Kerem Mustafa, Bedirli Abdulkadir, Ofluoglu Ebru, Deniz Kemal, Turkozkan Nurten, Pasaoglu Hatice, Sakrak Omer
Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
Liver Int. 2006 Oct;26(8):994-9. doi: 10.1111/j.1478-3231.2006.01330.x.
The protective effect of ischemic preconditioning (IPC) has been reported on improvement of survival, reduction of liver necrosis and enhancement of the regenerative capacity of hepatocytes after partial hepatectomy. This study was undertaken to confirm that IPC has a significant impact on regeneration of hepatocytes after partial hepatectomy in ischemically damaged liver. In addition, we sought to examine the role of adenine nucleotides in this process.
Wistar rats were subjected to 60 min of total hepatic ischemia, followed by 70% hepatectomy. The animals were subdivided into an IPC (10/15 min) group and a non-IPC (control) group. Liver function tests and arginase activity were analyzed. Hepatic adenosine triphosphate (ATP), adenosine diphosphate and adenosine monophosphate were measured using gradient high-performance liquid chromatography. The liver regeneration was identified using relative liver weight and proliferating cell nuclear antigen (PCNA) labeling index.
IPC treatment improved serum liver enzymes and tissue arginase activity (P<0.05) when compared with the control group. The preconditioned livers were associated with upregulation of ATP expression and also increased tissue energy charge. Regenerated liver weight in the IPC group was significantly higher than in the control group (P<0.05). The PCNA labeling index in the remnant livers in the IPC group was also significantly increased at 24 and 48 h after partial hepatectomy (P<0.05).
These results suggest that IPC-augmented liver regeneration after hepatectomy, probably due to the stabilization of energy metabolism in rats.
缺血预处理（IPC）对部分肝切除术后生存率的提高、肝坏死的减少以及肝细胞再生能力的增强具有保护作用，这一点已有报道。本研究旨在证实IPC对缺血损伤肝脏部分肝切除术后肝细胞再生有显著影响。此外，我们试图研究腺嘌呤核苷酸在此过程中的作用。
对Wistar大鼠进行60分钟的全肝缺血，随后进行70%肝切除术。将动物分为IPC（10/15分钟）组和非IPC（对照组）。分析肝功能测试和精氨酸酶活性。使用梯度高效液相色谱法测量肝三磷酸腺苷（ATP）、二磷酸腺苷和一磷酸腺苷。使用相对肝重量和增殖细胞核抗原（PCNA）标记指数来确定肝再生情况。
与对照组相比，IPC治疗改善了血清肝酶和组织精氨酸酶活性（P<0.05）。预处理的肝脏与ATP表达上调以及组织能量电荷增加有关。IPC组再生肝重量显著高于对照组（P<0.05）。部分肝切除术后24小时和48小时，IPC组残余肝脏中的PCNA标记指数也显著增加（P<0.05）。
这些结果表明，肝切除术后IPC增强了肝脏再生，这可能是由于大鼠能量代谢的稳定。
