP-9 mutants suppressed transdifferentiation of hepatic stellate cells to the myofibroblast like phenotype in vitro and in vivo. Moreover, adenoviral application of the mutants MMP-9-H401A and -E402Q led to increased apoptosis of activated hepatic stellate cells, thought to be the main promoters of hepatic fibrosis. Application of MMP-9 mutants as TIMP-1 scavengers may provide a new therapeutic strategy for hepatic fibrosis.

Antisense oligonucleotides-based inhibition of gene and protein expression of tissue inhibitor of metalloproteinase-2 on experimental liver fibrosis in rats

AIM: To investigate the inhibitory effect of tissue inhibitor of metalloproteinase-2 (TIMP-2) targeted antisense oligonucleotide (asON) on the progress of experimental liver fibrosis in rats.

METHODS: Twenty-two rats were divided into asON treatment (n = 6), model (n = 6), and normal control group (n = 10). The liver fibrosis model was induced by human serum albumin (HSA). During modeling, the rats were treated with antisense oligonucleotides via tail vein. The level of TIMP-2 expression was detected by reverse transcription polymerase chain reaction (RT-PCR), in situ hybridization, immunohistochemical staining and enzyme linked immunosorbent assay (ELISA). The effect of asON on liver fibrosis was analyzed by histopathological exami-nation, immunohistochemical staining of collagenⅠand Ⅳ, and special staining of collagen fiber as well as electron microscopy.

RESULTS: The pathological grading was notably im-proved in asON group than that in model group (u = 2.071, P <0.05). The serum and tissue expression of TIMP-2 were lower in asON group than those in model group (T = 55, P <0.05; t = 3.332, P <0.05), but higher than those in the control (T = 55, P <0.05; t = 5.550, P <0.05). Image quantitative analysis for immunohistochemical staining of collagen Ⅳ showed that the value was significant decreased in asON group as compared with that in model group (t = 2.310, P <0.05), but still higher than that in the control (t = 3.623, P <0.05); The value for collagenⅠwas also decreased in asON group as compared with that in model group (t = 2.845, P <0.05). Less collagen deposition was found in the hepatic sinusoid of asON group, which was not significantly different from that of model group.

CONCLUSION: TIMP-2 targeted asON can inhibit the progress of experimental liver fibrosis in rats.

Interleukin-10 gene therapy reverses thioacetamide-induced liver fibrosis in mice

Hepatic fibrosis represents a process of healing and scarring in response to chronic liver injury. Interleukin-10 (IL-10) is a cytokine that downregulates the proinflammatory response and has a modulatory effect on hepatic fibrogenesis. The aim of this study was to investigate whether IL-10 gene therapy possesses anti-hepatic fibrogenesis in mice. Liver fibrosis was induced by long-term thioacetamide administration in mice. Human IL-10 expression plasmid was delivered via electroporation after liver fibrosis established. IL-10 gene therapy reversed hepatic fibrosis and prevented cell apoptosis in a thioacetamide-treated liver. RT-PCR revealed IL-10 gene therapy to reduce liver transforming growth factor-beta1, tumor necrosis factor-alpha, collagen alpha1, cell adhesion molecule, and tissue inhibitors of metalloproteinase mRNA upregulation. Following gene transfer, the activation of alpha-smooth muscle actin and cyclooxygenase-2 was significantly attenuated. In brief, IL-10 gene therapy might be an effective therapeutic reagent for liver fibrosis with potential future clinical applications.

N/A

N/A

Effects of spironolactone on rat liver fibrosis and expression of transforming growth factor β1 and tissue inhibitor of metalloproteinase-1

AIM: To identify the effects of spironolactone on expressions of transforming growth factor β₁ and tissue inhibitor of metalloproteinase-1 and to evaluate the curative effect of spironolactone.

METHODS: Thirty four male SD rats were randomly divided into 3 groups: Hepatic fibrosis model group: the rats were injected with 400 mL/L CCl₄ 3 mL/kg subcutaneously two times a week; Spironolactone group: the rats were injected with 400 mL/L CCl₄ 3 mL/kg subcutaneously two times a week; Spironolactone equivalent to 20 mg/kg per day was given intragastrically; Normal control group: normal chow. Hepatic tissue was observed with light microscopy to compare histological alterations dynamically. The expression of transforming growth factor β₁ and tissue inhibitor of metalloproteinase-1 was detected by RT-PCR.

RESULTS: The grades of fibrosis in spironolactone group were less than those in hepatic fibrosis model group at the end of the week 10 (P < 0.05). However, at the end of week 13, there was no significant difference between the two groups. The expression of TGFβ₁ and TIMP-1 mRNA was up-regulated when fibrogenesis occurred (P < 0.05). Although at the end of week 10 there was an inclination that the levels of TGFβ₁ and TIMP-1 mRNA in spironolactone group were less than those in hepatic fibrosis model group, there was no significant difference between two groups.

