Apoptotic bone marrow CD34+ cells in cirrhotic patients

AIM: To access the frequency and level of apoptotic CD34+ cells isolated from the marrow fluid of patients with post-hepatitis cirrhosis.

METHODS: The frequency of bone marrow CD34+ cells and apoptotic bone marrow CD34+ cells in 31 in-patients with post-hepatitis cirrhosis (cirrhosis group), and 15 out-patients without liver or blood disorders (control group) was calculated by flow cytometry. Parameters were collected to evaluate liver functions of patients in cirrhosis group.

RESULTS: The percentage of normal bone marrow CD34+ cells was 6.30% ± 2.48% and 1.87% ± 0.53% (t = 3.906, P < 0.01) while that of apoptotic marrow CD34+ cells was 15.00% ± 15.81% and 5.73% ± 1.57% (t = 2.367, P < 0.05) in cirrhosis and control groups, respectively. The percentage of apoptotic marrow CD34+ cells was 6.25% ± 3.30% and 20.92 ± 18.5% (t = 2.409, P < 0.05) in Child-Pugh A and Child-Pugh B + C cirrhotic patients, respectively. The percentage of late apoptotic marrow CD34+ cells was positively correlated with the total bilirubin and aspartate aminotransferase serum levels in patients with cirrhosis.

CONCLUSION: The status of CD34+ marrow cells in cirrhotic patients may suggest that the ability of hematopoietic progenitor cells to transform into mature blood cells is impaired.

Significance of bone marrow CD34+ cell levels in cirrhotic patients

AIM: To analyze the significance of bone marrow CD34+ levels in cirrhotic patients.

METHODS: Bone marrow fluid was obtained from 31 cirrhotic patients and 15 healthy controls. The percentage of bone marrow CD34+ cells among mononuclear cells was detected by flow cytometry.

RESULTS: The percentage of bone marrow CD34+ cells among mononuclear cells was significantly higher in cirrhotic patients than in normal controls (6.30% vs 1.87%, t = 3.906, P < 0.05). The percentages of bone marrow CD34+ cells were not significantly different among patients with Child-Pugh A, B, and C cirrhosis (7.01 ± 2.1%, 4.58 ± 2.56% and 7.72 ± 1.49%, F = 3.586, P > 0.05).

CONCLUSION: The levels of bone marrow CD34+ cells increase in cirrhotic patients. Liver function grade is not correlated with bone marrow CD34+ cell levels in cirrhotic patients. Increased bone marrow CD34+ cells may contribute to the pathogenesis of cirrhosis.

Advances in understanding the role of transforming growth factor-β1 in the pathogenesis of liver fibrosis

Transforming growth factor-β1 (TGF-β1) is one of the most important cytokines leading to liver fibrosis and is most closely to the development and progression of liver fibrosis and extracellular matrix (ECM) metabolism. Numerous studies have demonstrated that TGF-β1 plays a significant role in the occurrence, development and progression of live fibrosis. Many therapeutic approaches targeting TGF-β1, especially gene therapy and immunotherapy, have been proposed to treat hepatic fibrosis in recent years. Here, we will review the recent advances in understanding the role of TGF-β1 in the pathogenesis of liver fibrosis.

Inhibitory effect of emodin and Astragalus polysaccharide on the replication of HBV

AIM: To evaluate the anti-viral effect of emodin plus Astragalus polysaccharide (APS) in hepatitis B virus (HBV) transgenic mice.

METHODS: Sixty HBV transgenic mice (HBV TGM) whose weight varied between 18 and 24 g were randomly divided into 3 groups, with 20 mice in each group. Group A was the normal control, where the mice were treated with physiological saline; group B was the positive control where the mice were treated with lamivudine solution (100 mL/kg per day). Group C was the experimental group where the mice were treated with physiological saline containing emodin and APS (57.59 mg/kg per day and 287.95 mg/kg per day, respectively). The mice were treated daily for 3 wk. After 1 wk recovery time, the mice were sacrificed and serum as well as liver tissues were collected for ELISA and histological examination.

RESULTS: After 21 d treatment, HBV DNA levels in group B and group C significantly declined when compared with group A (P < 0.05). However, a significant increase in HBV DNA content was observed in group B, whereas this phenomenon was not observed in group C. A reduction in the contents of HBsAg, HBeAg and HBcAg in the mice from group B and C was observed when compared with group A.

CONCLUSION: Emodin and APS have a weak but persistent inhibitory effect on HBV replication in vivo, which may function as a supplementary modality in the treatment of hepatitis B infection.

Immunoregulatory effects of saikosaponin-d in rats with experimental hepatocarcinoma

AIM: To investigate the immunoregulatory effects of saikosaponin-d (SSd) in rats with diethylnitrosamine (DEN)-induced experimental hepatocarcinoma and explore whether such immunoregulatory effects are associated with the antitumor effects of SSd.

