Drug therapy for non-alcoholic fatty liver disease / 中国实用内科杂志

Non-alcoholic fatty liver disease(NAFLD) is the most common chronic liver disease in the world, but currently there are no approved effective drugs for NAFLD. At present, healthy diet and lifestyle intervention are the basic treatment for NAFLD, but drug therapy, mainly for metabolic syndrome and liver injury, is also essential. Currently, the commonly used drugs include hepatic protectant,insulin sensitizer, lipid-modulating drug, antioxidant, slimming drug, and intestinal probiotics, etc. A variety of new drugs targeting different pathogenesis of NAFLD have been put into clinical trials. In this paper, the current status of drug treatment and research on NAFLD in recent years was summarized.

Efficacy and safety of tauroursodeoxycholic acid in the treatment of liver cirrhosis: a double-blind randomized controlled trial / 华中科技大学学报（医学）（英德文版）

No direct comparison of tauroursodeoxycholic acid (TUDCA) and ursodeoxycholic acid (UDCA) has yet been carried out in the treatment of liver cirrhosis in China. We designed a double-blind randomized trial to evaluate the potential therapeutic efficacy of TUDCA in liver cirrhosis, using UDCA as parallel control. The enrolled 23 patients with liver cirrhosis were randomly divided into TUDCA group (n=12) and UDCA group (n=11), and given TUDCA and UDCA respectively at the daily dose of 750 mg, in a randomly assigned sequence for a 6-month period. Clinical, biochemical and histological features, and liver ultrasonographic findings were evaluated before and after the study. According to the inclusion criteria, 18 patients were included in the final analysis, including 9 cases in both two groups. Serum ALT, AST and ALP levels in TUDCA group and AST levels in UDCA group were significantly reduced as compared with baseline (P<0.05). Serum albumin levels were significantly increased in both TUDCA and UDCA groups (P<0.05). Serum markers for liver fibrosis were slightly decreased with the difference being not significant in either group. Only one patient in TUDCA group had significantly histological relief. Both treatments were well tolerated and no patient complained of side effects. It is suggested that TUDCA therapy is safe and appears to be more effective than UDCA in the treatment of liver cirrhosis, particularly in the improvement of the biochemical expression. However, both drugs exert no effect on the serum markers for liver fibrosis during 6-month treatment.

Efficacy and safety of tauroursodeoxycholic acid in the treatment of liver cirrhosis: a double-blind randomized controlled trial / 华中科技大学学报（医学）（英德文版）

No direct comparison of tauroursodeoxycholic acid (TUDCA) and ursodeoxycholic acid (UDCA) has yet been carried out in the treatment of liver cirrhosis in China. We designed a double-blind randomized trial to evaluate the potential therapeutic efficacy of TUDCA in liver cirrhosis, using UDCA as parallel control. The enrolled 23 patients with liver cirrhosis were randomly divided into TUDCA group (n=12) and UDCA group (n=11), and given TUDCA and UDCA respectively at the daily dose of 750 mg, in a randomly assigned sequence for a 6-month period. Clinical, biochemical and histological features, and liver ultrasonographic findings were evaluated before and after the study. According to the inclusion criteria, 18 patients were included in the final analysis, including 9 cases in both two groups. Serum ALT, AST and ALP levels in TUDCA group and AST levels in UDCA group were significantly reduced as compared with baseline (P<0.05). Serum albumin levels were significantly increased in both TUDCA and UDCA groups (P<0.05). Serum markers for liver fibrosis were slightly decreased with the difference being not significant in either group. Only one patient in TUDCA group had significantly histological relief. Both treatments were well tolerated and no patient complained of side effects. It is suggested that TUDCA therapy is safe and appears to be more effective than UDCA in the treatment of liver cirrhosis, particularly in the improvement of the biochemical expression. However, both drugs exert no effect on the serum markers for liver fibrosis during 6-month treatment.