CONCLUSION: The expression of TGFβ₁ and TIMP-1 mRNA is up-regulated significantly when fibrogenesis occurs. Spironolactone may have a fibrogenesis-inhibiting effect on CCl₄ -induced hepatic fibrosis in some degree. Spironolactone has no significant effect on the expression of TGFβ₁ and TIMP-1 mRNA

Gene expression profiles in liver cirrhosis and normal liver tissues

AIM: To describe liver specific gene expression profiles and to identify genes with differential expression between liver cirrhotic tissues and normal liver tissues.

METHODS: The cDNA probes which were labeled with α-³²P dATP were synthesized from total RNAs of liver cirrhosis and normal liver tissues and hybridized to two identical Atlas human cDNA expression arrays membranes containing 588 known genes respectively.

RESULTS: Autoradiographic results were analyzed by specific AtlasImage^TM (version1.01a) software. Among the 588 genes analyzed, 17 genes were found up-regulated in cirrhosis, including integrin beta 7 and collagen type XVIII, and 98 genes were down-regulated in cirrhosis, including TFDP2, BAK and ABL. Expression of the genes was associated with the regulation of cell proliferation, apoptosis, differen-tiation, cell-cell interaction, invasion regulators and cytokines altered.

CONCLUSION: The results obtained from Atlas microarray provide a comprehensive liver cirrhosis specific expression profile. These results may be helpful for identification of target genes for diagnosis and designing rational therapeutic strategies.

N/A

N/A

Pathomorphological study on location and distribution of Kupffer cells in hepatocellular carcinoma

AIM: To clarify the location and distribution of Kupffer cells in hepatocellular carcinoma (HCC), and to investigate their role in hepatocarcinogenesis.

METHODS: Kupffer cells were immunohistochemically stained by streptavadin-peroxidase conjugated method (S-P). The numbers of Kupffer cells in cancerous, para-cancerous and adjacent normal liver tissues of 48 HCCs were comparatively examined.

RESULTS: The mean number of Kupffer cells in cancerous, para-cancerous and adjacent normal liver tissues was 12.7 ± 6.8, 18.1 ± 8.2 and 18.9 ± 7.9 respectively. The number of Kuppfer cells in cancerous tissues was significantly lower than that in para-cancerous tissues (t = 2.423, P < 0.05) and adjacent normal liver tissues (t = 2.521, P < 0.05). As tumor size increased, the number of Kupffer cells in cancerous tissues significantly decreased (F = 4.61, P < 0.05). Moreover, there was also a significant difference in the number of Kupffer cells among well-differentiated, moderately-differentiated and poorly-differentiated cases(F = 4.49, P < 0.05).

CONCLUSION: This study suggests that decrease of Kupffer cells in HCCs may play an important role in the carcinogenesis of HCC, the number of Kupffer cells in HCC is closely related to the size and differentiation grade of the tumor.

Effects of estradiol on type I, III collagens and TGF β1 in hepatic fibrosis in rats

AIM

To study the effects of estradiol on the production of collagen I, III and transforming growth factor β₁ (TGF β₁) in experimental fibrosis in rats induced by carbon tetrachloride (CCL4), and to investigate the suppressive effects of estrogen on liver fibrosis.

METHODS

Rats were randomly allocated into a normal control group, a model control group, a therapy control group and an estradiol group. Liver fibrosis was induced by CCL₄ administration. The estradiol group, apart from the administration of CCL₄, was treated subcutaneously with estradiol (benzoic estradiol) 1 mg/kg twice weekly. At the end of week 8, all the rats were sacrificed. Liver inflammation and collagen deposition were observed with HE and Masson's collagen stains, analyzed with scoring and staging systems. Type I, III collagens and TGF β₁ were observed with immunohistochemical method.

RESULTS

CCL₄ group had the typical liver fibrosis compared with normal control group. The fibrous septa were formed in CCL₄ group rats, and collagens were accumulated and deposited in the sinusoids and liver lobules. The expression of type I , III collagens (0.58±0.26 vs 6.34±2.24, 1.07±0.49 vs 5.28±1.28, P<0.001) and TGF β₁ was significantly increased. Estradiol significantly attenuated collagen accumulation (P<0.05) in the fibrotic livers, and decreased type I , III collagens (2.47±0.76 vs 6.34±2.24, 3.02±1.20 vs 5.28±1.28, P<0.05) and TGF β₁ expression in the liver.

CONCLUSION

Estradiol treatment reduces the synthesis of hepatic type I , III collagens and TGF β₁ in the fibrotic liver induced by CCL₄ administration, and attenuates hepatic fibrosis.

Expression of insulin-like growth factor 1 and insulin-like growth factor 1 receptor and its intervention by interleukin-10 in experimental hepatic fibrosis

AIM: To study the expression of IGF-1 and IGF-1R and its intervention by interleukin-10 in the course of experimental hepatic fibrosis.

