Splenic artery ligation improves remnant liver function in partially hepatectomized rats with ischemia/reperfusion injury

Background: In liver resection, the temporary occlusion of the hepatoduodenal ligament (Pringle maneuver) is often used. However, the maneuver causes severe ischemia/reperfusion injury in the remnant liver. Our aim was to investigate the effects of splenic artery ligation on the liver function in partially hepatectomized rat with the Pringle maneuver. Methods: The Pringle maneuver was conducted for 30 min just before a two‐thirds partial hepatectomy. Splenic artery ligation was performed before the Pringle maneuver. The efficacy of splenic artery ligation was assessed by survival, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), recovery of remnant liver weight, and portal pressure. Results: On day 3, animal survival was four rats of 12 in partially hepatectomized rats with the Pringle maneuver and 10 rats of 12 in the splenic artery ligation‐treated partially hepatectomized rats with the Pringle maneuver. A two‐thirds partial hepatectomy alone or splenic artery ligation itself did not show any effects on the survival. Compared with partially hepatectomized rats with the Pringle maneuver, splenic artery‐ligated animals had lower serum AST and ALT levels, and higher recovery of remnant liver weight. Splenic artery ligation significantly reduced the portal pressure and also decreased the fatality in excessively hepatectomized rats. Conclusions: Splenic artery ligation ameliorated the remnant liver function in partially hepatectomized rats with the Pringle maneuver and excessively hepatectomized rats. The amelioration may be mediated at least by decreasing portal pressure.     

Sterile inflammation in hepatic ischemia/reperfusion injury: Present concepts and potential therapeutics

Ischemia and reperfusion (I/R) injury is an often unavoidable consequence of major liver surgery and is characterized by a sterile inflammatory response that jeopardizes the viability of the organ. The inflammatory response results from acute oxidative and nitrosative stress and consequent hepatocellular death during the early reperfusion phase, which causes the release of endogenous self‐antigens known as damage‐associated molecular patterns (DAMPs). DAMPs, in turn, are indirectly responsible for a second wave of reactive oxygen and nitrogen species (ROS and RNS) production by driving the chemoattraction of various leukocyte subsets that exacerbate oxidative liver damage during the later stages of reperfusion. In this review, the molecular mechanisms underlying hepatic I/R injury are outlined, with emphasis on the interplay between ROS/RNS, DAMPs, and the cell types that either produce ROS/RNS and DAMPs or respond to them. This theoretical background is subsequently used to explain why current interventions for hepatic I/R injury have not been very successful. Moreover, novel therapeutic modalities are addressed, including MitoSNO and nilotinib, and metalloporphyrins on the basis of the updated paradigm of hepatic I/R injury.     

Splenectomy-reduced hepatic injury induced by ischemia/reperfusion in the rat

Abstract: In the present study, we investigated the role of the spleen in experimental hepatic ischemia/reperfusion in the rat. After a 90-min period of ischemia in the left and middle hepatic lobes, the ischemia was released and the liver was reperfused for up to 24 h. Plasma alanine aminotransferase reached a peak 3 h after the onset of reperfusion, and gradually decreased thereafter. A histological examination revealed evidence of hepatocellular necrosis and degeneration, especially 24 h after the onset of reperfusion. In addition, there was a noticeable accumulation of polymorphonuclear cells in the liver following ischemia/reperfusion. A splenectomy performed just prior to ischemia/reperfusion reduced both biochemical and histological hepatocellular injury. The number of polymorphonuclear cells in the liver following ischemia/reperfusion was significantly reduced in rats subjected to splenectomy, suggesting that the increase in polymorphonuclear cells may contribute to liver injury. The number of mononuclear cells also increased in the marginal zones of the spleen following ischemia/reperfusion, and appeared to be derived from the splenic monocyte/macrophage population, based on immunohistochemical studies. The spleen plays an important role in the pathogenesis of hepatic ischemia/reperfusion injury and the splenic monocyte/macrophage population contributes to liver damage.     

