Daglar Gul, Karaca Turgut, Yuksek Yunus Nadi, Gozalan Ugur, Akbiyik Filiz, Sokmensuer Cenk, Gurel Bora, Kama Nuri Aydin
Department of Fourth Surgery, Ankara Numune Education and Research Hospital, Ankara, Turkey.
J Surg Res. 2009 May 1;153(1):31-8. doi: 10.1016/j.jss.2008.02.052. Epub 2008 Mar 26.
Hepatic ischemia-reperfusion injury (I/R) may occur in transplantation, trauma, and elective hepatic resections. Leukotrienes have been shown to play a major role in hepatic I/R injury. Five-lipoxygenase enzyme is an important enzyme in the production of leukotrienes from arachidonic acid. MK-886 is an inhibitor of 5-lipoxygenase, and montelukast is a cysteinyl leukotriene receptor antagonist. The aim of this study was to investigate whether MK-886 and montelukast are effective in preventing hepatic I/R injury.
Rats were divided into five groups consisting of seven rats in each: (1) Control I/R, (2) Control-montelukast, (3) Control-MK-886, (4) I/R+montelukast, and (5) I/R+MK-886. Thirty min of total hepatic vascular occlusion and then 60 min reperfusion were performed to animals in groups 1, 4, and 5. In groups 2 and 4, montelukast, and in groups 3 and 5, MK-886 was applied intraperitoneally before and during the surgical procedures.
Apoptosis in the liver and intestine decreased significantly in the I/R+montelukast and I/R+MK-886 groups compared with the I/R group. Tissue malondialdehyde levels and glutathione consumptions also decreased significantly in the I/R+montelukast and I/R+MK-886 groups compared with the I/R group. The difference in serum alanine aminotransferase and aspartate aminotransferase levels between the groups did not reach significance.
Montelukast and MK-886 were found to be effective in prevention of liver and intestine injury by reducing apoptosis and oxidative stress in a hepatic I/R model. Anti-inflammatory properties and inhibition of lipid peroxidation by montelukast and MK-886 could be protective for these organs in I/R injury.
肝缺血再灌注损伤(I/R)可能发生于肝移植、创伤以及择期肝切除手术中。白三烯已被证明在肝缺血再灌注损伤中起主要作用。5-脂氧合酶是从花生四烯酸生成白三烯过程中的一种重要酶。MK-886是5-脂氧合酶的抑制剂,孟鲁司特是一种半胱氨酰白三烯受体拮抗剂。本研究的目的是探讨MK-886和孟鲁司特是否能有效预防肝缺血再灌注损伤。
将大鼠分为五组,每组七只:(1)对照I/R组,(2)对照-孟鲁司特组,(3)对照-MK-886组,(4)I/R+孟鲁司特组,(5)I/R+MK-886组。对第1、4和5组动物进行30分钟的全肝血管阻断,然后再灌注60分钟。在第2和4组中,于手术过程中和术前腹腔注射孟鲁司特;在第3和5组中,于手术过程中和术前腹腔注射MK-886。
与I/R组相比,I/R+孟鲁司特组和I/R+MK-886组肝脏和肠道中的细胞凋亡显著减少。与I/R组相比,I/R+孟鲁司特组和I/R+MK-886组的组织丙二醛水平和谷胱甘肽消耗也显著降低。各组间血清丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平的差异无统计学意义。
在肝缺血再灌注模型中,发现孟鲁司特和MK-886通过减少细胞凋亡和氧化应激,对预防肝脏和肠道损伤有效。孟鲁司特和MK-886的抗炎特性以及对脂质过氧化的抑制作用可能对这些器官在缺血再灌注损伤中起到保护作用。