METHODS: Hepatic fibrosis was induced in rats by carbon tetrachloride intoxication and liver specimens were taken from the rats administered CCl₄ with or without IL-10 treatment and the animals of the control group. Immunoreactivities for insulin-like growth factor-1 (IGF-1) and IGF-1 receptor(IGF-1R) were demonstrated by immunohistochemistry, and their intensities were evaluated in different animal groups.

RESULTS: The positive levels for IGF-1 and IGF-1R were increased with the development of hepatic fibrosis, with the positive signals localized in cytoplasm and/or at the plasmic membrane of hepatocytes. The positive signals of IGF-1 and IGF-1R were observed more frequently (P < 0.01) in the CCl₄-treated group (92.0% and 90.0%) compared to those in the control group. The positive signals decreased significantly (P < 0.05) in IL-10-treated group. The responses in IGF-1 and IGF-1R expression correlated with the time of IL-10 treatment.

CONCLUSION: The expression of IGF-1 and IGF-1R immunoreactivities in liver tissue seems to be up-regulated during development of hepatic fibrosis induced by CCl₄, and exogenic IL-10 inhibits the responses.

Experimental study of effect of Ganyanping on fibrosis in rat livers

AIM: To observe the effects of Ganyanping on CCl₄-induced hepatic fibrosis in rats.

METHODS: The rats were separated randomly into five groups. Groups A to group D, each consisting of 15 rats, were for different tests, while 8 rats were used as normal controls (N). For group D, CCl₄ was injected subcutaneously, at a dosage of 3 mL/kg for 9 wk. For group A, Ganyanping was administered via gastric tube at a dosage of 10 mL/kg. For group B, the treatment with Ganyanping was started 4 wk after CCl₄ administration. In group C, Ganyanping was administered 8 wk after the intoxication, and treatment lasted for 4 wk. Liver tissues were fixed in 10% formalin and embedded in paraffin. Pathologic changes, particularly fibrosis, were evaluated on the HE and V-G-stained sections. Ten middle-power fields were randomly selected for assessment of collagen deposition.

RESULTS: Loss of normal hepatic architecture, some with pseudo-lobule formation, was observed in group D, while hepatocytes steatosis and fibrosis were less pronounced in the animals treated with Ganyanping. Pseudo-lobule formation was not evident in the latter groups. The total collagen area and ratio were 840.23 ± 81.65 and 7.0 ± 0.9, respectively in group D, the ratio being reduced greatly in the Ganyanping-treated groups (148.73 ± 45.89 and 1.16 ± 0.33, respectively). The activities of MAO and ACP were elevated and that of SDH in group D decreased in the hepatic tissue as compared to the control group. The treatment with Ganyanping abrogated these enzymatic changes.

CONCLUSION: Our data approved that Ganyanping could improve the microcirculation in the liver, reduce oxygen-derived free radicals, and enhance the cellular metabolism and immune function, all resulting in an anti-fibrotic effect. Hence, Ganyanping can protect the liver from fibrosis. It may be a safe and effective preparation for patient with fibrosis.

N/A

N/A

Effect of expression of interferon-g gene in inhibition of growth of colon cancer cell

AIM: To investigate the effect of expression of interferon-γ(IFN-γ) in tumor cell and its inhibitory effect on the growth of tumor cell.

METHODS: pcDNA3-IFN-γ vector containing IFN- γ gene was constructed and transfected into LOVO, SW620, HCT116BG and Hela cell lines by lipofectamine, respectively. The expression of IFN-γ, CEA and HLA-DR in transfected cells were tested. Both the number of apoptosis of and the proportion of cell cycles of tumor cells were measured to investigate the anti-tumor effect of IFN-γ gene therapy.

RESULTS: LOVO and HCT116BG transfected cell lines had high expression of CEA, the average level of CEA was significantly increased from 26.02±6.76 to 38.85±7.07 mg/L (P < 0.05). However, there was no detectable increase in the supernatants of Hela, SW620 cell lines that naturally expressed little of CEA. Flow cytometry analysis showed that HLA-DR expression rate (11.67±7.20) was significantly higher than that prior gene transfection (3.91±3.61) (P < 0.01), and the IFN-γ gene transfer effectively induced the apoptosis of tumor cells, the proportion of DNA synthesis phase was deceased gradually after IFN-γ gene transfer, which indicated that the synthesis of DNA and growth of tumor cells were repressed.

CONCLUSION: IFN-γ gene therapy enhanced the expression of antigens on cell surface and thus induced powerful antitumor immunity. Repressing of synthesis of DNA, inducing the apoptosis of tumor cells and inhibiting the proliferation of tumor cells might be anti-tumor mechanisms of IFN-γ.

Effects of transmitters and interleukin-10 on rat hepatic fibrosis induced by CCl4

AIM: To study the effects of transmitters ET, AgII, PGI₂, CGRP and GG on experimental rat hepatic fibrosis and the antifibrogenic effects of IL-10.