The effects of intraportal administration of prostaglandin E1 on liver ischemia and hepatectomy in rats

The effects of intraportal administration of prostaglandin E₁ (PGE₁) on portal venous flow, hepatic arterial flow, peripheral tissue blood flow, and systemic arterial flow before and after 60 min total liver ischemia followed by 70% partial hepatectomy in rats were investigated. Total liver ischemia was induced by occluding the hepatoduodenal ligament for 60 min. PGE₁ at a dose of 0.5 μg/kg/min was infused intraportally for 15 min before inducing hepatic ischemia (preischemic period) and for 60 min after ischemia (postischemic reperfusion period) in the treatment group. Normal saline was infused in the control group. Seventy percent partial hepatectomy was performed during ischemia. Serum biochemical analysis and liver tissue histology were carried out 1, 3, and 24 h, and 1 and 24 h after reperfusion respectively. One-week survival of the PGE₁ group was improved to 70% compared to that of the control group of 30%. Postischemia reperfusion values of portal and peripheral tissue blood flows in the PGE₁ group were 6.33 ± 0.600 ml/min and 27.2 ± 23.5 (arbitrary), and were significantly different from those of the control group of 4.34 ± 0.400 ml/min and 23.5 ± 5.54 (arbitrary), respectively. There was no significant difference in hepatic arterial flow between the two groups. Serum alkaline phosphatase decreased significantly in the prostaglandin group. Histological examination revealed a significant portal venous congestion in the control group 1 and 24 h after reperfusion. The extent of the sinusoidal congestion was also severe in the control group 24 h after reperfusion. It was concluded that PGE₁ has a protective effect against liver damage when the liver was injured by warm ischemia and reperfusion followed by partial resection.     

Plasma-kallikrein clearance during liver regeneration after partial hepatectomy in the rat

Abstract: Aims/Background: The liver clears circulating plasma-kallikrein through a receptor-mediated endocytosis process: an initial fast phase is followed by a slow exponential phase. Methods: To determine whether the clearance rate of plasma-kallikrein is affected during liver regeneration, we perfused isolated rat livers with rat plasma-kallikrein (rPK) at 0, 1, 2, 3 and 7 days after partial hepatectomy or sham operation. Results: Liver regeneration was followed by the expression of the proliferating-cell nuclear antigen (PCNA) labeling index. The serum concentration of α₂-macroglobulin, an acute phase protein in rats, was measured. At day 1, the fast phase of rPK clearance rate increased in hepatectomized rats when compared with day 0 (4.9±0.4 and 3.7±0.4 mU/g liver · min, p<0.05). However, at day 2, the rPK fast phase clearance rate dropped significantly (2.6±0.2, p<0.05), when compared with day 1. No difference was found among the sham groups at different days of hepatectomy. These changes seem to be independent of the acute phase reaction. The regenerative liver weight increased continuously during the observation period. PCNA expression increased significantly after hepatectomy, with maximal PCNA-labeling indices at days 1 and 2, declining thereafter. Conclusion: The rPK fast phase clearance rate changes during liver regeneration, with a zenith occurring when PCNA labeling index is maximal (day 1) and a nadir occurring at the mitotic phase (day 2).     

Kinetic changes of liver regeneration and hepatocellular carcinoma cells after partial hepatectomy in rats

We investigated, using rats, the effect of partial hepatectomy (PH) on hepatocellular carcinoma (HCC, KDH-8 and AH-66) cells, and the effect of HCC cells on the regeneration of remaining hepatocytes after PH. Our results showed that PH significantly enhanced the growth of HCC cells in rats. Tumor volume increased more significantly in the partially hepatectomized group (H-group) than in the control group, and the tumor wet weights on the 14th postoperative day were significantly higher in the H-group than in the control group. Such an enhanced growth effect of PH on the injected (s.c) HCC cells was related to an abrupt increase of tumor volume within 24 hours after operation, which was supported by the mitotic indices (MI) of the KDH-8 cells. These phenomena of the enhanced growth of the HCC cells following PH were not observed at all in rats injected with estrogen receptor (ER)-negative mammary carcinoma (SST-2) or nonepithelial fibrosarcoma (KMT-75) cells. The MIs of the remaining hepatocytes after PH increased abruptly at the 30th postoperative hour and reached a maximum at the 36th postoperative hour, and the MIs were significantly higher in the H-group with the KDH-8 cells than in the H-group without them from the 42th to the 60th postoperative hour. In the control group, the MIs of hepatocytes were not regardless of the presence of KDH-8 cells. From these results, we speculate that some growth factor(s) induced by PH may act on injected (s.c.) HCC cells, and that the other growth factor(s) secreted by HCC cells may act on the regenerating hepatocytes after PH. This work was supported in part by a grant from the Japanese Ministry of Education. Science and Culture.     

