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Gut 55:1606-1616 doi:10.1136/gut.2005.076778
  • Liver

Naltrexone, an opioid receptor antagonist, attenuates liver fibrosis in bile duct ligated rats

  1. M R Ebrahimkhani1,
  2. S Kiani2,
  3. F Oakley3,
  4. T Kendall3,
  5. A Shariftabrizi2,
  6. S M Tavangar4,
  7. L Moezi2,
  8. S Payabvash2,
  9. A Karoon2,
  10. H Hoseininik2,
  11. D A Mann3,
  12. K P Moore5,
  13. A R Mani5,
  14. A R Dehpour2
  1. 1Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran, and the UCL Institute of Hepatology, Department of Medicine, Royal Free and University College Medical School, University College London, London, UK
  2. 2Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3Liver Group, Southampton General Hospital, University of Southampton, Southampton, UK
  4. 4Department of Pathology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  5. 5The UCL Institute of Hepatology, Department of Medicine, Royal Free and University College Medical School, University College London, London, UK
  1. Correspondence to:
    Professor K P Moore
    The UCL Institute of Hepatology, Department of Medicine, Royal Free and University College Medical School, University College London, Rowland Hill St, London NW3 2PF, UK; kmoore{at}medsch.ucl.ac.uk
  • Accepted 28 February 2006
  • Revised 20 February 2006
  • Published Online First 16 March 2006

Abstract

Aim: The aim of this study was to investigate the hypothesis that the opioid system is involved in the development of hepatic fibrosis.

Methods: The effect of naltrexone (an opioid receptor antagonist) on hepatic fibrosis in bile duct ligated (BDL) or sham rats was assessed by histology and hepatic hydroxyproline levels. Liver matrix metalloproteinase 2 (MMP-2) was measured by zymography, and α smooth muscle actin (α-SMA) and CD45 (leucocyte common antigen) by immunohistochemistry. The redox state of the liver was assessed by hepatic glutathione (GSH)/oxidised glutathione (GSSG) and S-nitrosothiol levels. Subtypes of opioid receptors in cultured hepatic stellate cells (HSCs) were characterised by reverse transcriptase-polymerase chain reaction, and the effects of selective δ opioid receptor agonists on cellular proliferation, tissue inhibitor of metalloproteinase 1 (TIMP-1), and procollagen I expression in HSCs determined.

Results: Naltrexone markedly attenuated the development of hepatic fibrosis as well as MMP-2 activity (p<0.01), and decreased the number of activated HSCs in BDL rats (p<0.05). The development of biliary cirrhosis altered the redox state with a decreased hepatic GSH/GSSG ratio and increased concentrations of hepatic S-nitrosothiols, which were partially or completely normalised by treatment with naltrexone, respectively. Activated rat HSCs exhibited expression of δ1 receptors, with increased procollagen I expression, and increased TIMP-1 expression in response to δ1 and δ2 agonists, respectively.

Conclusions: This is the first study to demonstrate that administration of an opioid antagonist prevents the development of hepatic fibrosis in cirrhosis. Opioids can influence liver fibrogenesis directly via the effect on HSCs and regulation of the redox sensitive mechanisms in the liver.

Footnotes

  • Published online first 16 March 2006

  • Conflict of interest: None declared.

  • This work was presented at EASL 2004, Berlin, and was awarded the best poster prize.