METHODS: One hundred SD rats were randomly divided into 3 groups: control group (N): intraperitoneal injection with saline 2 mL·kg^-1 twice a week; the fibrogenesis group (C): intraperitoneal injection with 50% CCl₄ 2 mL·kg^-1 twice a week; IL-10 treated group (E): besides same dosage of CCl₄ given, intraperitoneal injection with IL-10 4 μg·kg^-1 from the third week. In the fifth, the seventh and the ninth week, rats in three groups were selected randomly to collect plasma and liver tissues. The levels of ET, AgII, PGI₂, CGRP and GG were assayed by radioimmunoassay (RIA). The liver fibrosis was observed with silver staining.

RESULTS: The hepatic fibrosis was developed with the increase of the injection frequency of CCl₄. The ET, AgII, PGI₂, CGRP and GG levels in serum of group N were 71.84 ± 60.2 ng·L^-1, 76.21 ± 33.3 ng·L^-1, 313.03 ± 101.71 ng·L^-1, 61.97 ± 21.4 ng·L^-1 and 33.62 ± 14.37 ng·L^-1, respectively; the levels of them in serum of group C were 523.30 ± 129.3 ng·L^-1, 127.24 ± 50.0 ng·L^-1, 648.91 ± 357.29 ng·L^{- 1}, 127.15 ± 62.0 ng·L^-1 and 85.26 ± 51.83 ng·L^{- 1}, respectively; the levels of them in serum of group E were 452.52 ± 99.5 ng·L^-1, 90.60 ± 44.7 ng·L^-1, 475.57 ± 179.70 ng·L^-1, 102.2 ± 29.7 ng·L^-1 and 38.05 ± 19.94 ng·L^-1, respectively. The histological examination showed that the degrees of the rats liver fibrosis in group E were lower than those in group C.

CONCLUSION: The transmitters ET, AgII, PGI₂, CGRP and GG play a significant role in the rat hepatic fibrosis induced by CCl₄. IL-10 has the antagonistic action on these transmitters and can relieve the degree of the liver fibrosis.

Preparation and identification of anti-transforming growth factor β1 U1 small nuclear RNA chimeric ribozyme in vitro

AIM: To study the preparation and cleavage activity of anti-transforming growth factor (TGF)β1 U1 small nuclear (sn) RNA chimeric hammerhead ribozymes in vitro.

METHODS: TGFβ1 partial gene fragment was cloned into T-vector at the downstream of T7 promoter. ³²p-labeled TGFβ1 partial transcripts as target RNA were transcribed in vitro and purified by denaturing polyacrylamide gel electrophoresis (PAGE). Anti-TGFβ1 ribozymes were designed by computer, then synthetic ribozyme fragments were cloned into the U1 ribozyme vector pZeoU1EcoSpe containing U1 snRNA promoter/enhancer and terminator. ³²p-labeled U1 snRNA chimeric ribozyme transcripts were gel-purified, incubated with target-RNAs at different conditions and autoradiographed after running denaturing PAGE.

RESULTS: Active U1snRNA chimeric ribozyme (U1Rz803) had the best cleavage activity at 50 °C; at 37 °C, it was active, K_m = 34.48 nmol/L, K_cat = 0.14 min^-1; while the point mutant ribozyme U1Rz803_m had no cleavage activity, so these indicated the design of U1Rz803 was correct.

CONCLUSION: U1Rz803 prepared in this study possessed the perfect specific catalytic cleavage activity. These results indicate U1 snRNA chimeric ribozyme U1Rz803 may suppress the expression of TGFβ1 in vivo, therefore it may provide a new avenue for the treatment of liver fibrosis in the future.

A novel HBV antisense RNA gene delivery system targeting hepatocellular carcinoma

AIM

To construct a novel HBV antisense RNA delivery system targeting hapatocellular carcinoma and study its inhibitory effect in vitro and in vivo.

METHODS

GE7,a 16-peptide specific to EGFR, and HA20,a homologue of N-terminus of haemagglutinin of influenza viral envelope protein, were synthesized and conjugated with polylysin. The above conjugates were organized into the pEBAF-as-preS2, a hepatocarcinoma specific HBV antisense expression vector, to construct a novel HBV antisense RNA delivery system, named AFP-enhancing 4-element complex. Hepatocelluar carcinoma HepG2.2.15 cells was used to assay the in vitro inhibition of the complex on HBV. Expression of HBV antigen was assayed by ELISA. BALB/c nude mice bearing HepG2.2.15 cells were injected with AFP-enhancing 4-element complex. The expression of HBV antisense RNA was examined by RT-PCR and the size of tumor in nude mice were measured.

RESULTS

The AFP-enhancing 4-element complex was constructed and DNA was completely trapped at the slot with no DNA migration when the ratio of polypeptide to plasmid was 1:1. The expression of HBsAg and HBeAg of HepG2.2.15 cells was greatly decreased after being transfected by AFP-enhancing 4-element complex. The inhibitory rates were 33.4 % and 58.5 % respectively. RT-PCR showed HBV antisense RNA expressed specifically in liver tumor cells of tumor-bearing nude mice. After 4 injections of AFP-enhancing 4-element complex containing 0.2 micro g DNA, the diameter of the tumor was 0.995 cm+/-0.35, which was significantly smaller than that of the control groups(2.215 cm+/-0.25, P<0.05).

