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rhGH 可减轻肝移植相关肝内胆管缺血性损伤。

RhGH attenuates ischemia injury of intrahepatic bile ducts relating to liver transplantation.

机构信息

Department of Hepatobiliary Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

出版信息

J Surg Res. 2011 Nov;171(1):300-10. doi: 10.1016/j.jss.2010.02.003. Epub 2010 Mar 5.

Abstract

BACKGROUND

To study the effect of rhGH administration on intrahepatic cholangiocytes relating to liver transplantation with ischemia of hepatic artery, and ultimately, clarify pathologic mechanism of the injury.

METHODS

Rat orthotopic autologous liver transplantation was performed first. Three hours later, the rats were grouped as followed: HAL (hepatic artery ligation) group; HAL + rhGH (hepatic artery ligation followed by rhGH administration) group; CON (without hepatic artery ligation) group. Specimen was collected after 7 d. ALT and ALP of serum were measured. The pathologic changes of bile ducts of liver tissue were observed. The number of bile ducts and blood vessels in portal area were counted. Immunochemistry for VEGF, VEGFR-2, VEGFR-3, GHR, and IGF-1R of intrahepatic cholangiocytes was performed. Cholangiocytes apoptosis was evaluated by TUNEL analysis. Cholangiocytes proliferation was evaluated by PCNA immunolabeling.

RESULTS

ALT and ALP of HAL + rhGH group were significantly ameliorated compared with untreated animals (P < 0.05). ALT and ALP of HAL group were significantly higher compared with CON group (P < 0.05). In HAL group, the main injury of bile ducts was not reversible, whereas it was reversible in CON and rhGH groups. In HAL group, the number of bile ducts in portal area decreased, while the number of bile ducts not accompanying blood vessels increased (P < 0.05). In rhGH group, the number of bile ducts in portal area increased, while the number of bile ducts accompanying blood vessels increased compared with HAL group (P < 0.05). The expression of VEGF, VEGFR-2, VEGFR-3, GHR, and IGF-1R was significantly lower in HAL group than in CON group (P < 0.05). Following administration of rhGH to HAL rats, the expression of VEGF, VEGFR-2, VEGFR-3, IGF-1R, and GHR was significantly higher (P < 0.05). Administration of rhGH prevented increase in cholangiocytes apoptosis induced by HAL (P < 0.05). Administration of rhGH promoted increase in cholangiocytes proliferation held by HAL (P < 0.05).

CONCLUSIONS

Administration of rhGH appears to attenuate ischemia injury of intrahepatic bile ducts relating to liver transplantation. This function is partly related to the capacity that rhGH inhibits the apoptosis of intrahepatic cholangiocytes and prompts the proliferation and angiogenesis by increasing the expression of VEGF, VEGFR2, VEGFR3, GHR, and IGF1-R.

摘要

背景

研究重组人生长激素(rhGH)对肝移植后肝动脉缺血相关的肝内胆管细胞的作用,最终阐明损伤的病理机制。

方法

首先进行大鼠原位自体肝移植。3 小时后,将大鼠分为以下几组:HAL(肝动脉结扎)组;HAL+rhGH(肝动脉结扎后给予 rhGH 治疗)组;CON(未结扎肝动脉)组。7d 后收集标本。检测血清丙氨酸氨基转移酶(ALT)和碱性磷酸酶(ALP)。观察肝组织胆管的病理变化。计数门脉区胆管和血管数量。对肝内胆管细胞的 VEGF、VEGFR-2、VEGFR-3、GHR 和 IGF-1R 进行免疫组织化学染色。通过 TUNEL 分析评估胆管细胞凋亡。通过 PCNA 免疫标记评估胆管细胞增殖。

结果

与未治疗动物相比,HAL+rhGH 组的 ALT 和 ALP 明显改善(P<0.05)。与 CON 组相比,HAL 组的 ALT 和 ALP 明显升高(P<0.05)。在 HAL 组,胆管的主要损伤是不可逆转的,而在 CON 和 rhGH 组则是可逆的。在 HAL 组,门脉区胆管数量减少,而不伴血管的胆管数量增加(P<0.05)。在 rhGH 组,与 HAL 组相比,门脉区胆管数量增加,伴血管的胆管数量增加(P<0.05)。与 CON 组相比,HAL 组 VEGF、VEGFR-2、VEGFR-3、GHR 和 IGF-1R 的表达明显降低(P<0.05)。在 HAL 大鼠给予 rhGH 治疗后,VEGF、VEGFR-2、VEGFR-3、IGF-1R 和 GHR 的表达明显升高(P<0.05)。rhGH 治疗可预防 HAL 诱导的胆管细胞凋亡增加(P<0.05)。rhGH 治疗可促进 HAL 诱导的胆管细胞增殖(P<0.05)。

结论

rhGH 治疗似乎减轻了与肝移植相关的肝内胆管缺血损伤。这种作用部分与 rhGH 通过增加 VEGF、VEGFR2、VEGFR3、GHR 和 IGF1-R 的表达抑制肝内胆管细胞凋亡和促进增殖和血管生成的能力有关。

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