Hepatology: 果糖及其代谢产物升高会导致酒精性肝病的发生

2020-11-10 MedSci原创 MedSci原创

酒精相关性肝病(ALD)是世界范围内常见的慢性肝病,其发病率和死亡率很高,并且美国食品药品监督管理局目前还没有批准的疗法。

背景和目标

酒精相关性肝病(ALD)是世界范围内常见的慢性肝病,其发病率和死亡率很高,并且美国食品药品监督管理局目前还没有批准的疗法。果糖,其代谢产物尿酸和醛糖还原酶(AR,是唯一可产生果糖的内源性酶)与非酒精性脂肪肝的发生密切相关。但是,AR或其代谢产物在ALD中的作用仍未得到充分研究,本项研究对此进行了相关探索。

 

 

方法与结果

研究人员在酒精性肝炎患者的肝脏样本中证明了AR地上调和AR代谢产物(山梨糖醇,果糖和尿酸)的升高,这与(1)脂质过氧化副产物和内质网(ER)应激增加密切相关,( 2)保护性ER分子伴侣减少,(3)细胞死亡和肝损伤更大都有关系。此外,研究通过证明AR敲除小鼠的遗传缺陷阻止了酒精引起的有害AR代谢产物,有毒醛,脂肪变性,内质网应激,细胞凋亡和肝损伤的增加,从而证实了AR在ALD中的因果作用。最后,在实验小鼠中证明了在实验性ALD中药理性AR抑制对酒精诱导的肝损伤的治疗潜力。

 

 

结论

通过以上数据研究人员发现:肝脏AR上调以及果糖,山梨糖醇和/或尿酸的升高是导致酒精诱导的脂肪变性,内质网应激,细胞凋亡以及实验性和人ALD肝损伤的重要因素。

 

原始出处:

Min Wang. Et al. Elevated Fructose and Uric Acid Through Aldose Reductase Contribute to Experimental and Human Alcoholic Liver Disease. Hepatology.2020.

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    2020-11-12 ms6000001414112870

    涨知识

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    2020-11-12 gwc384
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1673628, encodeId=bb4316e3628ee, content=<a href='/topic/show?id=757b954e922' target=_blank style='color:#2F92EE;'>#酒精性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95479, encryptionId=757b954e922, topicName=酒精性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=398f26933958, createdName=huiwelcome, createdTime=Thu Feb 11 22:41:11 CST 2021, time=2021-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=898820, encodeId=be7b898820e7, content=涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d3e95433715, createdName=ms6000001414112870, createdTime=Thu Nov 12 22:14:51 CST 2020, time=2020-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1343700, encodeId=c0ee1343e00da, content=<a href='/topic/show?id=63ad95484f9' target=_blank style='color:#2F92EE;'>#酒精性肝病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95484, encryptionId=63ad95484f9, topicName=酒精性肝病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4f2c2500194, createdName=446798725_87912765, createdTime=Thu Nov 12 13:41:11 CST 2020, time=2020-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427470, encodeId=5c14142e470f6, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Thu Nov 12 13:41:11 CST 2020, time=2020-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1513475, encodeId=415e15134e58c, content=<a href='/topic/show?id=8e4b2540671' target=_blank style='color:#2F92EE;'>#代谢产物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25406, encryptionId=8e4b2540671, topicName=代谢产物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e1510553828, createdName=124987c6m39暂无昵称, createdTime=Thu Nov 12 13:41:11 CST 2020, time=2020-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=898455, encodeId=b978898455f4, content=水果吃多了也不好。, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211019/df01a4bfb64246379ddfef3370d04115/e1274c8eb5e440918f56f83bcfea9031.jpg, createdBy=3a345397082, createdName=Jessica, createdTime=Wed Nov 11 14:31:39 CST 2020, time=2020-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=898422, encodeId=6cee898422e5, content=👍👍👏👏, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=927d5267470, createdName=1481627fm11暂无昵称, createdTime=Wed Nov 11 10:08:51 CST 2020, time=2020-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=898383, encodeId=f6d7898383b9, content=那蔗糖里面的果糖怎么办, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Wed Nov 11 06:28:24 CST 2020, time=2020-11-11, status=1, ipAttribution=)]
    2020-11-11 Jessica

    水果吃多了也不好。

    0

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    2020-11-11 1481627fm11暂无昵称

    👍👍👏👏

    0

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    2020-11-11 liyu7822

    那蔗糖里面的果糖怎么办

    0

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AP&T:非酒精性脂肪肝患者晚期肝纤维化与心血管疾病相关

非酒精性脂肪肝疾病(NAFLD)与心血管疾病的风险增加相关是明确的。但是,尚不清楚哪些NAFLD患者罹患心血管疾病的风险最高。

J Hepatology: 白色念珠菌毒素candidalysin促进酒精相关的肝脏疾病的发展

酒精相关性肝病是肝移植的主要指征,也是死亡的主要原因。肠道菌群的改变导致酒精相关性肝病的发病机理目前还不清楚,比如患有酒精相关性肝病的患者念珠菌的比例增加。在粪便菌群中,关于肠道念珠菌对疾

AJG:非酒精性脂肪性肝病和肌肉减少症与心血管风险独立相关

目前已知,非酒精性脂肪肝疾病(NAFLD)和肌肉减少症与动脉粥样硬化性心血管疾病(ASCVD)的风险增加密切相关。因此,本项研究旨在验证NAFLD和少肌症对ASCVD风险的影响。

AP&T: 酒精性肝炎患者中的微量元素缺乏症与感染和死亡相关

营养不良在酒精相关性肝病患者中很常见,并且与酒精性肝炎患者的结局有关。

2020 AISF临床实践指南:酒精性肝病

2020年1月,意大利肝病学会(AISF)发布了酒精性肝病管理指南,酒精使用障碍是西方国家最常见的肝损伤的原因,其疾病范围广泛,包括脂肪变性,脂肪性肝炎,肝纤维化,肝硬化和肝癌。本文主要内容涉及酒精性肝病的流行病学,病理生理学,临床表现,诊断以及治疗的相关内容,主要目的是针对酒精性肝病的临床管理提供指导建议。