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缺血预处理和甲基强的松龙均能同等程度减轻肝脏缺血/再灌注损伤。

Ischemic preconditioning and methylprednisolone both equally reduce hepatic ischemia/reperfusion injury.

作者信息

Glanemann Matthias, Strenziok Romy, Kuntze Robert, Münchow Simone, Dikopoulos Nektarios, Lippek Frank, Langrehr Jan M, Dietel Manfred, Neuhaus Peter, Nussler Andreas K

机构信息

Department of General, Visceral, and Transplantation Surgery, Charité, Campus Virchow Klinikum, Humboldt University Berlin, Berlin, Germany.

出版信息

Surgery. 2004 Feb;135(2):203-14. doi: 10.1016/j.surg.2003.08.011.

Abstract

BACKGROUND

Ischemic preconditioning (I/P) and methylprednisolone (MP) have been suggested to protect against ischemia-reperfusion (IR) injury, which results in an increased tolerance against organ hypoxia.

METHODS

Before 45 minutes of hepatic ischemia, male Wistar rats were pretreated with either I/P (5/30 minutes) or MP (30 mg/kg BW). The degree of IR injury and the postischemic inflammatory (leukocyte infiltration, myeloperoxidase, intercellular adhesion molecule-1) and apoptotic (TUNEL, caspase 3, cytochrome C) activity was measured in both groups and compared with non-pretreated (ischemic) animals.

RESULTS

Histology and enzyme release revealed that I/P and MP treatment provided significant protection as compared with ischemic controls. TUNEL-positive cells, as well as caspase 3 and cytochrome C expression, were clearly reduced in hepatic tissue of MP-treated animals and partially reduced in I/P-treated animals when compared with ischemic animals. The inflammatory response was considerably reduced in MP- and I/P-treated animals, especially in the early period after ischemia. NF-kappaB/Rel-binding activity was increased after I/P and decreased in MP-treated animals, whereas ischemic controls showed a constant binding activity.

CONCLUSIONS

MP (probably by downregulation of NF-kappaB-binding activity) and I/P attenuated the postischemic apoptotic and inflammatory response. Both treatments equally reduced IR-related hepatocellular damage, and, thus, may also be applied equally in surgery involving warm organ hypoxia.

摘要

背景

缺血预处理(I/P)和甲基泼尼松龙(MP)已被证实可预防缺血再灌注(IR)损伤,从而提高器官对缺氧的耐受性。

方法

在45分钟肝脏缺血前,对雄性Wistar大鼠进行I/P(5/30分钟)或MP(30mg/kg体重)预处理。测量两组的IR损伤程度以及缺血后炎症(白细胞浸润、髓过氧化物酶、细胞间黏附分子-1)和凋亡(TUNEL、半胱天冬酶3、细胞色素C)活性,并与未预处理(缺血)动物进行比较。

结果

组织学和酶释放结果显示,与缺血对照组相比,I/P和MP治疗提供了显著的保护作用。与缺血动物相比,MP治疗动物肝组织中TUNEL阳性细胞以及半胱天冬酶3和细胞色素C表达明显降低,I/P治疗动物则部分降低。MP和I/P治疗动物的炎症反应显著降低,尤其是在缺血后的早期。I/P后NF-κB/Rel结合活性增加,MP治疗动物降低,而缺血对照组显示出恒定的结合活性。

结论

MP(可能通过下调NF-κB结合活性)和I/P减轻了缺血后的凋亡和炎症反应。两种治疗同样降低了IR相关的肝细胞损伤,因此,也可同样应用于涉及温暖器官缺氧的手术中。

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