Behrends Matthias, Hirose Ryutaro, Park Yeon Ho, Tan Vivian, Dang Kim, Xu Fengyung, Park Se Hun, Niemann Claus U
Department of Anesthesia and Perioperative Care, University of California San Francisco, 521 Parnassus Avenue, S 455, San Francisco, CA 94143-0648, USA.
J Gastrointest Surg. 2008 Mar;12(3):490-5. doi: 10.1007/s11605-007-0252-6. Epub 2007 Aug 14.
Liver ischemia/reperfusion has been shown to result in injury of remote organs such as the heart and lungs. Whether or not acute liver injury also results in kidney injury has so far not been adequately addressed. In anesthetized Wistar rats, partial (70%) normothermic hepatic ischemia was applied for 75 min. After 24 h of reperfusion, renal injury was assessed by histology, creatinine and blood urea nitrogen (BUN) serum concentrations, renal expression of proinflammatory genes [quantitative real-time polymerase chain reaction (qRT-PCR)], caspase-3 activation (Western blot), and neutrophil accumulation (myeloperoxidase assay). Twenty-four hours after hepatic ischemia, creatinine (0.57+/-0.06 vs. 0.32+/-0.04 mg/dL) and BUN (40.7+/-15.3 vs. 14.3+/-2.0 mg/dL) were increased when compared to sham. qRT-PCR revealed higher renal intercellular adhesion molecule-1 gene expression following hepatic ischemia (166+/-45% when compared to sham) but no differences in renal monocyte chemoattractant protein-1, macrophage inflammatory protein-2, and inducible NO synthase expression. In both groups, kidneys showed no morphological damage and no increase in caspase-3 and myeloperoxidase activity. Severe hepatic ischemia results in a moderate impairment of renal function in rats but does not trigger an inflammatory response in the kidney and does not result in morphological damage of the kidney.
肝脏缺血/再灌注已被证明会导致诸如心脏和肺等远处器官的损伤。急性肝损伤是否也会导致肾损伤,目前尚未得到充分研究。在麻醉的Wistar大鼠中,进行了75分钟的部分(70%)常温肝脏缺血。再灌注24小时后,通过组织学、肌酐和血清尿素氮(BUN)浓度、促炎基因的肾表达[定量实时聚合酶链反应(qRT-PCR)]、半胱天冬酶-3激活(蛋白质印迹法)和中性粒细胞聚集(髓过氧化物酶测定)来评估肾损伤。肝脏缺血24小时后,与假手术组相比,肌酐(0.57±0.06 vs. 0.32±0.04 mg/dL)和BUN(40.7±15.3 vs. 14.3±2.0 mg/dL)升高。qRT-PCR显示肝脏缺血后肾细胞间黏附分子-1基因表达更高(与假手术组相比为166±45%),但肾单核细胞趋化蛋白-1、巨噬细胞炎性蛋白-2和诱导型一氧化氮合酶表达无差异。两组中,肾脏均未显示形态学损伤,半胱天冬酶-3和髓过氧化物酶活性也未增加。严重肝脏缺血导致大鼠肾功能中度受损,但不会引发肾脏的炎症反应,也不会导致肾脏的形态学损伤。