CONCLUSION

AFP-enhancing 4-element complex could deliver HBV antisense RNA targeting on hepatocarcinoma and inhibit both HBV and liver tumor cells in vitro and in vivo.

Inhibition on the production of collagen type I, III of activated hepatic stellate cells by antisense TIMP-1 recombinant plasmid

AIM: To investigate the inhibition effects on the production of collagen type I, III secreted by activated rat hepatic stellate cells (rHSCs) by antisense tissue inhibitors of metalloproteinase 1 (TIMP-1) recombinant plasmid through elevating interstitial collagenase activity.

METHODS: rHSCs were extracted from normal rat liver by pronase and collagenase digestion and purified by centrifugal elutriation, and were cultured on plastic dishes until they were activated to a myofibroblastic phenotype after 7-10 d. RT-Nest-PCR and gene recombinant techniques were used to construct the rat antisense TIMP-1 recombinant plasmids which can express in eucaryotic cells. The recombinant plasmid and the pcDNA3 empty plasmid were transfected in rHSCs by Effectene (QIAGEN) separately. Cells were selected after growing in DMEM containing 400 μg/mL G418 for 2-3 wk. Expression of exogenous gene was assessed by Northern blot, and expression of TIMP-1 in rHSCs was determined by Northern blot and Western blot. We tested the interstitial collagenase activity with FITC-labled type I collagen as substrate. Ultimately, we quantified the type I, III collagen by Western blot.

RESULTS: The exogenous antisense TIMP-1 recombinant plasmid could be expressed in rHSCs well, which could block the expression of TIMP-1 greatly, the ratio of TIMP-1/GAPDH was 0.67, 2.41, and 2.97 separately at mRNA level (P < 0.05); the ratio of TIMP-1/β-actin was 0.31, 0.98 and 1.32 separately at protein level (P < 0.05); It might elevate active and latent interstitial collagenase activity, the collagenase activity was 0.3049, 0.1411 and 0.1196 respectively. (P < 0.05), which led to promotion the degradation of type I, III collagen, the ratio of collagen I/β-actin was 0.63, 1.78 and 1.92 separately (P < 0.05); and the ratio of collagen III/β-actin was 0.59, 1.81 and 1.98 separately (P < 0.05).

CONCLUSION: These data shows that the antisense TIMP-1 recombinant plasmid has the inhibitory effects on the production of type I, III collagens secreted by activated rHSCs in vitro. It could be a novel method to reverse hepatic fibrosis in the future.

Expression of TIMP-1 in normal and fibrotic livers in rats

AIM: To investigate the expression of TIMP-1 in normal and experimental fibrotic livers in rats.

METHODS: Hepatic fibrosis rat models were induced with human serum albumin, and normal rats were used as control. TIMP-1 mRNA and its related antigens in liver were examined with immunohistochemistry and in situ hybridization. Expression of TIMP-1 gene was detected with PCR.

RESULTS: The positive signal of TIMP-1 proteins was mainly located in cytoplasm rather than nucleus in hepatic myofibroblasts and fibroblasts, which dominated in portal areas and fibrous septums fibrotic rats. Such distribution of expression of TIMP-1 detected with immunohistochemistry was consistent with that in situ hybridization. The level of TIMP-1 expression in fibrotic rats was obviously higher than that in normal ones.

CONCLUSION: TIMP-1 was expressed dominantly in fibroblast and myofibroblast in fibrotic liver, the expression level increased with progression of liver injury and severity of hepatic fibrosis.

Effects of hepatocyte growth factor on fibrosis and hepatic expression of MMP-1 andTIMP-1

AIM: To investigate the effect of hepatocyte growth factor (HGF) on severity of liver fibrosis and hepatic expressions of MMP-1, TIMP-1 and to explore the mechanism of HGF in preventing liver fibrosis in rats.

METHODS: Eighty male Wistar rats were randomly divided into normal control group (Group A, 16 rats), liver fibrosis model group (Group B, 54 rats) and HGF therapy group (Group C, 10 rats). The liver fibrosis model was induced by administration CCl₄ intraperitoneally. Rats in Group C had been administered HGF for six weeks and were sacrificed afterwards. Eight rats from each of group A and B were randomly sacrificed on week 6 simultaneously as that in group C. The remaining rats in-group B were randomly further subdivided into liver fibrosis model group (Group D, 12 rats) and HGF therapy group (Group E, 10 rats), HGF was administered to rats in group E on week. 7.All rats in group D and E were sacrificed on week 10.Liver function and levels of serum hyaluronic acid (HA), mucin (LN), collegen type IV (CIV), procollagen III (PCIII) were tested; the expression of MMP-1 and TIMP-1 were determined by immunohistochemical staining and analyzed by computer.

