血红素氧合酶-1在临床肝移植中肝脏保护作用的研究

目的 研究移植肝脏血红素氧合酶(HO-1)表达水平与缺血再灌注损伤和移植术后肝脏功能的关系.方法 研究28例人类临床原位肝脏移植,根据供肝血红素氧合酶(HO-1)表达的平均值将供肝分为两组:移植前供肝HO-1高表达组和移植前供肝HO-1低表达组.比较两组移植术后血浆AST、ALT水平、胆汁中胆盐含量以及术前术后HO-1 mRNA和蛋白表达情况.结果 再灌注后移植术前HO-1低表达组的HO-1 mRNA表达显著增加,而高表达组HO-1 mRNA表达却有所下降.肝脏移植后,术前HO-1低表达组与高表达组相比,血浆转氨酶显著降低,胆汁中胆盐含量明显高于后者.结论 移植术前HO-1低表达组供肝在再灌注过程中能够进一步诱导HO-1表达,与高表达组供肝相比其所遭受的缺血再灌注损伤较轻,移植术后肝脏功能较好.移植过程中HO-1表达的增强要比移植前HO-1高表达更具有细胞保护作用.免疫荧光染色证实枯否细胞是人类肝脏表达HO-1的主要部位.

Protecting function of heme oxygenase-1 in human liver transplantation

Objective To explore the relation of donor liver's heme oxygenase-1 level to ische-mia/reperfusion injury and the liver function after liver transplantation. Methods Twenty-eight pa-tients receiving orthotopic liver transplantation (OLT) were divided into two groups according to the donor liver's heme oxygenase level of high HO-1 expression group and low HO-1 expression group.The recipients' serum levels of ALT, AST, bile salt output and the expression of HO-1 mRNA were determined and compared between the 2 groups. Results HO-1 mRNA of low expression group in-creased significantly after the reperfusion. Meanwhile, the HO-1 mRNA of high expression group de-creased. The serum levels of ALT and AST of HO-1 in low expression group were much lower but bile salt concentration higher than those in high expression group. Conclusion HO-1 can be further induced in the liver of HO-1 low expression group during the reperfusion period. The I/R injury in the HO-1 low expression group was less severe than that in high expression group, but the liver function was better. The increase of HO-1 during the transplantation seems better for protecting the liver than the initial HO-1 high expression. Kupffer cells are of the main localization for HO-1 protein in human liver.