Liang Rui, Bruns Helge, Kincius Marius, Lin Tao, Ludwig Jochen, Dei-Anane Genevieve, Guan Xiaohai, Gebhard Martha-Maria, Büchler Markus W, Schemmer Peter
Department of General Surgery, Ruprecht-Karls-University, Heidelberg, Germany.
Transpl Int. 2009 Nov;22(11):1100-9. doi: 10.1111/j.1432-2277.2009.00925.x. Epub 2009 Aug 3.
Reperfusion injury remains one of the major problems in transplantation. Free radicals and disturbance of microcirculation are the supposed main contributors. Recent evidence shows that Danshen, a traditional Chinese drug used in vascular diseases, can scavenge radicals and improve microcirculation. This study investigates its effect on liver transplantation (LTx). Before organ recovery, female Sprague-Dawley rats (210-240 g) received intravenous Danshen or the same volume of Ringer solution as control. LTx was performed after 1 h of cold storage. Microperfusion, leukocyte-endothelium interaction and latex-bead phagocytosis were evaluated with in vivo microscopy. Survival, transaminases and histology were assessed. Immunohistology was used for TNF-alpha levels. anova and Fisher's exact test were employed for statistical analyses as appropriate. Survival increased from 60% in controls to 100% (P < 0.05). AST and LDH decreased from 3969 +/- 1255 U/l and 15444 +/- 5148 U/l in controls to 1236 +/- 410 U/l and 5039 +/- 1594 U/l, respectively (P < 0.05). In vivo microscopy revealed decreased leukocyte-adherence and increased blood flow velocity in sinusoidal zones after administration of Danshen (P < 0.05), while latex-bead phagocytosis was found in 60% of controls (P < 0.05). The TNF-alpha index decreased from 2.08 +/- 0.09 in controls to 1.09 +/- 0.09 (P < 0.05). This study clearly demonstrates hepatoprotective effects after experimental LTx, which can be explained via anti-oxidative effects, improved microcirculation and decreased Kupffer cell activation.
再灌注损伤仍然是移植中的主要问题之一。自由基和微循环紊乱被认为是主要原因。最近的证据表明,用于治疗血管疾病的传统中药丹参可以清除自由基并改善微循环。本研究调查其对肝移植(LTx)的影响。在器官获取前,雌性Sprague-Dawley大鼠(210 - 240 g)静脉注射丹参或相同体积的林格液作为对照。冷保存1小时后进行肝移植。用体内显微镜评估微灌注、白细胞与内皮细胞相互作用和乳胶珠吞噬作用。评估生存率、转氨酶和组织学。免疫组织化学用于检测肿瘤坏死因子-α(TNF-α)水平。视情况采用方差分析和Fisher精确检验进行统计分析。生存率从对照组的60%提高到100%(P < 0.05)。天冬氨酸转氨酶(AST)和乳酸脱氢酶(LDH)分别从对照组的3969±1255 U/L和15444±5148 U/L降至1236±410 U/L和5039±1594 U/L(P < 0.05)。体内显微镜检查显示,丹参给药后窦状隙区域白细胞黏附减少,血流速度增加(P < 0.05),而对照组60%出现乳胶珠吞噬现象(P < 0.05)。TNF-α指数从对照组的2.08±0.09降至1.09±0.09(P < 0.05)。本研究清楚地证明了实验性肝移植后丹参具有肝脏保护作用,这可以通过抗氧化作用、改善微循环和减少库普弗细胞活化来解释。