Protective effect of IGF-1 on experimental liver cirrhosis-induced common bile duct ligation

BACKGROUND/AIMS: The causes of malnutrition in liver cirrhosis are multifactorial. Levels of IGF-1 (insulin like growth factor-1) that is a crucial regulator of intermediary metabolism decreases. The aim of this study was to analyze the effect of IGF-1 supplementation during liver cirrhosis induced by common bile duct ligation. METHODOLOGY: Rats were divided into five different groups: One sham and four experimental groups. Rats in three of four groups were treated with 2 micrograms/day IGF-1 with a different time of experiment in each group. Blood biochemical parameters, tissue malondialdehyde, glutathione levels and the activity of tissue antioxidant enzymes and conventional and immunohistochemical analysis of liver samples were studied for each group. RESULTS: Serum albumin, total protein, fibrinogen levels decreased and prothrombin time was prolonged in the bile duct ligated and transected experimental group but not in the IGF-I treated rats compared with the rats in sham group. Liver malondialdehyde levels significantly increased in control group but not in IGF-1 treated groups. The activities of antioxidant enzymes were decreased compared with the other groups. Histopathology findings of liver biopsy demonstrated intense degree fibrosis and overexpression of fibroblast growth factor and desmin in the control group but a lesser degree of those in the IGF-1 treated groups. CONCLUSIONS: IGF-1 treatment improves liver function and decreases oxidative liver damage and histopathological findings. Further studies are required to delineate the mechanisms of protective effects of IGF-1.     

The effect of bile duct ligation, bile duct cannulation, and hypothermia on alpha-naphthylisothiocyanate-induced hyperbilirubinemia and cholestasis in rats

The hyperbilirubinemic and cholestatic responses to alpha-naphthylisothiocyanate (ANIT) in the rat were altered by subjecting test animals to various environmental and surgical manipulations. Studies utilizing hypo- and hyperthermic conditions showed that a positive correlation exists between the rectal temperature and the effects of ANIT. In addition, it was observed that ANIT produced an apparent poikilothermic response, in that treated rats were unable to maintain normal rectal temperatures. Bile duct ligation inhibited the cholestatic and altered the hypothermic responses to ANIT treatment. Cannulation of the bile duct prior to ANIT administration significantly inhibited the hyperbilirubinemia and cessation of bile flow. These data demonstrate the importance of an intact enterohepatic circulation and normal body temperature in the actions of ANIT. The effect of the various parameters on the ANIT-induced hyperbilirubinemia and cholestasis suggests the involvement of a biotransformation product of ANIT.     

Ketorolac pharmacokinetics in experimental cirrhosis by bile duct ligation in the rat

The purpose of the present work was to study the pharmacokinetics of ketorolac, a poorly metabolized drug, in experimental cirrhosis. Cirrhosis was induced by bile duct ligation (BDL) for four weeks in male Wistar rats. Ketorolac was given intravenously (1 mg/kg ) or orally (3.2 mg/kg) to control (sham-operated) and BDL-rats. Determination of ketorolac in plasma was carried out by HPLC and estimation of pharmacokinetic parameters was performed by non-compartmental analysis. Indicators of liver damage and liver fibrosis were significantly increased (p < 0.05) in BDL compared to control rats. Experimental cirrhosis did not induce any significant alteration in intravenous ketorolac pharmacokinetics. Volume of distribution, clearance, AUC and t1/2 were similar in BDL and control animals. Notwithstanding, oral ketorolac bioavailability was significantly altered in BDL rats. AUC and Cmax were reduced, while tmax was prolonged, suggesting that both, the extent and the rate of ketorolac absorption were decreased. Results show that liver cirrhosis may result in significant pharmacokinetic alterations, even for poorly bio-transformed drugs, but that alterations may vary with the route of administration. In conclusion, uncritical generalizations on the effect of liver damage on drug kinetics should be avoided and systematic studies for every drug and every route of administration are thus recommended.     