RESULTS: Compared with Group B, the serum levels of ALT, AST, HA, LN, CIV, PCIII in Group C were significantly reduced (P < 0.01), MMP-1 activity was slightly increased (0.25 ± 0.02, vs 0.22 ± 0.05, P < 0.05), TIMP-1 activity was markedly reduced (0.34 ± 0.05, vs 0.45 ± 005, P < 0.01). TIMP-1 activity in Group E (0.31 ± 0.07) was also markedly reduced in comparison with Group D (0.42 ± 0.06) (P < 0.01).

CONCLUSIONS: HGF has obvious effect in preventing development of liver fibrosis; it might facilitate degradation of hepatic fibrosic tissue via increasing the MMP-1 activity and or inhibiting TIMP-1 activity.

Effect of Chinese herb Shuangjiawuling on expression of TIMPs in rat with liver fibrosis

AIM: To explore the effect of Chinese herb Shuangjiawuling in preventing hepatic fibrosis in rat with liver fibrosis.

METHODS: Rat immunogenic liver fibrosis model was induced by administration human serum albumin (HSA 200 g/L) intravenously, 80 rats were randomly divided into 5 groups. Shuangjiawuling was taken orally simultaneously with (group A), immediately after (group B), or 3 months after (group C) administration of HAS intravenously. Colchine tablets were taken orally with the administration of HAS (group D), normal rats were used as control (Group E). The pathological changes of liver tissue were observed by HE and Von-Gieson staining. The hepatic mRNA and protein of TIMP-1 and TIMP-2 were analyzed by in site hybridization and immunohistochemistry.

RESULTS: Hepatic fibrosis developed gradually and became obviously on the third month after administration of HAS. And strong expressions of TIMP-1 and TIMP-2 were observed, however, its expression and hepatic fibrosis were reduced dramatically following administration of Shuangjiawuling and colchine tablets. The effect of Shuangjiawuling in preventing fibrosis was superior to that of colchine tablets (P<0.05), and its effect in group A, B, and C decreased in order.

CONCLUSION: Chinese herb Shuangjiawuling can inhibit the development of hepatic fibrosis and the expression of TIMPs, and promoted the effect of the degradation of the extracellular matrix.

Developing strategies for liver fibrosis treatment

Liver fibrosis represents a major worldwide healthcare burden. Current therapy is limited to removing the causal agent. This approach is successful in some diseases; particularly haemochromatosis and chronic viral hepatitis. However, for many patients treatment is not possible, while other patients present to medical attention at an advanced stage of fibrosis. There is therefore a great need for novel therapies for liver fibrosis. The hepatic stellate cell has been recognised to be responsible for most of the excess extracellular matrix observed in chronic liver fibrosis. The detailed understanding of hepatic stellate cell biology has allowed the rational design of novel antifibrotic therapies. This review describes for the general reader the novel emerging therapies for liver fibrosis.

Estrogen reduces CCL4- induced liver fibrosis in rats

AIM: Chronic liver diseases, such as fibrosis or cirrhosis, are more common in men than in women. This gender difference may be related to the effects of sex hormones on the liver. The aim of the present work was to investigate the effects of estrogen on CCL₄-induced fibrosis of the liver in rats.

METHODS: Liver fibrosis was induced in male, female and ovariectomized rats by CCL₄ administration. All the groups were treated with estradiol (1 mg/kg) twice weekly. And tamoxifen was given to male fibrosis model. At the end of 8 wk, all the rats were killed to study serum indicators and the livers.

RESULTS: Estradiol treatment reduced aspartate aminotransferase (AST), alanine aminotransferase (ALT), hyaluronic acid (HA) and type IV collagen (CIV) in sera, suppressed hepatic collagen content, decreased the areas of hepatic stellate cells (HSC) positive for α-smooth muscle actin (α-SMA), and lowered the synthesis of hepatic type I collagen significantly in both sexes and ovariectomy fibrotic rats induced by CCL₄ administration. Whereas, tamoxifen had the opposite effect. The fibrotic response of the female liver to CCL₄ treatment was significantly weaker than that of male liver.

CONCLUSION: Estradiol reduces CCL₄-induced hepatic fibrosis in rats. The antifibrogenic role of estrogen in the liver may be one reason for the sex associated differences in the progression from hepatic fibrosis to cirrhosis.

Hepatoprotective role of ganoderma lucidum polysaccharide against BCG-induced immune liver injury in mice

AIM: To examine the effect of ganoderma lucidum polysaccharide (GLP) on the immune liver injury induced by BCG infection, and investigate the relationship between degrees of hepatic damage and NO production in mice.

METHODS: Immune hepatic injury was markedly induced by BCG-pretreatment (125 mg·kg^-1, 2-week, iv) or by BCG-pretreatment plus lipopolysaccharide (LPS, 125 μg·kg^-1, 12-hour, iv) in mice in vivo. Hepatocellular damage induced by BCG-pretreated plus inflammatory cytokines mixture (CM), which was included TNF-α, IL-1β, IFN-γ and LPS in culture medium in vitro. Administration of GLP was performed by oral or incubating with culture medium at immune stimuli simultaneity. Liver damage was determined by activity of alanine aminotransferase (ALT) in serum and in hepatocytes cultured supernatant, by liver weight changes and histopathological examination. NO production in the cultured supernatant was determined by the Griess reaction. Moreover, inducible nitric oxide synthase (iNOS) protein expression was also examinated by immunohistochemical method.

