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LIVER |
1 Department of Surgery, Thomas E Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
2 Mirus Corporation, 505 S Rosa Rd, Madison, WI 53717, USA
3 Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
4 Department of Surgery, Thomas E Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA, and Department of Pathology, Veterans Administration Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Correspondence to:
Correspondence to:
Dr C R Gandhi
Thomas E Starzl Transplantation Institute, University of Pittsburgh, E-1540 BST, 200 Lothrop St, Pittsburgh, PA 15213, USA; Gandhics{at}msx.upmc.edu
Background and aims: Hepatic concentrations of the powerful vasoconstrictor and fibrogen endothelin 1 (ET-1) and its receptors increase in human and experimental cirrhosis, suggesting a major role for ET-1 in the pathology of chronic liver disease. We investigated whether ET-1 receptor antagonism, after the development of fibrosis and cirrhosis, arrests/reverses the progression of chronic liver disease.
Methods: Chronic liver injury was induced in rats by carbon tetrachloride (CCl4) treatment (0.15 ml/kg intraperitoneally twice a week) in conjunction with phenobarbital in drinking water (0.4 g/l) for four (group 1: fibrosis) and eight (group 2: cirrhosis) weeks. Rat were then treated concurrently with the ET-1 receptor antagonist TAK-044 (10 mg/kg/day) and CCl4/phenobarbital for a further four weeks.
Results: Histopathological examination revealed significant arrest of progression to cirrhosis in group 1 and reversal of cirrhosis in group 2 rats. TAK-044 treatment caused significant amelioration of portal hypertension, systemic hypotension, and liver injury (reduced activities of serum aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase), and improved hepatic synthetic capacity (increased serum albumin concentration) in both groups of rats relative to vehicle treated rats. TAK-044 treatment reduced collagen synthesis, as evidenced by decreased hepatic hydroxyproline content, mRNA expression of collagen-
type I, and tissue inhibitors of matrix metalloproteinases 1 and 2, and mRNA and protein expression of a potent fibrogenic cytokine, transforming growth factor ß1.
Conclusions: The results emphasise the role of ET-1 in the development of cirrhosis and strongly suggest that blockade of its actions can be a rational therapy for chronic liver disease and its complications.
Abbreviations: ET, endothelin; MAP, mean arterial pressure; MMP, matrix metalloproteinase; NO, nitric oxide; PAF, platelet activating factor; SMA, smooth muscle actin; TGF, transforming growth factor; TIMP, tissue inhibitors of metalloproteinases; CCl4, carbon tetrachloride; TGF-ß, transforming growth factor ß; 
-GT, -glutamyl transferase; LDH, lactate dehydrogenase; ALP, alkaline phosphatase; AST, aspartate aminotransferase; ALT, alanine aminotransferase; RT-PCR, reverse transcriptase-polymerase chain reaction; QRT-PCR, quantitative real time PCR; ECM, extracellular matrix
Keywords: liver; cirrhosis; fibrosis; endothelin; antagonist; receptor
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  J. A. Fallowfield, M. Mizuno, T. J. Kendall, C. M. Constandinou, R. C. Benyon, J. S. Duffield, and J. P. Iredale Scar-Associated Macrophages Are a Major Source of Hepatic Matrix Metalloproteinase-13 and Facilitate the Resolution of Murine Hepatic Fibrosis J. Immunol., April 15, 2007; 178(8): 5288 - 5295. [Abstract] [Full Text] [PDF]
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