Kuebler J F, Jarrar D, Wang P, Bland K I, Chaudry I H
Center for Surgical Research, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama 35294-0019, USA.
J Surg Res. 2001 May 15;97(2):196-201. doi: 10.1006/jsre.2001.6155.
Recent studies have shown that administration of the sex steroid dehydroepiandrosterone (DHEA) in males following trauma-hemorrhagic shock has salutary effects on the depressed cardiovascular and immunological functions under those conditions. Since the effects of sex steroids are gender specific, we examined whether administration of DHEA has any beneficial effects on hepatocellular function in female rats with low estrogen levels following trauma-hemorrhage.
Ovariectomy was performed in female Sprague-Dawley rats 14 days prior to the experiments. The animals then underwent a 5-cm midline laparotomy and were subjected to hemorrhagic shock (40 mm Hg for 90 min). This was followed by fluid resuscitation (Ringer's lactate over 60 min) and administration of DHEA (30 mg/kg BW) or vehicle subcutaneously at the end of resuscitation. At 24 h after resuscitation hepatocellular function, i.e., clearance of indocyanine green (ICG), and hepatocyte damage (serum alanine aminotransferase) were measured. Plasma levels of DHEA and 17beta-estradiol were also assayed.
Vehicle-treated rats had significantly reduced hepatocellular function, increased ALT activity, and decreased levels of 17beta-estradiol following trauma-hemorrhage compared to sham-operated animals (P < 0.05, ANOVA and Student-Newman-Keuls test). In animals receiving DHEA following trauma-hemorrhage, hepatocellular function and ALT activity were similar to those of shams. However, administration of DHEA did not influence the plasma levels of 17beta-estradiol.
Administration of DHEA following trauma-hemorrhage restored hepatocellular function and reduced hepatic damage that was observed in ovariectomized female rats under such conditions. This salutary effect of DHEA did not appear to be due to elevated levels of plasma 17beta-estradiol. We therefore propose that DHEA should be considered a novel, safe, and useful adjunct in the treatment of trauma-induced hepatocellular dysfunction in ovariectomized and postmenopausal females.
最近的研究表明,创伤性失血性休克后给雄性大鼠施用性类固醇脱氢表雄酮(DHEA),对该情况下受抑制的心血管和免疫功能具有有益作用。由于性类固醇的作用具有性别特异性,我们研究了给创伤性出血后雌激素水平低的雌性大鼠施用DHEA是否对肝细胞功能有任何有益影响。
在实验前14天对雌性Sprague-Dawley大鼠进行卵巢切除术。然后对动物进行5厘米中线剖腹术,并使其遭受失血性休克(40毫米汞柱,持续90分钟)。随后进行液体复苏(60分钟内输注乳酸林格氏液),并在复苏结束时皮下施用DHEA(30毫克/千克体重)或赋形剂。复苏后24小时测量肝细胞功能,即吲哚菁绿(ICG)清除率,以及肝细胞损伤(血清丙氨酸转氨酶)。还测定了血浆中DHEA和17β-雌二醇的水平。
与假手术动物相比,创伤性出血后接受赋形剂治疗的大鼠肝细胞功能显著降低,ALT活性增加,17β-雌二醇水平降低(P < 0.05,方差分析和Student-Newman-Keuls检验)。创伤性出血后接受DHEA治疗的动物,其肝细胞功能和ALT活性与假手术动物相似。然而,施用DHEA并未影响血浆中17β-雌二醇的水平。
创伤性出血后施用DHEA可恢复卵巢切除雌性大鼠在这种情况下观察到的肝细胞功能,并减少肝损伤。DHEA的这种有益作用似乎并非由于血浆17β-雌二醇水平升高。因此,我们建议DHEA应被视为治疗卵巢切除和绝经后女性创伤性肝细胞功能障碍的一种新型、安全且有用的辅助药物。