心肌缺血/再灌注损伤后的肺组织损伤

目的初步探讨心肌缺血／再灌注损伤对肺组织损伤的可能机制。方法选取雄性成年SD大鼠（4～6月龄）,体重130～160g,建立成年大鼠缺血／再灌注模型。运用CK和MPO试剂盒检测肌酸激酶（CK）和髓过氧化物酶（MPO）的含量,运用双抗体夹心ABC—ELISA法检测细胞间黏附分子-1（ICAM-1）的含量。结果与伪手术组相比,缺血／再灌注大鼠的AN／AAR比值明显增高（P〈0．05）,CK在心肌缺血／再灌注大鼠血清中的含量明显升高（P〈0．05）,MPO与ICAM-1在心肌缺血／再灌注组大鼠血清和肺组织中含量明显升高（P〈0．05）。结论大鼠心肌缺血再灌注损伤后肺组织受到一定的损伤,可能与体循环中炎性介质的作用及肺组织的炎性应激有关。     

Splenic artery ligation ameliorates hepatic ischemia and reperfusion injury in rats.

BACKGROUND/AIMS: Hepatic injury caused by ischemia/reperfusion (I/R) is a key clinical problem associated with liver transplantation and liver surgery. The spleen is involved in hepatic I/R injury. In this study, we examined the effects of splenic artery ligation on hepatic I/R injury. METHODS: Splenic artery ligation was performed 7 days, 3 days, or just before the hepatic ischemia. Hepatic ischemia was conducted by occluding the blood vessels to the median and left lateral lobes with an atraumatic vascular clamp. Hepatic I/R injury was induced by 45 min of ischemia followed by 120 min of reperfusion. RESULTS: When splenic artery ligation was performed at 3 days or just before the ischemia, serum aspartate transaminase and alanine transaminase activities, as markers for hepatic injury, decreased as compared with the rats with I/R alone. Splenic artery ligation also reduced the myeloperoxidase activity, an enzyme present in neutrophils, and the expression of interleukin-6 mRNA, a proinflammatory cytokine, in rat livers with I/R. Efficacy of splenic artery ligation on hepatic I/R injury was also confirmed by histology. On the other hand, when splenic artery ligation was conducted 7 days before the ischemia, efficacy of splenic artery ligation was disappeared. CONCLUSIONS: Splenic artery ligation ameliorates hepatic I/R injury in rats. These results strongly suggest the clinical usefulness of this surgical procedure to protect the liver against I/R injury.     

大鼠脑缺血/再灌注损伤后血管内皮细胞生长因子的表达

目的　探讨大鼠局灶性脑缺血 /再灌注后脑组织内血管内皮细胞生长因子 (VEGF)的表达及意义。方法　制备大鼠局灶性脑缺血再灌注模型 ,应用免疫组化 S- P法检测 VEGF蛋白的表达。结果　缺血再灌注损伤后 VEGF表达增加 ,随再灌注时间的延长 ,在缺血灶周边区 ,阳性表达的小血管数量明显增多。结论　脑缺血再灌注损伤可以诱导 VEGF表达增强 ,VEGF可促进毛细血管增生。     

Melatonin abates liver ischemia/reperfusion injury by improving the balance between nitric oxide and endothelin

Introduction Melatonin (5-methoxy-N-acetyltryptamine) is a naturally occurring hormone derived from the amino acid tryptophan andproduced mainly by the pineal gland (pinealocytes) in the brain as well as in the retina and gastrointestinal tract. Although the major role of melatonin is in the sleep-wake cycle through its circadian fluctuation, a large body of literature has recently demonstrated that melatonin also exerts complex physiological and pharmacological effects on multiple systems and…     

Effect of serotonin receptor 2 blockage on liver regeneration after partial hepatectomy in the rat liver.