Effects of cAMP-response element binding protein-1 (CREB-1) on transforming growth factor-b3 (TGFb3) mRNA expression and promoter activity in hepatic stellate cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effects of cAMP-response element binding protein-1 (CREB-1) on transforming growth factor-b3 (TGF b3) mRNA expression and promoter activity in hepatic stellate cells (HSCs).</p><p><b>METHODS</b>Freshly isolated HSCs from rats were divided into six groups: CREB-1 expression plasmid transfected group (C), siRNA-CREB-1 plasmid transfected group (S), negative control group (N), forskolin treated group (F), H-89 treated group (H), and blank group (B). Rats in each group were further sub-divided according to whether (+) or not (-) they were exposed to exogenous TGF b3. TGF b3 mRNA expression was measured by real time quantitative PCR. HSCs of the C, S, N, F, H and B groups were transfected with the TGF b3 promoter luciferase reporter plasmid (PGL3-TGF b3-P; W group), the TGF b3 promoter luciferase reporter plasmid with CRE mutation (PGL3-basic-TGF b3P-mCRE; M group) and the renilla luciferase control plasmid (pRL-SV40; control group). TGF b3 promoter activity was assessed by luciferase reporter assays.</p><p><b>RESULTS</b>Compared to N(-), the TGF b3 mRNA expression was reduced to 0.69+/-0.15 in S(-) (P less than 0.05) and increased to 4.68+/-2.76 in C(-) (P more than 0.05). Compared to B(-), the TGF b3 mRNA expression was reduced to 0.57+/-0.08 in H(-) (P less than 0.05). The differences between N(+) and N(-), S(+) and S(-), B(+) and B(-), and H(+) and H(-) were all significant (P less than 0.05). The values of TGF b3 promoter activity in S(W), N(W), and C(W) were 0.062+/-0.013, 0.122+/-0.011, and 0.165+/-0.016 (P less than 0.05), but the changes of TGF b3 promoter activity in S(M), N(M), and C(M) were not significant (P more than 0.05). The values of TGF b3 promoter activity in H(W), B(W), and F(W) were 0.154+/-0.010, 0.188+/-0.016, and 0.276+/-0.031 (P less than 0.05), but the changes of TGF b3 promoter activity in H(M), B(M), and F(M) were not significant (P more than 0.05).</p><p><b>CONCLUSION</b>Increased levels of CREB-1 mRNA or p-CREB-1 up-regulate the TGF b3 mRNA expression and promoter activity in rat HSCs. The CRE site in the TGF b3 promoter is critical for this effect, and the gene's activity becomes significantly decreased when the site is missing. Exogenous TGF b3 enhances expression of endogenous TGF b3 in rat HSCs.</p>

Effects of exogenous TGF-β3 on the expression of endogenous TGF-β3 in hepatic stellate cell-T6 (HSC-T6) / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effects of exogenous TGF-β3 on the expression of endogenous TGF-b3 in hepatic stellate cell (HSC).</p><p><b>METHODS</b>HSCs were cultured and divided into two groups: TGF-β3 group and blank control group, the cells of TGF-β3 group were exposed to TGF-b3 (10 ng/ml), whereas the blank control group was not treated. The cells were incubated in the presence of exogenous TGF-β3 and then (1) were harvested at 0h, 1h, 2h, 4h, 12h, 24h, and real time PCR was performed to detect the mRNA expression of endogenous TGF-β3. (2) The cells were collected at 0h, 1h, 6h, 12h, and western-blot was used to detect the protein synthesis of endogenous TGF-β3 in HSC; (3) The cell culture supernatant was harvested at 0h, 1h, 2h, 4h, 8h, 14h, 24h, and ELISA was performed to measure the total protein of extracellular TGF-β3; HSCs were treated with TGF-β3 (10 ng/ml) for 2h. The cells were then incubated in serum-free medium and the cell culture supernatant was harvested at 2.25h, 2.5h, 3h, 4h, 6h, 10h and 14h. ELISA was used to detect the extracellular secret ion of endogenous TGF-β3 by HSCs.</p><p><b>RESULTS</b>(1) Exogenous TGF-β3 treatment induced a marked increase in TGF-β3 mRNA expression. By 2h of exogenous TGF-β3 treatment, maximal TGF-β3 mRNA expression levels (2.796 ± 0.518) of 2.74 fold above control values (1.022 ± 0.038) was reached (P < 0.05). Thereafter, TGF-β3 mRNA expression level declined, and the expression level was maintained at level of 1.45-fold for at least 10h and was 1.18-fold above control values by 24h TGF-β3 treatment (P < 0.05); (2) No significant difference about the intracellular protein expression level of endogenous TGF-β3 was found between two groups. (P > 0.05); (3) The total expression level of TGF-β3 reached a peak [(18.931 ± 2.904) ng/ml] at 4h after TGF-β3 treatment (1.89-fold higher than basic TGF-β3 (10 ng/ml). After that, it slowly declined. The expression peak [(0.835 ± 0.027) ng/ml] induction of extracellular secreted TGF-β3 was at 3h (32.12-fold higher than control [(0.026 ± 0.022) ng/ml], (P < 0.05). Thereafter, TGF-β3 slowly decreased after the peak time, and their expressions were still statistically significant as compared to the control (P < 0.05).</p><p><b>CONCLUSION</b>Exogenous TGF-β3 could increase the expression of endogenous TGF-β3 mRNA and extracellular secreted TGF-β3 protein obviously.</p>