Antifibrotic effect of N-acetyl-seryl-aspartyl-lysyl-proline on bile duct ligation induced liver fibrosis in rats

AIM:To investigate the preventive effect of N-acetyl-seryl-aspartyl-lysyl-proline (AcSDKP) on bile duct ligation (BDL)induced liver fibrosis in rats. METHODS:Liver fibrosis in rats was induced by BDL and AcSDKP was infused subcutaneously for 2 wkvia a osmotic minipump (Alzet 2ML4) immediately after BDL operation. After scarifying, serum and liver specimens were collected. Hematoxylin and eosin staining, Sirius red staining, enzyme linked immunosorbent assay, Western blot or real-time polymerase chain reaction were used to determinate liver functions, histological alterations, collagen deposition, mRNA expression of markers for fibroblasts, transforming growth factor-β1 (TGF-β1) and bone morphogenetic protein-7 (BMP-7). RESULTS:When compared to model rats, chronic exogenous AcSDKP infusion suppressed profibrogenicTGF-β1 signaling, α-smooth muscle actin positivity (α-SMA), fibroblast specific protein-1 (FSP-1) staining and collagen gene expression. Col Ⅰ, Col Ⅲ, matrix metalloproteinase-2, tissue inhibitors of metallopro-teinase-1 and tissue inhibitors of metalloproteinase-2 mRNA expressions were all significantly downregulated by AcSDKP infusion (2.02 ± 1.10vs 14.16 ± 6.50, 2.02 ± 0.45vs 10.00 ± 3.35, 2.91 ± 0.30vs 7.83 ± 1.10, 4.64 ± 1.25 vs 18.52 ± 7.61, 0.46 ± 0.16 vs 0.34 ± 0.12, respectively, P 0.05). Chronic exogenous AcSDKP infusion attenuated BDL-induced liver injury, inflammation and fibrosis. BDL caused a remarkable increase in alanine transaminase, aspartate transaminase, total bilirubin, and prothrombin time, all of which were reduced by AcSDKP infusion. Mast cells, collagen accumulation, α-SMA, TGF-β1, FSP-1 and BMP-7 increased. The histological appearance of liver specimens was also improved. CONCLUSION:Infusion of exogenous AcSDKP attenu-ated BDL-induced fibrosis in the rat liver. Preservation of AcSDKP may be a useful therapeutic approach in the management of liver fibrosis.     

Abdominal operations: effect on subsequent experimental faecal peritonitis

Rats were subjected to laparotomy, anaesthesia only (controls), laparotomy plus 1-cm-segment ileum isolation, or no treatment (controls) and were challenged with endogenous faecal peritonitis 1 and 2 weeks later, respectively. Survival rates were 40% for the laparotomy group and 100% for the ileum isolation group, whereas all controls died. The number of peritoneal leucocytes, particularly macrophages and neutrophils, was significantly (p less than 0.05) higher in the laparotomy group than in the control group. The data show that abdominal operations alone--and especially in combination with a minor infectious challenge--entail an increased tolerance to subsequent peritonitis, possibly mediated by the previously stimulated and sensitized leucocytes.     

Transabdominal ligation of the thoracic duct as treatment of choice for postoperative chylothorax after esophagectomy

Postoperative chylothorax after injury of the thoracic duct during esophagectomy is a rare but severe complication which may lead to serious problems such as loss of fat and proteins, and immunodeficiency. Without treatment mortality can rise to over 50%. From 1988 to 2005, we treated 10 patients with postoperative chylothorax after 409 resections of the esophagus (2.4%). Of these 10 patients nine underwent transthoracic esophagectomy with gastric pull-up to enable an intrathoracic (n = 7) or cervical (n = 2) anastomosis and one patient received a transhiatal esophagectomy with gastric pull-up and cervical anastomosis. The average amount of postoperative chylus was 2205 mL (200-4500 mL) per day. After a median postoperative interval of 10 days, relaparotomy and transhiatal double ligation of the thoracic duct was performed in nine out of 10 patients. One patient could be managed conservatively. The average amount of chylus was reduced to 151 mL per day (90.5%). Seven patients had no complications, and three suffered from postoperative pneumonia. Two of the patients with pneumonia recovered, and one died. Discharge from hospital, after ligation of the thoracic duct, was possible after a median time of 18 days (11-52). Ligation of the thoracic duct via relaparotomy appeared to be a simple and safe method to treat postoperative chylothorax.     

