Ofluoglu E, Kerem M, Pasaoglu H, Turkozkan N, Seven I, Bedirli A, Utku Yilmaz T
Department of Biochemistry, Gazi University, Medical Faculty, Ankara, Turkey.
Eur Surg Res. 2006;38(2):114-21. doi: 10.1159/000093300. Epub 2006 May 11.
Hepatic ischemia/reperfusion (IR) injuries associated with hepatic resections are unresolved problems in the clinical practice. The aim of this study is to elucidate the effect of ischemic preconditioning (IPC) on the energy charge (EC) and related mechanisms at the late phase of hepatic IR injury.
30 Wistar rats were randomly divided into sham, IR and IPC groups. The model of partial hepatic IR was used. The rats were subjected to 60 min hepatic ischemia, pretreated by IPC (10/15 min) or not. After 24 h of reperfusion, serum alanine aminotransferase (ALT), nitrite/nitrate (NOx), malondialdehyde (MDA), hepatic tissue arginase activity, adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP) and EC of the liver were measured.
Liver injury reduced by IPC is measured by liver tissue arginase activity and serum ALT. Tissue NOx levels in rats pretreated with IPC were significantly higher than levels in the IR group (p < 0.001). Tissue levels of MDA in the liver of the IPC group were found to be significantly lower than the levels in the IR group (p < 0.001). ATP and EC levels 24 h after hepatic ischemia in rats pretreated with IPC were higher than the levels in the IR (p < 0.05). All groups had similar ADP and AMP levels in the liver tissues. The IPC procedure significantly reduced the hepatic necrosis (p < 0.001).
The results of this study demonstrated that pretreatment with IPC improved tissue ATP, EC, and hepatic necrosis at late stages of ischemia reperfusion injury of the liver. Increased nitric oxide, reduced MDA and arginase activity seemed to play a regulatory role in this delayed protective effect of IPC.
肝切除术中相关的肝脏缺血/再灌注(IR)损伤是临床实践中尚未解决的问题。本研究的目的是阐明缺血预处理(IPC)对肝脏IR损伤后期能量电荷(EC)及相关机制的影响。
将30只Wistar大鼠随机分为假手术组、IR组和IPC组。采用部分肝脏IR模型。大鼠接受60分钟肝脏缺血,分为经IPC预处理(10/15分钟)组和未预处理组。再灌注24小时后,检测血清丙氨酸氨基转移酶(ALT)、亚硝酸盐/硝酸盐(NOx)、丙二醛(MDA)、肝组织精氨酸酶活性、三磷酸腺苷(ATP)、二磷酸腺苷(ADP)、一磷酸腺苷(AMP)以及肝脏的EC。
通过肝组织精氨酸酶活性和血清ALT评估,IPC减轻了肝脏损伤。IPC预处理大鼠的组织NOx水平显著高于IR组(p < 0.001)。发现IPC组肝脏组织MDA水平显著低于IR组(p < 0.001)。IPC预处理大鼠肝脏缺血24小时后的ATP和EC水平高于IR组(p < 0.05)。所有组肝脏组织中的ADP和AMP水平相似。IPC操作显著减轻了肝脏坏死(p < 0.001)。
本研究结果表明,IPC预处理改善了肝脏缺血再灌注损伤后期的组织ATP、EC及肝脏坏死情况。一氧化氮增加、MDA减少以及精氨酸酶活性降低似乎在IPC的这种延迟保护作用中发挥调节作用。