METHODS: Ninety Sprague-Dawley male rats, weighting 248.18 ± 12.32 g, were divided into five groups randomly: normal control group (n = 10), model control group (n = 20) and three treatment groups (n = 20 in each group). Except the normal control group, rats in other groups were administrated with 2 mg/L DEN at a dose of 10 mg/kg bodyweight five times one week for sixteen weeks. Meanwhile, rats in the treatment groups were injected intraperitoneally with SSd at different doses (1.0, 1.5 and 2.0 mg/kg, respectively) once daily for sixteen weeks. Rats were anesthetized and killed at the end of last week. Hematoxylin and eosin (HE) staining was used to examine the pathological changes in the liver. T lymphocyte subsets (CD3⁺ CD4⁺%, CD3⁺ CD8⁺% and CD3⁺ CD4⁺/ CD3⁺ CD8⁺ ratio) were measured by flow cytometry.

RESULTS: Both tumor volume and tumor number were significantly reduced in the three SSd treatment groups when compared with the model control group. According to criteria of Edmondson and Steiner, the majority of tumors in the model group were histologically classified as grade III while those in the three SSd treatment groups were classified as grades I-II. The tumors in the treatment groups were well differentiated while those in the model control group were poorly differentiated. Compared with the control group, the percentage of CD4⁺ T lymphocytes and CD4⁺/CD8⁺ ratio significantly decreased in the model control group while the percentage of CD8⁺ T lymphocytes markedly increased (33.56% ± 4.16% vs 45.50% ± 4.03%, 1.06 ± 0.56 vs 1.93 ± 0.28 and 30.62% ± 3.65% vs 22.88% ± 3.15%, respectively; all P < 0.05). In contrast, a significant increase in the percentage of CD4⁺ T lymphocytes and CD4⁺/CD8⁺ ratio and a marked decrease in the percentage of CD8⁺ T lymphocytes were noted in the three SSd treatment groups (especially in high-dose SSd treatment group) when compared with the model control group (39.06% ± 3.98% vs 33.56% ± 4.16%, 1.55 ± 0.29 vs 1.06 ± 0.56 and 18.99% ± 3.09% vs 30.62% ± 3.65%, respectively; all P < 0.05).

CONCLUSION: SSd has inhibitory effects on DEN-induced hepatocarcinogenesis in rats perhaps through exerting an immunoprotective effect.

Advances in research on the role of cytokines in chronic liver diseases

Cytokines play an important role in the development of liver inflammatory injury. Various pro-inflammatory and anti-inflammatory cytokines constitute a cytokine network that mediates the development of various liver diseases. In recent years, numerous studies have been carried out on chronic liver diseases such as viral hepatitis, fatty liver, alcoholic liver disease and hepatic cirrhosis. Here, we will review the recent advances in research on the role of cytokines in chronic liver diseases and discuss future prospects in this field.

Identification of a novel protein binding to hepatitis C virus core protein

BACKGROUND

Hepatitis C virus (HCV) core protein is a multi-functional viral protein that interacts with several target proteins of both viral and cellular origin.

AIM AND METHODS

To gain insight into the mechanism of action of HCV core protein, we used a yeast two-hybrid system to identify the core protein-interacting cellular targets.

RESULTS

A cDNA clone encoding an aspartoacylase was obtained, termed aspartoacylase 3 (ACY3). Interaction between ACY3 and HCV core protein was verified using a co-immunoprecipitation assay in vitro, and a mammalian two-hybrid system in vivo. Fluorescence microscopy showed green fluorescence protein-fused ACY3 localized in the cytoplasm.

CONCLUSION

Our data suggest that ACY3 is an HCV core binding protein, which may play a role in the development of HCV-associated diseases.

[Angiogenesis inhibitory effect of saikosaponin-d on chicken embryo]

OBJECTIVE

To investigate the inhibitory effects of saikosaponin-d (SSd) on angiogenesis in chicken embryos and its mechanism of action.

METHODS

Chorioallantoic membrane (CAM) model was established successfully in 86 chicken embryos. They were divided into 4 groups after fenestration: the three SSd treated groups (A, B and C) treated with high (20 microg/mL, n = 16), middle (10 microg/mL, n = 19) and low (5 microg/mL, n = 25) dose of SSd respectively, and the control group treated with 0.01 mol/L PBS (n = 26). The drug or reagent was administered by grafting 20 microL onto the surface of CAM. After incubation for 3 days, the vessel growth was recorded by digital photography; inflammatory cells were counted under light microscope with HE staining, and the positive rate of angiogenesis reaction was calculated by Leica image analyzer.