Protective effect of misoprostol, a synthetic prostaglandin E1 analog, on experimental pancreatitis induced by pancreatic duct ligation in rat

This study was performed to assess the effects of misoprostol (M), a synthetic prostaglandin E1 analog, on experimental pancreatitis in rat. Pancreatitis was induced by ligation of the main pancreatic duct of 3-month-old male Wistar rats. Pancreatic lesions were observed at 6, 12, 24, 48, and 96 h after pancreatic duct ligation (PDL). A time of 48 h was chosen to evaluate M treatment. M was injected intraperitoneally (500 micrograms/kg every 4 h) between time 0 and 48 h after PDL. Stereological analysis was performed on light and electron microscopy. Total pancreatic amylase and chymotrypsin concentrations were determined. Four groups of five rats were studied: sham operated (SO), M without PDL (PG), duct ligation without M (DL), and duct ligation with M (DLPG). Edema, dedifferentiation of pancreatic acinar cells, and heterogeneous distribution of zymogen granule diameters observed after PDL were significantly decreased by M in the DLPG group. Enzyme concentrations were also decreased by M in the DLPG group. Enzyme concentrations were also decreased by M both in normal (PG) and duct ligated rats (DL). M has protective effects against pancreatic lesions induced by PDL. In this model, the protective effect of M may be due to a blockade of the autodigestive secretions of the pancreatic acinar cells.     

狗肝硬化门脉高压症血浆儿茶酚胺浓度变化的实验研究

本研究通过结扎狗胆总管形成肝硬化门脉高压症的动物模型,对模型形成前后门静脉压力、肝静脉压力、门静脉血流量、肝动脉血流量、门静脉血管阻力,肝动脉血管阻力和门静脉、肝静脉、腹主动脉。下腔静脉四部位血浆儿茶酚胺浓度的变化进行了自身对照性对比研究。结果:①肝硬化形成后门脉压力明显增高,肝静脉嵌塞区也明显增高,门脉血流量减少而肝动脉血流量增加,门脉血管阻力增加而肝动脉血管阻力则下降。这些变化与人类肝硬化门脉高压症相同。②门静脉、肝静脉。腹主动脉和下腔静脉血浆去甲肾上腺素的含量均在门脉高压形成后明显增加。提示肝硬化时血浆去甲肾上腺素的增加可能参与门脉高压症的某些病理生理过程,并进一步支持用 a 受体阻滞剂降低门脉压力和门脉血管阻力,治疗肝硬化食道静脉曲张破裂出血或预防出血。     

The effect of thoracic duct drainage on lymphocyte dynamics and clinical symptoms in patients with rheumatoid arthritis

Thoracic duct drainage (TDD) was performed in 4 patients with severe rheumatoid arthritis. Clinical effects were apparent in all during drainage, but the term of TDD and the cumulative number of lymphocytes drained had no direct relation to the improvement of clinical symptoms. The number of lymphocytes in the peripheral blood increased despite discharge of lymphocytes from the thoracic duct in the very early stage of drainage, suggesting that lymph drainage from thoracic duct accelerates migration of lymphocytes from lymphocyte pools to the blood stream. Biopsy specimens of synovial membranes obtained post-TDD showed marked decrease of mononuclear cell infiltration as compared to the specimens obtained preoperatively. These findings suggest that clinical effectiveness may be due not only to systemic immunosuppression induced by lymphocyte depletion but also to accelerated migration of inflammatory cells from the synovial tissues to the blood stream occurring with dynamic change of lymph flow during TDD.     

新型生长抑素类似物SOM230减轻胆总管结扎大鼠肝纤维化

目的 应用胆总管结扎大鼠肝纤维化模型,观察长效生长抑素类似物SOM230对胆管结扎所致大鼠肝纤维化的治疗作用.方法 雄性SD大鼠80只,随机分为模型组、高剂量预防组(80 mg/kg SOM230)、低剂量预防组(8 mg/kg SOM230)、假手术组及正常对照组.分别在术后第2周和第4周取心脏血及肝组织,观察肝组织...     

