Thatch Keith A, Schwartz Marshall Z, Yoo Edward Y, Mendelson Kim G, Duke Duane S
St. Christopher's Hospital for Children, Philadelphia, PA 19134, USA.
J Pediatr Surg. 2008 Dec;43(12):2169-73. doi: 10.1016/j.jpedsurg.2008.08.045.
BACKGROUND/PURPOSE: The major side effect of total parenteral nutrition is liver injury leading to liver failure. This study was designed to assess specific growth factors in modulating the hepatic response in an ANIT-induced liver-injury model.
Sprague-Dawley rats were divided into four groups: control (n = 5), liver-injury control (alpha-naphthylisothiocyanate [ANIT], 100 mg/kg, n = 8), ANIT + epidermal growth factor (EGF, 150 mug/kg per day, n = 10), and ANIT + hepatocyte growth factor (HGF, 250 mug/kg per day, n = 9). Rats were given intraperitoneal injections of saline (control) or ANIT and implantation of an osmotic mini-pump for 7 days of continuous intravenous saline (liver injury control), EGF, or HGF. Seven and 14 days later, liver biopsies were obtained and evaluated for interleukin (IL)-6 and tumor necrosis factor alpha expression by immunofluorescent staining, and for apoptosis, by the terminal transferase dUTP nick end labeling (TUNEL) technique. All animals were euthanized at 14 days.
Epidermal growth factor (P < .025) and HGF (P < .001) groups induced less IL-6 expression at day 14 compared to liver-injury controls. In addition, the interval decrease in IL-6 expression between days 7 and 14 was greater in EGF (P < .001) and HGF (P < .001) groups compared to liver-injury controls. At day 14, HGF also demonstrated decreased tumor necrosis factor alpha expression (P < .005). Apoptotic activity was significantly less for the EGF (P < .011) and HGF (P < .0012) groups.
Epidermal growth factor and HGF modulated the hepatic inflammatory response and apoptotic index in this established liver-injury model and may diminish or prevent liver damage in patients with total parenteral nutrition-induced liver injury.
背景/目的:全胃肠外营养的主要副作用是肝损伤,可导致肝衰竭。本研究旨在评估特定生长因子在调节ANIT诱导的肝损伤模型中肝脏反应方面的作用。
将Sprague-Dawley大鼠分为四组:对照组(n = 5)、肝损伤对照组(α-萘异硫氰酸酯[ANIT],100 mg/kg,n = 8)、ANIT + 表皮生长因子(EGF,每天150 μg/kg,n = 10)和ANIT + 肝细胞生长因子(HGF,每天250 μg/kg,n = 9)。大鼠腹腔注射生理盐水(对照组)或ANIT,并植入渗透微型泵,连续7天静脉输注生理盐水(肝损伤对照组)、EGF或HGF。7天和14天后,获取肝脏活检组织,通过免疫荧光染色评估白细胞介素(IL)-6和肿瘤坏死因子α的表达,并通过末端脱氧核苷酸转移酶介导的dUTP缺口末端标记(TUNEL)技术评估细胞凋亡情况。所有动物在14天时实施安乐死。
与肝损伤对照组相比,表皮生长因子组(P < .025)和HGF组(P < .001)在第14天时诱导产生的IL-6表达较少。此外,与肝损伤对照组相比,EGF组(P < .001)和HGF组(P < .001)在第7天至第14天期间IL-6表达的下降幅度更大。在第14天时,HGF还显示肿瘤坏死因子α表达降低(P < .005)。EGF组(P < .011)和HGF组(P < .0012)的细胞凋亡活性明显较低。
在这个已建立的肝损伤模型中,表皮生长因子和HGF调节了肝脏炎症反应和凋亡指数,可能减轻或预防全胃肠外营养诱导的肝损伤患者的肝损害。