RESULTS

On the 6th day of the embryonic age, vessels in the chicken embryo CAM showed a radial growing in spok-wheel pattern around the gelatin sponges with lateral axis running through it. Whereas after 3 days of SSd treatment, the angiogenesis reduced significantly with vague microvessels around the sponge, and vascular truncation and absence revealed. Microscopic examinations showed that the number of microvessels and infiltrated inflammatory cells in the sponge and peripheral CAM mesenchyme in the SSd groups were less than those in the control group, especially on vessels of medium and small size (P < 0.05, P < 0.01, respectively), but was insignificant on great vessels (P > 0.05). Correlation analysis revealed no correlation between the number of the great vessels in CAM and the infiltrated inflammatory degrees (r = 0.117, P > 0.05), but the increase of small vessels in CAM was positively correlated with that of inflammatory cells (r = 0.971, P < 0.01).

CONCLUSIONS

SSd could inhibit the physiological angiogenesis of chicken embryoe, especially for the medium and small vessels, while there was no significant effect on great vessels (P > 0.05). Its mechanism of action may be related to its inhibition on leukocyte migration and activation.

Changes in count and function of splenic lymphocytes from patients with portal hypertension

AIM: To investigate changes in numbers and proliferative function of splenic lymphocytes in patients with hypersplenism due to portal hypertension (PH), to provide evidence for further study of immune status of the spleen during PH.

METHODS: Twelve spleens from patients with hypersplenism due to PH served as the PH group, and four spleens from cases of traumatic spleen rupture were regarded as the control group. After weighing the spleen, lymphocytes were separated and counted using a cell counting plate to calculate the lymphocyte count per gram of spleen tissue (relative quantity) and total lymphocyte count in whole spleen (absolute quantity). The immunohistochemical SP method was used to observe the density and distribution of lymphocytes in the spleen. The MTT method was used to observe changes in lymphocyte proliferative function.

RESULTS: As compared to the control group, the splenic lymphocytes in the PH group showed that: (1) There was no difference in distribution but a significant decrease in density; (2) the number of lymphocytes per gram of spleen (relative quantity) decreased significantly [(0.822 ± 0.157) × 10⁸vs (1.174 ± 0.254) × 10⁸, P < 0.01]; (3) with the significant increase in the weight of the PH spleen (832.6 ± 278.2 g vs 211.7 ± 85.6 g, P < 0.01), the total quantity of lymphocytes (absolute quantity) increased significantly [(0.685 ± 0.072) × 10¹¹vs (0.366 ± 0.057) × 10¹¹, P < 0.01]; and (4) the proliferative function of lymphocytes was enhanced: T lymphocytes, (0.022 ± 0.005 vs 0.015 ± 0.003, P < 0.05), and B lymphocytes (0.034 ± 0.006 vs 0.023 ± 0.001, P < 0.01).

CONCLUSION: Although lymphocyte density in the spleen decreased in patients with PH, the total quantity of lymphocytes increased because spleen weight increased greatly, along with the proliferating function. With respect to changes in lymphocytes, PH spleens may still have immune function, although it may be disordered. However, complete evaluation of the immune function of the spleen in PH requires more research.

Inhibitory effects of saikosaponin-d on CCl4-induced hepatic fibrogenesis in rats

AIM: To investigate the suppressive effect of saikosaponin-d (SSd) on hepatic fibrosis in rats induced by CCl₄ injections in combination with alcohol and high fat, low protein feeding and its relationship with the expression of nuclear factor-κB (NF-κB), tumor necrosis factor-alpha (TNF-α) and interleukins-6 (IL-6).

METHODS: Hepatic fibrosis models were induced by subcutaneous injection of CCl₄ at a dosage of 3 mL/kg in rats. At the same time, rats in treatment groups were injected intraperitoneally with SSd at different doses (1.0, 1.5 and 2.0 mg/kg) once daily for 6 wk in combination with CCl₄, while the control group received olive oil instead of CCl₄. At the end of the experiment, rats were anesthetized and killed (except for 8 rats which died during the experiment; 2 from the model group, 3 in high-dose group, 1 in medium-dose group and 2 in low-dose group). Hematoxylin and eosin (HE) staining and Van Gieson staining were used to examine the changes in liver pathology. The levels of alanine aminotransferase (ALT), triglyeride (TG), albumin (ALB), globulin (GLB), hyaluronic acid (HA) and laminin (LN) in serum and the content of hydroxyproline (HYP) in liver were measured by biochemical examinations and radioimmuneoassay, respectively. In addition, the expression of TNF-α and IL-6 in liver homogenate was evaluated by enzyme-linked immunosorbent assay (ELISA) and the levels of NF-κBp65 and I-κBα in liver tissue were analyzed by Western blotting.