The role of intestinal endotoxin in experimental peritonitis

Escape of endotoxin from the intraintestinal site was investigated in experimental models of intestinal ischemia and during intraabdominal infection in rats. Following the instillation of Salmonella abortus equi endotoxin (S-form) into the proximal large bowel, we recorded the presence of the lipopolysaccharide molecule in the bowel wall, the intestinal lymph nodes, the peritoneal cavity, and in the liver sinusoids by immunohistochemical methods. At 3, 6, 12, 24, and 48 hr after the operative procedure, peritoneal fluid, blood, and tissue samples were taken. Survival rates were similar between the two test-groups (occlusion of the superior mesenteric artery [SMA] and cecal ligation and puncture [CLP]) and were not influenced by the amount of the injected endotoxin. There was no detectable morbidity in the sham-operated control animals with endotoxin doses up to 20 mg. Endotoxin could only be detected at 24 and 48 hr in the SMA group in the liver as well as in the peritoneal sediment and in intestinal lymph nodes. CLP and control samples remained negative throughout the observation period. Bacteria were found intraperitoneally within 12 to 24 hr in the SMA group and within 3 to 12 hr in the CLP group.     

硬化性腹膜炎的动物实验研究

本文用大鼠建立持续腹膜透析（ＣＡＰＤ）实验模型，模拟ＣＡＰＤ中长期接触生物不相容物质所致的腹膜硬化关系。结果表明，乳酸盐透析液有较好的生物相容性，醋酸盐透析没有肯定的致腹膜硬化作用。单纯高糖高渗透析液也有致腹膜硬化的作用。若伴有细菌感染以及消毒液（如碘液）污染透析液，则可加重腹膜损伤和硬化程度，并对临床上防治硬化性腹膜炎的措施进行了探讨。     

Melatonin exerts a therapeutic effect on cholestatic liver injury in rats with bile duct ligation

We examined whether melatonin exerts a therapeutic effect on cholestatic liver injury in rats treated with bile duct ligation (BDL). Cholestatic liver injury was induced in male Wistar rats aged 4 wk by ligating the bile duct. Cholestatic liver injury developed 5 days after BDL and continued to 13 days, judging from the levels of serum hepatobiliary injury markers. The serum concentration of thiobarbituric acid reactive substances (TBARS), an index of lipid peroxidation, and the hepatic level of TBARS and the activity of hepatic myeloperoxidase, an index of tissue neutrophil infiltration, increased 5 days after BDL, and these increases were enhanced at 13 days. A similar increase in the serum total cholesterol concentration occurred 5 and 13 days after BDL, while the hepatic cholesterol concentration tended to increase at 13 days. When melatonin [10 or 100 mg/kg body weight (BW)] was orally administered to BDL-treated rats everyday for 8 days, starting 5 days after BDL, the indoleamine attenuated cholestatic liver injury observed at 13 days after BDL was more effective at the higher dose than at the lower dose. The administered melatonin (10 or 100 mg/kg BW) reduced the increases in serum and hepatic TBARS concentrations and hepatic myeloperoxidase activity observed at 13 days after BDL and the higher dose of indoleamine was more effective than the lower dose. Neither dose of melatonin affected the increased serum total cholesterol concentration or the hepatic cholesterol concentration observed at 13 days after BDL. These results indicate that orally administered melatonin at pharmacological doses exerts a therapeutic effect on cholestatic liver injury in rats with BDL possibly through its antioxidant and anti-inflammatory actions.     

Qualitative and quantitative changes in thoracic duct lymph during canine experimental shock.

Changes of the body fluid exchange and of the composition of metabolites in the hepatosplanchnic area in canine hemorrhagic and endotoxin or septic shock models were studied by investigating the qualitative and quantitative changes in thoracic duct lymph draining from abdominal organs. In the present study, it might be summarized that the changes in the flow rate and composition of thoracic duct lymph were put forward to much more directly and apparently indicate the degree of hepatosplanchnic cellular impairment in canine experimental shock than in the circulating blood.