Effects of transforming growth factor beta 3 on the histopathology and expression of collagen I in experimental hepatic fibrotic rats / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investgate the effects of TGFbeta3 on rat hepatic fibrosis.</p><p><b>METHODS</b>The TGFbeta3 cDNA was cloned into rAAV2 vector. Rats were randomly divided into four groups: normal control group, model group, negative control group and TGFbeta3 group. Hepatic fibrosis was induced by hypodermic injection of 40% CCl(4). Recombinant AAV2-TGFbeta3 viral particles were injected via the vena caudalis one week before CCl(4) treatment. Rats were executed 8 weeks after CCl(4) treatment, global histological change was observed after HE staining, the distribution of the collagen fibers was observed after masson staining, histochemistry was done to observe the expression of collagen I; The positive area rate of the collagen fibers and the average optical rate of collagen I were quantified.</p><p><b>RESULTS</b>HE staining indicated that collagen fibers were reduced in the TGFbeta3 group. Masson staining shown that the collagen fibers were distributed around the blood vessel, in the portal area and disse space. Compared to the model group (13.2%+/-2.2%) and negative control group (12.3%+/-1.5%), the collagen fibers in liver tissues of TGFbeta3 group (7.7%+/-1.5%) were significantly decreased (q = 9.456, P < 0.01; q = 8.217, P < 0.01). Histochemistry indicated that the collagen fibers of liver tissues of TGFbeta3 group (0.185+/-0.033) were significantly higher than those in the model group (0.252+/-0.042) and the negative control group (0.230+/-0.029), (q = 6.228, P < 0.01; q = 4.346, P < 0.01).</p><p><b>CONCLUSION</b>TGFbeta3 alleviates the damage to hepatic cell and the level of fibrosis in CCl(4) treated rats and inhibits the expression of collagen I.</p>

Effects of transforming growth factor-beta 3 gene transfer on type I collagen synthesis of hepatic stellate cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To observe the effects of transforming growth factor-beta 3 gene transfer on type I collagen synthesis of cells of HSC-T6.</p><p><b>METHODS</b>Transforming growth factor-beta 1 expression plasmid and transforming growth factor-beta 3 expression plasmid were constructed. The recombinant expression plasmids pcDNA3.1(+)-TGF beta 1 and pcDNA3.1(+)-TGF beta 3 were respectively transfected and cotransfected into cultured HSC-T6 cells; expression of TGF betav1, TGF beta 3, type I collagen mRNA were detected by real-time quantitative PCR, expression of TGF beta 1 and type I collagen protein were detected by Western blot. The recombinant expression plasmid pcDNA3.1(+)-TGF beta 1 was transfected into cultured HSC-T6 cells; positive clones were selected by G418. The positive clones were transfected by the recombinant expression plasmid pcDNA3.1(+)-TGF beta 3; expression of TGF beta 1, TGF beta 3 and type I collagen mRNA were detected by real-time quantitative PCR; expression of TGF beta 1 and type I collagen protein were detected by Western blot.</p><p><b>RESULTS</b>HSC-T6 was transfected by recombinant expression plasmid pcDNA3.1(+)-TGF beta 1 and pcDNA3.1(+)-TGF beta 3 and the transfection efficiency was 28.2%. After the cells were transfected with pcDNA3.1-TGF beta 3, type I collagen mRNA and the protein expression in the cells were higher than those in the untransfected cells (control group) (P < 0.05). The increase reached to the maximal at 72 h after the transfection. Expressions of type I collagen mRNA and the protein in the cells transfected by pcDNA3.1(+)-TGF beta 1 were higher than in those cotransfected by pcDNA3.1(+)-TGF beta 1 and pcDNA3.1(+)-TGF beta 3 (P < 0.05). TGF beta 1 protein, type I collagen mRNA and type I collagen protein expression significantly decreased in the clones transfected by recombinant expression plasmid pcDNA3.1(+)-TGF beta 3 (P < 0.05), but the changes of TGF beta 1 mRNA were not significant (P > 0.05).</p><p><b>CONCLUSIONS</b>Expression of type I collagen increased after the cultured HSC-T6 cells were transfected by TGF beta 3 gene. The significant decrease of the expression of type I collagen of the TGF beta 3 gene transfected positive clones suggests that TGF beta 3 could inhibit the occurrence of liver fibrosis.</p>

