期刊
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
卷 24, 期 3, 页码 -出版社
MDPI
DOI: 10.3390/ijms24032485
关键词
PiZZ deficiency; liver; cholestasis; cirrhosis; Z-AAT polymers; mRNA expression; transcriptome profiling; nCounter Fibrosis Panel; lipid metabolism
PiZZ (Glu342Lys) alpha 1-antitrypsin deficiency (AATD) is a risk factor for liver disease development in children, characterized by intrahepatic AAT polymerization. The presence of Z-AAT polymers in hepatocytes is common among PiZZ children, but the clinical outcomes vary, with some developing neonatal cholestasis and cirrhosis. The expression of genes related to liver fibrosis/cirrhosis and lipid, aldehyde/ketone, and bile acid metabolism differ between groups, suggesting that changes in specific genes and pathways may reflect the degree of liver injury.
PiZZ (Glu342Lys) alpha 1-antitrypsin deficiency (AATD) is characterized by intrahepatic AAT polymerization and is a risk factor for liver disease development in children. The majority of PiZZ children are disease free, hence this mutation alone is not sufficient to cause the disease. We investigated Z-AAT polymers and the expression of fibrosis-related genes in liver tissues of PiZZ children with different clinical courses. Liver biopsies obtained during 1979-2010 at the Department of Paediatrics, Karolinska University Hospital, Sweden, were subjected to histological re-evaluation, immunohistochemistry and NanoString-based transcriptome profiling using a panel of 760 fibrosis plus 8 bile acid-related genes. Subjects were divided into three groups based on clinical outcomes: NCH (neonatal cholestasis, favourable outcome, n = 5), NCC (neonatal cholestasis, early cirrhosis and liver transplantation, n = 4), and NNCH (no neonatal cholestasis, favourable outcome, n = 5, six biopsies). Hepatocytes containing Z-AAT polymers were abundant in all groups whereas NCC showed higher expression of genes related to liver fibrosis/cirrhosis and lower expression of genes related to lipid, aldehyde/ketone, and bile acid metabolism. Z-AAT accumulation per se cannot explain the clinical outcomes of PiZZ children; however, changes in the expression of specific genes and pathways involved in lipid, fatty acid, and steroid metabolism appear to reflect the degree of liver injury.
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