Ito Koji, Ozasa Hisashi, Noda Yumi, Horikawa Saburo
Department of Pathological Biochemistry, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan.
Liver Int. 2006 Mar;26(2):254-60. doi: 10.1111/j.1478-3231.2005.01220.x.
BACKGROUND/AIMS: Hepatic injury caused by ischemia/reperfusion (I/R) is a key clinical problem associated with liver transplantation and liver surgery. The spleen is involved in hepatic I/R injury. In this study, we examined the effects of splenic artery ligation on hepatic I/R injury.
Splenic artery ligation was performed 7 days, 3 days, or just before the hepatic ischemia. Hepatic ischemia was conducted by occluding the blood vessels to the median and left lateral lobes with an atraumatic vascular clamp. Hepatic I/R injury was induced by 45 min of ischemia followed by 120 min of reperfusion.
When splenic artery ligation was performed at 3 days or just before the ischemia, serum aspartate transaminase and alanine transaminase activities, as markers for hepatic injury, decreased as compared with the rats with I/R alone. Splenic artery ligation also reduced the myeloperoxidase activity, an enzyme present in neutrophils, and the expression of interleukin-6 mRNA, a proinflammatory cytokine, in rat livers with I/R. Efficacy of splenic artery ligation on hepatic I/R injury was also confirmed by histology. On the other hand, when splenic artery ligation was conducted 7 days before the ischemia, efficacy of splenic artery ligation was disappeared.
Splenic artery ligation ameliorates hepatic I/R injury in rats. These results strongly suggest the clinical usefulness of this surgical procedure to protect the liver against I/R injury.
背景/目的：缺血/再灌注（I/R）所致肝损伤是肝移植和肝脏手术相关的关键临床问题。脾脏参与肝I/R损伤。在本研究中，我们检测了脾动脉结扎对肝I/R损伤的影响。
在肝缺血前7天、3天或即将缺血时进行脾动脉结扎。通过用无损伤血管夹阻断中叶和左外叶的血管来进行肝缺血。缺血45分钟后再灌注120分钟诱导肝I/R损伤。
当在缺血前3天或即将缺血时进行脾动脉结扎时，作为肝损伤标志物的血清天冬氨酸转氨酶和丙氨酸转氨酶活性与单纯I/R大鼠相比降低。脾动脉结扎还降低了I/R大鼠肝脏中髓过氧化物酶活性（一种存在于中性粒细胞中的酶）和促炎细胞因子白细胞介素-6 mRNA的表达。脾动脉结扎对肝I/R损伤的疗效也通过组织学得到证实。另一方面，当在缺血前7天进行脾动脉结扎时，脾动脉结扎的疗效消失。
脾动脉结扎可改善大鼠肝I/R损伤。这些结果强烈提示该手术操作在保护肝脏免受I/R损伤方面的临床实用性。