Analysis of change in viral titers under different conditions in cultured cells persistently-infected with Japanese encephalitis virus / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the change of viral titers under different conditions in cultured cells persistently-infected with different strains of Japanese encephalitis virus (JEV) and find out the factors that influence viral multiplication.</p><p><b>METHODS</b>JEV JaGAr-01 and Nakayama wild strains were used to infect human hepatoma cell line KN73 respectively, and the persistent infection model was established. Viral titers were examined by plaque methods using BHK cells. Human nerve fibroblastoma cell line IMR-32 was infected with the strains of the virus that can cause persistent infection, and the thermal sensitivity of the viral strains was measured at 30 degrees C and 37 degrees C. KN73 cells persistently infected with JEV were infected with two JEV strains respectively, and viral superinfection was studied. To explore the replication of the persistently-infected viruses, KN73 and IMR-32 cells were infected with the viral strains.</p><p><b>RESULTS</b>Two persistently infected viral strains did not show any thermal difference. The results of superinfection were that the viral titers of JaGAr-01 strains were 1.3 and 8.8 percent of the control, respectively, and the viral titers of Nakayama strain were 80 and 1.7 percent of the control, respectively. JaGAr-01 wild strains, Nakayama wild strains and their persistently-infected strains infected KN73 and IMR-32 respectively. The replication of the persistently-infected strains was obviously lower than the wild strains in KN73 cells, however, in IMR-32 cells their replication was similar.</p><p><b>CONCLUSIONS</b>The two strains of JEV were not found to be temperature-mutant. It is possible that mutant viruses containing DI particles exist in JEV persistently-infected strains. In different cells there may be different host factors hindering the replication of the persistently-infected strains.</p>

Changes of mast cells and protease activated receptor-2 in experimental rat liver fibrosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the quantity of mast cells and the role of protease activated receptor-2 (PAR-2) in experimental rat liver fibrosis.</p><p><b>METHODS</b>Rats were sacrificed at 0, 2, 4, 8, and 12 weeks after subcutaneous injection of CCl(4). Mast cells were displayed by toluidine blue stain. The content of liver hydroxyproline was measured by the method of base hydrolyzate. The mRNA expression and the protein expression of PAR-2 in livers were detected by RT-PCR and immunohistochemistry at each time point.</p><p><b>RESULTS</b>In normal rat livers there were a few mast cells (2.5+/-1.0) distributed along the hepatic portal areas. In the cirrhosis model group the number of mast cells in the livers increased degree by degree (2 weeks vs 4 weeks vs 8 weeks, 9.1+/-0.5 vs 15.7+/-3.0 vs 32.0+/-3.3; P less than 0.05), and they were distributed densely around the hepatic portal areas and the central veins. The content of liver hydroxyproline increased progressively from 0 to 12 weeks. In normal livers PAR-2 mRNA was hardly detected, at 2 weeks there was some expression of PAR-2 mRNA (PAR-2/beta-actin 0.15+/-0.01, P less than 0.05), at 4 weeks its expression increased (PAR-2/beta-actin 0.35+/-0.02, P less than 0.05) and it maintained a higher level (PAR-2/beta-actin 0.80+/-0.02, P less than 0.05) since then. The changing trend of the protein expression of PAR-2 was the same as that of PAR-2 mRNA expression.</p><p><b>CONCLUSIONS</b>PAR-2 mRNA expression and the protein expression of PAR-2 were consistent with the increase of the mast cells, and the content of liver hydroxyproline may play an important role in mediating liver fibrosis.</p>

Expression of netrin-1 in placenta from patients with pre-eclampsia and the relation to placental angiogenesis / 中华妇产科杂志

Objective To investigate the expression of netrin-1 in placenta from patients with pre- eclampsia and the relation to placental angiogenesis.Methods Twenty patients with pre-eclampsia(12 mild cases and 8 severe cases)and 20 normal late pregnant women were investigated.The expression of netrin-1 mRNA and protein was determined with RT-PCR and Western blotting respectively.The placenta vascular density was examined by immunohistochemical F8 staining.Results (1)The values of netrin-1 mRNA in normal group and pre-eclampsia groups were 0.51?0.08 and 0.41?0.06;The values of netrin- 1 protein in normal group and pre-eclampsia groups were 26.4?1.8 and 20.5?1.3(P