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乙肝合并肝纤维化对内外源性代谢的影响及治疗学启示

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目的:研究乙肝合并肝纤维化对肝脏内外源性代谢的影响及甘草酸-替诺福韦(TFV)酯联用对抗乙型肝炎病毒(HBV)药效的影响。方法:慢性CCl4诱导HBV小鼠形成乙肝合并肝纤维化模型。H&E染色、天狼星红染色、α-SMA免疫组化用于检测肝组织病理学变化。运用代谢组学检测乙肝合并肝纤维化小鼠肝脏内源性代谢的改变。采用LC-MS/MS检测TFV及其有活性的代谢物(TFV-DP)的血浆及肝脏浓度,考察外源性代谢的变化。结果:HBV+CCl4小鼠出现肝损伤、胶原沉积等肝纤维化症状;乙肝合并肝纤维化影响肝脏核苷酸代谢、氨基酸代谢以及三羧酸循环、磷酸戊糖通路等内源性代谢,减少肝脏中TFV-DP含量,降低抗病毒药效。通过与甘草酸联用或形成自组装制剂,TFV在肝脏中的有活性的代谢物TFV-DP水平提高,抗病毒药效增强。结论:乙肝合并肝纤维化可影响肝脏内外源性代谢,通过不同形式的甘草酸-TFV联用,可提高肝脏TFV-DP含量以及抗病毒药效。
Influence of hepatitis B combined with hepatic fibrosis on endoge-nous and exogenous metabolism and therapeutic implications
AIM:To study the effect of hepatitis B combined with hepatic fibrosis on endogenous and exogenous metabolism of liver and the effect of glycyrrhizic acid combined with tenofovir(TFV)es-ter on anti-HBV efficacy.METHODS:Hepatitis B mouse was induced by chronic CCI4 to form a mod-el of hepatitis B with hepatic fibrosis.H&E staining,Sirius Red Staining,α-SMA immunohistochemistry were used to detect pathological changes in liver tissue.The changes of liver endogenous metabo-lism in mice with hepatitis B and hepatic fibrosis were detected by metabolomics.LC-MS/MS was used to investigate the plasma and liver concentra-tions of TFV and its active metabolite(TFV-DP),for investigating the changes of exogenous metabo-lism.RESULTS:HBV+CCl4 mice showed fibrosis symptoms such as liver injury and collagen deposi-tion.Hepatitis B combined with hepatic fibrosis af-fected nucleotide metabolism,amino acid metabo-lism,tricarboxylic acid cycle,pentose phosphate pathway and other endogenous metabolism,low-ered the hepatic level of TFV-DP,and decreased the antiviral efficacy.By combining with glycyrrhizic acid or forming a self-assembled preparation,the hepatic level of TFV-DP was improved,and the anti-viral efficacy was enhanced.CONCLUSIONS:Hepati-tis B combined with hepatic fibrosis affected both endogenous and exogenous metabolism of liver.Different forms of combination of glycyrrhizic acid and TFV could elevate the level of TFV-DP in liver and improve the antiviral efficacy in HBV+CCI4 mice.

hepatitis B combined with hepatic fi-brosisendogenous metabolismmetabolic activa-tion of tenofovir estercombination with glycyrrhi-zic acid

倪姐、洪小丹、计可、贾元威、王广基、张经纬

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中国药科大学药物代谢动力学重点实验室,南京 210009,江苏

皖南医学院弋矶山医院药物临床评价中心,芜湖 241001,安徽

乙肝合并肝纤维化 内源性代谢 替诺福韦酯代谢活化 甘草酸联用

国家自然科学基金面上项目

82173887

2024

中国临床药理学与治疗学
中国药理学会

中国临床药理学与治疗学

CSTPCD北大核心
影响因子:0.97
ISSN:1009-2501
年,卷(期):2024.29(8)