Blocking P2X4 purinergic receptor attenuates alcohol-related liver fibrosis by inhibiting hepatic stellate cell activation through PI3K/AKT signaling pathway

Alcoholic liver fibrosis（ALF）, as a liver disease caused by long-term alcoholism, attracts international attention. Activation of hepatic stellate cells is a key step in the development of alcoholic-associated liver fibrosis. Increasing studies have shown that P2X4 receptor, as a component of purinoceptor family in adenosine pathway, plays an important role in numerous liver diseases. In this study, it was found that the expression of P2X4 receptor was significantly increased in the mouse liver fibrosis model fed with ethanol plus CCL4 and in the HSC-T6 cell model stimulated by acetaldehyde. In vivo, C57BL/6J mice were used to establish ALF models, and 5-BDBD, a specific inhibitor of P2X4 receptor, was injected intraperitoneally at 6-8 weeks of ALF development. The results indicated that 5-BDBD could reduce the expression of fibrotic markers and attenuate the pathological features of fibrosis, thus demonstrating the alleviation of ALF.In vitro, PI3K/AKT pathway was activated in HSC-T6 cells stimulated by acetaldehyde. Silencing P2X4 receptor or administration of 5-BDBD could inhibit the phosphorylation of PI3K and AKT, thereby inhibiting the activation of HSC-T6 cells. In addition, 5-BDBD was administered to RAW264.7 cells activated by acetaldehyde, and then part of the supernatant was added to HSC-T6 cells culture medium. The results showed that 5-BDBD could reduce the expression of classical inflammatory pathways such as TGF-β pathway in RAW267.4 cells, thus inhibiting the activation of HSC-T6 cells. Taken together, these results suggest that P2X4 receptors may influence the progression of alcohol-related liver fibrosis by directly mediating the PI3K/AKT pathway, or indirectly by influencing RAW264.7 cells to regulate hepatic stellate cell activation.