RESULTS: Both histological examination and Van Gieson staining demonstrated that SSd could attenuate the area and extent of necrosis and reduce the scores of liver fibrosis. Similarly, the levels of ALT, TG, GLB, HA, and LN in serum, and the contents of HYP, TNF-α and IL-6 in liver were all significantly increased in model group in comparison with those in control group. Whereas, the treatment with SSd markedly reduced all the above parameters compared with the model group, especially in the medium group (ALT: 412 ± 94.5 IU/L vs 113.76 ± 14.91 IU/L, TG: 0.95 ± 0.16 mmol/L vs 0.51 ± 0.06 mmol/L, GLB: 35.62 ± 3.28 g/L vs 24.82 ± 2.73 g/L, HA: 42.15 ± 8.25 ng/mL vs 19.83 ± 3.12 ng/mL, LN: 27.56 ± 4.21 ng/mL vs 13.78 ± 2.57 ng/mL, HYP: 27.32 ± 4.32 μg/mg vs 16.20 ± 3.12 μg/mg, TNF-α: 4.38 ± 0.76 ng/L vs 1.94 ± 0.27 ng/L, IL-6: 28.24 ± 6.37 pg/g vs 12.72 ± 5.26 pg/g, respectively, P < 0.01). SSd also decreased ALB in serum (28.49 ± 4.93 g/L vs 37.51 ± 3.17 g/L, P < 0.05). Moreover, the expression of NF-κB p65 in the liver of treated groups was lower than that in model groups while the expression of I-κBα was higher in treated group than in model group (P < 0.01). The expression of NF-κBp65 and TNF-α had a positive correlation with the level of HA in serum of rats after treatment with CCl₄ (r = 0.862, P < 0.01; r = 0.928, P < 0.01, respectively).

CONCLUSION: SSd attenuates CCl₄-induced hepatic fibrosis in rats, which may be related to its effects of hepato-protective and anti-inflammation properties, the down-regulation of liver TNF-α, IL-6 and NF-κBp65 expression and the increased I-κBα activity in liver.

Inhibitory effect of Huangqi Zhechong decoction on liver fibrosis in rat

AIM: To assess the inhibitory effect of Huangqi Zhechong decoction on hepatic fibrosis in rats induced by CCl₄ plus alcohol and high fat low protein diet.

METHODS: Male SD rats were randomly divided into hepatic fibrosis model group, control group and 3 treatment groups consisting of 12 rats in each group. Except for the normal control group, all the rats were subcutaneously injected with CCl₄ at a dosage of 3 mL/kg. In 3 treated groups, either high-dose group (9 mL/kg), or medium-dose group (6 mL/kg), or low-dose group (3 mL/kg) was daily gavaged with Huangqi Zhechong decoction, and saline vehicle was given to model and normal control rats. Enzyme-linked immunosorbent assay (ELISA) and biochemical examinations were used to determine the changes of alanine aminotransferase (ALT), aspartate aminotransferase (AST), hyaluronic acid (HA), laminin (LN), type-III-procollagen-N- peptide (PIIIP), and type IV collagen content in serum, and hydroxyproline (Hyp) content in liver after sacrificing the rats. Pathologic changes, particularly fibrosis were examined by hematoxylin and eosin (HE) and Van Gieson staining.

RESULTS: Compared with the model control group, serum ALT, AST, HA, LN, PIIIP and type IV collagen levels dropped markedly in Huangqi Zhechong decoction groups, especially in the medium-dose Huangqi Zhechong decoction group (1 954 ± 576 U/L vs 759 ± 380 U/L, 2 735 ± 786 U/L vs 1 259 ± 829 U/L, 42.74 ± 7.04 ng/mL vs 20.68 ± 5.85 ng/mL, 31.62 ± 5.84 ng/mL vs 14.87 ± 1.45 ng/mL, 3.26 ± 0.69 ng/mL vs 1.47 ± 0.46 ng/mL, 77.68 ± 20.23 ng/mL vs 25.64 ± 4.68 ng/mL, respectively) (P < 0.05). The Hyp content in liver tissue was also markedly decreased (26.47 ± 11.24 mg/mgprot vs 9.89 ± 3.74 mg/mgprot) (P < 0.01). Moreover, the stage of the rat liver fibrosis in Huangqi Zhechong decoction groups was lower than that in model group, and more dramatic drop was observed in medium-dose Huangqi Zhechong decoction group (P < 0.01).

CONCLUSION: Huangqi Zhechong decoction can inhibit hepatic fibrosis resulted from chronic liver injure, retard the development of cirrhosis, and notably ameliorate the liver function. It may be a safe and effective therapeutic drug for patients with fibrosis.