The effect of serotonin receptor 2 blockade (5-HT(2)) on liver regeneration after 30-34% and 60-70% partial hepatectomy in the rat liver was investigated. Materials and methods: Male Wistar rats were subjected to 60-70% (group I) and 30-34% (group II) partial hepatectomy. Serotonin receptor 2 blockade was exerted by intraperitoneal administration of ketanserin at different doses and time points after partial hepatectomy. The rats of all groups were killed at different time points until 96 h after partial hepatectomy. The rate of liver regeneration was evaluated by the mitotic index in hematoxylin and eosin sections, the immunochemical detection of Ki67 and proliferating cell nuclear antigens, the rate of [(3)H]-thymidine incorporation into hepatic DNA and liver thymidine kinase enzymatic activity. Results: Liver regeneration peaked at 24 and 32 h after partial hepatectomy in 60-70% hepatectomized rats. In 30-34% hepatectomized rats liver regeneration peaked at 60 h, whereas low rates of regenerative activity were observed between 24 and 72 h after partial hepatectomy. Ketanserin administration arrested liver regeneration only when administered at 16 h after 60-70% partial hepatectomy. Ketanserin also abrogated the observed peak of regenerative activity at 60 h in 30-34% hepatectomized rats when administered at 52 h after partial hepatectomy. All indices of liver regeneration were affected by ketanserin administration. Conclusions: Serotonin receptor 2 blockade can arrest liver regeneration only when administered close to G1/S transition point, and that while serotonin may be a cofactor for DNA synthesis, it does not play a role in initiation of liver regeneration.     

曲美他嗪后处理对心肌缺血再灌注损伤大鼠细胞凋亡的保护性作用

目的研究曲美他嗪后处理对大鼠急性心肌缺血再灌注损伤后细胞凋亡的影响。方法实验大鼠40只,随机分为5组：假手术组（n＝8）、再灌注损伤模型组（n＝8）、曲美他嗪低剂量组（10mg/kg,n＝8）、曲美他嗪高剂量组（20mg/kg, n＝8）,后处理组（n＝8）。制作再灌注损伤模型后,观察各组大鼠心肌梗死面积、Bcl2/bax蛋白表达以及电子显微镜下心肌组织切片观察。结果（1）各组大鼠心肌梗死面积测定：假手术组未见梗死,其余各组大鼠心肌组织不同程度梗死,以后处理组及曲美他嗪高剂量组最轻,差异具有统计学意义（P＜0.01）。（2）各组大鼠Bcl2/Bax蛋白表达比较：在模型组中Bax蛋白强阳性表达,表现为软件分析结果灰度值最低。而曲美他嗪高剂量组及后处理组灰度值较模型组比较灰度值明显增大（P＜0.01）。Bcl2蛋白在模型组中表达较少,在曲美他嗪高剂量组中及后处理组中明显表达,且差异具有统计学意义（P＜0.01）。（3）电子显微镜下观察：除假手术组大鼠外,各组大鼠均有不同程度损伤及细胞凋亡,后处理组及曲美他嗪高剂量组损伤较轻。结论高剂量曲美他嗪（20mg/kg）对大鼠心肌缺血再灌注损伤后细胞凋亡有抑制作用。     

Allopurinol improves scavenging ability of the liver after ischemia/reperfusion injury

Abstract: Deterioration of energy metabolism and oxidative stress represent fundamental mechanisms in ischemia and reperfusion injury. In a normothermic ischemia/reperfusion rat model, we investigated whether allopurinol (ALL) may improve the scavenging ability of the liver after ischemia. ALL was given prior to ischemia and reperfusion (concentration 100 or 50 mg/kg) and controls were given a placebo. After a basal period of 30 min, 1 h normothermic ischemia was induced in the median and left liver lobes followed by 24 h observation. The overall liver function was assessed by bile secretion, and free oxygen production was assessed by glutathione efflux into bile during the first 60 min of reperfusion and at 24 h. Allopurinol (concentration 100 mg/kg) protected hepatocyte function as bile flow improved significantly in this group after 1 and 24 h of reperfusion compared with that of controls. Oxidative stress was also significantly attenuated in this group, as efflux of glutathione into bile was significantly higher in the ALL group (100 mg/kg) after 24 h but not after 1 h of reperfusion compared with that of controls. ALL given in a concentration 50 mg/kg had some, but a non-significant, effect. We conclude that biliary glutathione is an important marker of oxidative stress and may reflect the scavenging ability of the liver after ischemic injury. Significant correlation of bile flow with biliary glutathione during reperfusion indicates that oxidative stress is an important mechanism attenuating liver function after ischemia/reperfusion injury.