Oreopoulos George D, Wu Heshui, Szaszi Kati, Fan Jie, Marshall John C, Khadaroo Rachel G, He Ruijan, Kapus Andras, Rotstein Ori D
Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada.
Hepatology. 2004 Jul;40(1):211-20. doi: 10.1002/hep.20281.
Ischemia/reperfusion (I/R) of the liver occurs in many clinical scenarios including trauma, elective surgery, and transplantation. Events initiated by this process can lead to inflammation in the liver, culminating in local injury as well as distant organ dysfunction. Recent studies have suggested that hypertonic saline exerts anti-inflammatory effects, which may be beneficial in preventing organ injury. In the present study, we examine the effect of hypertonic saline on the development of liver inflammation following I/R in both rat and mouse models. Hypertonic pretreatment was shown to prevent liver enzyme release concomitant with a reduction in liver neutrophil sequestration. Hypertonic saline appeared to exert this effect by inhibiting liver tumor necrosis factor alpha (TNF-alpha) generation, an effect that culminated in reduced liver adhesion molecule expression. Hypertonic saline pretreatment was shown to augment liver interleukin 10 (IL-10) expression following I/R, as a potential mechanism underlying its anti-inflammatory effect. To examine the role of IL-10 in the protective effect of hypertonic saline on liver I/R injury, we used a murine model of I/R. In wild type mice, hypertonic pretreatment similarly prevented liver injury induced by I/R. However, in IL-10 knockout animals, hypertonic pretreatment was unable to prevent the liver enzyme release, TNF-alpha generation, or neutrophil sequestration induced by I/R. In conclusion, these findings define a novel mechanism responsible for the anti-inflammatory effects of hypertonic saline and also suggest a potential clinical role for hyperosmolar solutions in the prevention of liver injury associated with I/R.
肝脏缺血/再灌注(I/R)发生于多种临床情况,包括创伤、择期手术和移植。这一过程引发的事件可导致肝脏炎症,最终造成局部损伤以及远处器官功能障碍。最近的研究表明,高渗盐水具有抗炎作用,这可能有助于预防器官损伤。在本研究中,我们在大鼠和小鼠模型中研究了高渗盐水对I/R后肝脏炎症发展的影响。结果显示,高渗预处理可防止肝酶释放,同时减少肝脏中性粒细胞滞留。高渗盐水似乎通过抑制肝脏肿瘤坏死因子α(TNF-α)的产生发挥这一作用,该作用最终导致肝脏黏附分子表达降低。高渗盐水预处理可增强I/R后肝脏白细胞介素10(IL-10)的表达,这是其抗炎作用的潜在机制。为了研究IL-10在高渗盐水对肝脏I/R损伤的保护作用中的作用,我们使用了I/R小鼠模型。在野生型小鼠中,高渗预处理同样可预防I/R诱导的肝脏损伤。然而,在IL-10基因敲除动物中,高渗预处理无法预防I/R诱导的肝酶释放、TNF-α产生或中性粒细胞滞留。总之,这些发现确定了一种导致高渗盐水抗炎作用的新机制,也提示了高渗溶液在预防与I/R相关的肝脏损伤方面的潜在临床作用。