新型GLP-1/GIP双受体激动剂替西帕肽改善db/db小鼠代谢相关脂肪性肝病的研究
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1.徐州医科大学附属淮安临床学院内分泌科;2.南京医科大学附属淮安第一人民医院内分泌科

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徐州医科大学附属医院发展基金资助项目(XYFY2021031)


The study of GLP-1/GIP dual receptor agonist tirzepatideameliorates metabolic associated fatty liver disease in db/db mice
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1.Department of Endocrinology and Metabolism,The Huai'2.'3.an Clinical College of Xuzhou Medical University,Huai’an

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the Development Fund of the Affiliated Hospital of Xuzhou Medical University

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    摘要:

    目的:比较新型胰高血糖素样肽-1(Glucagon-like peptide-1,GLP-1)/葡萄糖依赖性促胰岛素多肽(Glucose-dependent insulinotropic polypeptide,GIP)双受体激动剂替西帕肽与GLP-1受体激动剂利拉鲁肽改善db/db小鼠代谢相关脂肪性肝病(metabolic associated fatty liver disease,MAFLD)的效果。方法:以db/db小鼠作为MAFLD模型,db/m小鼠作为对照组,分为Control组、Model组、Liraglutide 组和Tirzepatide 组。Liraglutide 组和Tirzepatide 组小鼠每天分别接受腹腔注射 10nmol/kg 的利拉鲁肽及替西帕肽,连续10周。Control组和Model组小鼠在同一时间内腹腔注射等量生理盐水。实验结束后,比较各组小鼠空腹血糖(fasting blood glucose, FBG),糖化血红蛋白(glycated haemoglobin A1c, HbA1c)及体重。自动生化仪检测并比较各组小鼠血清TC、TG、LDL-C、HDL-C、ALT及AST含量。通过HE染色及油红O染色比较各组小鼠肝组织病理学改变以及肝脏脂质沉积情况。采用Western blot及 RT-PCR法检测各组小鼠肝组织炎症因子及纤维化介质蛋白及mRNA表达差异。结果:Model组小鼠FBG、HbA1、体重、TC、TG、LDL-C、ALT及AST较Control组小鼠明显升高,HDL-C显著下降。与Model组小鼠相比,Liraglutide 组小鼠血糖、糖化血红蛋白、体重及TC、TG、LDL-C、ALT及AST分别下降60%、32%、20%、19%、22%、39%、26%及28%,HDL-C升高25%。而替西帕肽组小鼠血糖、糖化血红蛋白、体重及TC、TG、LDL-C、ALT及AST分别下降69%、40%、30%、31%、35%、57%、46%和38%,HDL-C升高了61%。肝脏HE染色及油红O染色显示,与Control组比较,Model组小鼠肝脏表现出明显的肝细胞脂肪变性,呈气球样变及呈空泡化,肝细胞内聚集大量脂滴。对比Model组小鼠,两组干预组小鼠肝细胞脂肪变性以及肝脏脂肪沉积得到改善,并且替西帕肽的效果优于利拉鲁肽。Western blot 及RT-PCR结果显示,Model组小鼠IL-1β、IL-6、TNF-α、Fibronectin、Col-Ⅰ、α-SMA蛋白表达明显升高,IL-1β、IL-6、TNF-α、ASC、Caspase-1、Fibronectin、α-SMA、Col-Ⅰ、Col-IV、TGF-β mRNA含量显著升高,药物治疗后,两组小鼠上述炎症因子及纤维化介质表达量明显並且替西帕肽改善上述指标的效果优于利拉鲁肽。结论:新型GLP-1/GIP双受体激动剂替西帕肽可改善MAFLD模型小鼠的糖脂代谢紊乱,降低体重,改善肝损伤及减少肝脏脂肪沉积,延缓肝脏炎症及纤维化,其综合疗效优于利拉鲁肽,可能为MAFLD提供新的治疗方案。

    Abstract:

    Objective:To compare the therapeutic of the novel Glucagon-like peptide-1 (GLP-1)/Glucose-dependent insulinotropic polypeptide (GIP) dual receptor agonist tirzepatide and the GLP-1 receptor agonist liraglutide in improving metabolic associated fatty liver disease (MAFLD) in db/db mice. Methods:Db/db mice were used as the MAFLD Model and db/m mice as the Control group, which were divided into Control group, Model group, Liraglutide group and Tirzepatide group. Mice in Liraglutide and tirzepatide groups received intraperitoneal injections of 10 nmol/kg of Liraglutide and tirzepatide daily for 10 consecutive weeks. The mice in the Control group and the Model group were intraperitoneally injected with the same volume of saline at the same time. At the end of the experiment, the fasting blood glucose (FBG), glycated haemoglobin A1c (HbA1c) and body weight of mice in each group were compared. The levels of serum TC, TG, LDL-C, HDL-C, ALT and AST in each group were detected and compared by automatic biochemical analyzer. HE staining and oil red O staining were used to compare the liver pathological changes and lipid deposition in each group. Western blot and RT-PCR were used to detect the protein and mRNA expressions of inflammatory factors and fibrosis mediators in the liver tissue of mice in each group. Results: Compared with the Control group, the FBG, HbA1c, body weight, TC, TG, LDL-C, ALT and AST in the Model group were significantly increased, while HDL-C was decreased. Compared with the Model group, the levels of FBG, HbA1c, body weight, TC, TG, LDL-C, ALT and AST in the Liraglutide group decreased by 60%, 32%, 20%, 19%, 22%, 39%, 26% and 28%, respectively, while HDL-C increased by 25%. In Tirzepatide group, FBG, HbA1c, body weight, TC, TG, LDL-C, ALT, and AST decreased by 69%, 40%, 30%, 31%, 35%, 57%, 46% and 38%, respectively, while HDL-C increased by 61%. HE staining and oil red O staining showed that compared with the Control group, the liver of the Model group showed obvious hepatocyte steatosis, balloon-like degeneration and vacuolization, and a large number of lipid droplets were accumulated in hepatocytes. Compared with the Model group, the hepatocyte steatosis and liver fat deposition of the two intervention groups were improved, and the effect of tirzepatide was better than that of liraglutide. Western blot and RT-PCR results showed that the protein expressions of IL-1β, IL-6, TNF-α, Fibronectin, Col-Ⅰ, and α-SMA in the Model group were significantly increased. The mRNA levels of IL-1β, IL-6, TNF-α, ASC, Caspase-1, Fibronectin, α-SMA, Col-Ⅰ, Col-IV, and TGF-β were significantly increased. After drug treatment, the expression levels of the above inflammatory factors and fibrosis mediators in the two groups were significantly decreased. Tirzepatide is more effective than liraglutide in improving the above indicators. Conclusions: The novel GLP-1/GIP dual receptor agonist tirzepatide can improve glucose and lipid metabolism disorders, reduce body weight, improve liver injury, reduce liver fat deposition, and delay liver inflammation and fibrosis in MAFLD mice, and its comprehensive efficacy is better than that of liraglutide, which may provide a new treatment for MAFLD.

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  • 收稿日期:2024-04-01
  • 最后修改日期:2024-08-02
  • 录用日期:2024-09-10
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