RESULTS: Immune hepatic injury was markedly induced by BCG or BCG plus inflammatory cytokines in BALB/c mice in vivo and in vitro. Under BCG-stimulated condition, augment of the liver weight and increase of the serum/supernatant ALT level were observed, as well as granuloma forming and inflammatory cells soakage were observed by microscopic analysis within liver tissues. Moreover, NO production was also increased by BCG or/and CM stimuli in the culture supernatant, and a lot of iNOS positive staining was observed in BCG-prestimulated hepatic sections. Application of GLP significantly mitigated hepatic tumefaction, decreased ALT enzyme release and NO production in serum/supernatant, improved the pathological changes of chronic and acute inflammation induced by BCG-stimuli in mice. Moreover, the immunohistochemical result showed that GLP inhibited iNOS protein expression in BCG-immune hepatic damage model.

CONCLUSION: The present study indicates that NO participates in immune liver injury induced by Mycobacterium bovis BCG infection. The mechanisms of protective roles by GLP for BCG-induced immune liver injury may be due to influence NO production in mice.

Apoptosis of rat hepatic stellate cells induced by anti-focal adhesion kinase antibody

AIM: To explore the role of focal adhesion kinase (FAK) in the apoptosis in culture-activated rat hepatic stellate cells (HSCs) using a specific anti-FAK antibody.

METHODS: Rat HSCs were prepared from Wistar rats by in situ perfusion of collagenase and pronase and single-step density Nycodenze gradient. Culture-activated HSCs were serum-starved and treated with the anti-FAK antibodies for 24, 48 or 72 h. The apoptosis of HSC was detected by DNA-fragment assay, flow cytometry and caspase-3 activity determination. The expression of tissue inhibitor of metalloproteinase-1 (TIMP-1) mRNA was assessed by reverse transcription polymerase chain reaction (RT-PCR).

RESULTS: The experiment showed that anti-FAK antibodies induced apoptosis of culture-activated rat HSCs. This phenomenon displayed the classical features of apoptotic cell death (DNA fragmentation, cell cycle analysis) after treated with 30 mg·L^-1 FAK antibody for 72 h, and accompanied by a significant increase of caspase-3 activity (1208 ± 76) vs (309 ± 28) nmol·min^-1·g^-1, t = 208.5, P < 0.05. Meanwhile, treatment with the FAK antibody in HSCs could markedly decrease the TIMP-1 mRNA expression (0.07 ± 0.01 vs 0.38 ± 0.03, t = 2.72, P < 0.05).

CONCLUSION: FAK plays an important role in the survival of HSCs and the specific anti-FAK antibody could induce the apoptosis in rat HSCs.

Subcellular daunorubicin distribution and its relation to multidrug resistance phenotype in drug-resistant cell line SMMC-7721/R

AIM: To investigate the correlation between subcellular daunorubicin distribution and the multidrug resistance phenotype in drug-resistant cell line SMMC-7721/R.

METHODS: The multidrug resistant cell line SMMC-7721/R, a human hepatocellular carcinoma cell line, was established. Antisense oligonucleotides (AS-ODN) were used to obtain different multidrug resistance phenotypes by inhibiting the expression of mdr1 gene and/or multidrug resistance-related protein gene (mrp) using Lipofectamine as delivery agent. Expression of mdr1 and mrp genes was evaluated by RT-PCR and Western blotting. Intracellular daunorubicin (DNR) concentration was measured by flow cytometry. Subcellular DNR distribution was analyzed by confocal laser scanning microscopy. Adriamycin (ADM) and DNR sensitivity was examined by MTT method.

RESULTS: Low level expression of mdr1 and mrp mRNAs and no expression of P-Glycoprotein (P-gp) and multidrug resistance-related protein (P₁₉₀) were detected in parental sensitive cells SMMC-7721/S, but over-expression of these two genes was observed in drug-resistant cell SMMC-7721/R. The expression of mdr1 and mrp genes in SMMC-7721/R cells was down-regulated to the level in the SMMC-7721/S cells by AS-ODN. Intracellular DNR concentration in SMMC-7721/S cells was 10 times higher than that in SMMC-7721/R cells. In SMMC7721/S cells intracellular DNR distributed evenly in the nucleus and cytoplasm, while in SMMC-7721/R cells DNR distributed in a punctate pattern in the cytoplasm and was reduced in the nucleus. DNR concentration in SMMC-7721/R cells co-transfected with AS-ODNs targeting to mdr1 and mrp mRNAs recovered to 25 percent of that in SMMC7721/S cells. Intracellular DNR distribution pattern in drug-resistant cells treated by AS-ODN was similar to drug-sensitive cell, and the cells resistance index (RI) to DNR and ADM decreased at most from 88.0 and 116.0 to 4.0 and 2.3, respectively. Co-Transfection of two AS-ODNs showed a stronger synergistic effect than separate transfection.

