J Hepatol:Th17的频率与原发性硬化性胆管炎低骨量有关

2019-02-20 陈林,李婉玉 临床肝胆病杂志

骨质疏松性骨折是原发性硬化性胆管炎患者发病和生活质量下降的主要原因,原发性硬化性胆管炎(PSC)是一种病因不明的进行性胆管疾病。尽管 一般认为这种病理是钙稳态受损和吸收不良的结果,PSC相关骨质疏松的细胞和分子机制尚不清楚。

骨质疏松性骨折是原发性硬化性胆管炎患者发病和生活质量下降的主要原因,原发性硬化性胆管炎(PSC)是一种病因不明的进行性胆管疾病。尽管 一般认为这种病理是钙稳态受损和吸收不良的结果,PSC相关骨质疏松的细胞和分子机制尚不清楚。

研究者采用双X射线吸收法测定骨密度,用高分辨率外周定量计算机断层扫描评估PSC患者的骨显微结构。测定肝脏和骨代谢的实验室标志物,并通过纤维扫描评估肝脏硬度。共测定40例PSC患者外周血单个核细胞体外刺激后辅助性T淋巴细胞(Th)17的频率。为了探讨IL-17在PSC相关骨丢失中的潜在作用,分析了缺乏Abcb 4和或IL-17的小鼠的骨骼表型。

与原发性胆汁性胆管炎不同,PSC患者骨丢失与病程或肝纤维化无关。然而,研究者观察到骨吸收生物标志物脱氧吡啶啉与PSC骨密度之间存在显着负相关,表明骨吸收增加。重要的是,外周血辅助T细胞17的频率与尿脱氧吡啶啉呈正相关,与骨量呈负相关。研究者观察到Abcb 4缺乏的小鼠表现为低骨量表型,经Il-17缺乏或抗IL-17治疗后纠正,而肝脏病理未受影响。

研究表明,Th17频率的增加与PSC的骨吸收有关。以抗体为基础的IL-17阻断是否有利于防止PSC患者骨丢失应该在今后的研究中讨论。

原始出处:Tobias Schmidt, Dorothee Schwinge, Tim Rolvien, et al. Th17 cell frequency is associated with low bone mass in primary sclerosing cholangitis. J Hepatol. 2019 Jan 11.

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    2019-11-19 clmlylxy
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    2019-02-22 zhaojie88
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    2019-02-22 gwc384
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