CONCLUSIONS: P-gp and P₁₉₀ are two members mediating MDR in cell line SMMC7721/R. Intracellular drug concentration increase and subcellular distribution change are two important factors in multidrug resistance (MDR) formation. The second factor, drugs transport by P-gp and P₁₉₀ from cell nucleus to organell in cytoplasm, may play a more important role.

Methodologic research on TIMP-1, TIMP-2 detection as a new diagnostic index for hepatic fibrosis and its significance

AIM

To set up a new method to detect tissue inhibitors of metalloproteinase-1 and -2(TIMP-1 and TIMP-2) in sera of patients with hepatic cirrhosis, and to investigate the expression and location of TIMP-1 and TIMP-2 in liver tissue of patients with hepatic cirrhosis, and the correlation between TIMPs in liver and those in sera so as to discuss whether TIMPs can be used as a diagnosis index of hepatic fibrosis.

METHODS

The monoclonal antibodies (McAbs) of TIMP-1 and TIMP-2 were used to sensitize erythrocytes, and solid-phase absorption to sensitized erythrocytes (SPASE) was used to detect TIMP-1 and TIMP-2 in the sera of patients with hepatic cirrhosis. Meanwhile, with the method of in situ hybridization and immunohistochemistry, we studied the mRNA expression and antigen location of TIMP-1 and TIMP-2 in the livers of 40 hepatic cirrhosis patients with pathologic diagnosis.

RESULTS

With SPASE, they were 16.4% higher in the acute hepatitis group, 33.3% higher in the chronic hepatitis group, and the positive rates were 73.6% and 61.2% respectively in sera of hepatic cirrhosis patients, which were remarkably higher than those in chronic hepatitis and acute hepatitis group (P<0.001). In 40 samples of hepatic cirrhosis tissues, all of them showed positive expression of TIMP-1 and TIMP-2 mRNA detected with immunohistochemistry or in situ hybridization (positive rate was 100%). Expression of TIMPs in different degrees could be found in liver tissue with cirrhosis. TIMPs were located in cytoplasm of liver cells of patients with hepatic cirrhosis. There was a significant correlation between serum TIMPs level and liver TIMPs level.

CONCLUSION

SPASE is a useful method to detect the TIMP-1 and TIMP-2 in sera of patients with hepatic cirrhosis, and TIMP-1 and TIMP-2 can be considered as a useful diagnostic index of hepatic fibrosis, especially TIMP-1.

Regulating effect of Chinese herbal medicine on the peritoneal lymphatic stomata in enhancing ascites absorption of experimental hepatofibrotic mice

AIM

To observe the regulatory effect of Chinese herbal medicine on peritoneal lymphatic stomata and its significance in treating ascites in liver fibrosis model mice.

METHODS

Two Chinese herbal composite prescriptions were used separately to treat the carbon tetrachloride-induced mouse model of liver fibrosis. The histo-pathologic changes of the liver sections (HE and VG stainings) were observed. The peritoneal lymphatic stomata was detected by scanning electron microscopy and computer image processing. The changes of urinary volume and sodium ion concentration were measured.

RESULTS

In the model group, lots of fibrous tissue formed in liver and extended into the hepatic lobules to separate them incompletely. In the treated and prevention groups, the histo-pathologic changes of liver was rather milder, only showed much less fibrous tissue proliferation in the hepatic lobules. The peritoneal lymphatic stomata enlarged with increased density in the experimental groups (diameter: PA, 3.07 +/- 0.69 microm; PB, 2.82 +/- 0.37 microm; TA, 3.25 +/- 0.82 microm and TB, 2.82 +/- 0.56 microm; density: PA, 7.11 +/- 1.90 stomata.1000 microm(-2); PB, 8.76 +/- 1.45 stomata.1000 microm(-2); TA, 6.55 +/- 1.44 stomata.1000 microm(-2)and TB, 8.76+/-1.79 stomata.1000 microm(-2)), as compared with the model group (diameter: 2.00+/-0.52 microm density: 4.45+/-1.05 stomata.1000 microm(-2)). After treatment, the urinary volume and sodium ion excretion increased in the experimental groups (PA, 231.28+/-41.09 mmol.L(-1); PB, 171.69 +/- 27.48 mmol.L(-1) and TA, 231.44 +/- 34.12 mmol.L(-1)), which were significantly different with those in the model group (129.33 +/- 36.75 mmol.L(-1)).

CONCLUSION

Chinese herbal medicine has marked effects in alleviating liver fibrosis, regulating peritoneal lymphatic stomata, improving the drainage of ascites from peritoneal cavity and causing increase of urinary volume and sodium ion excretion to reduce the water and sodium retention, and thus have favorable therapeutic effect in treating ascites.