Department of Surgery, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania 19134, USA.
J Surg Res. 2010 Oct;163(2):294-8. doi: 10.1016/j.jss.2010.04.042. Epub 2010 May 21.
Total parenteral nutrition (TPN) induced liver failure is the leading indication for transplantation in children. Our previous research demonstrated the benefit of a specific intravenous dose of hepatocyte growth factor (HGF) in the amelioration of TPN-induced liver injury. This study was designed to ascertain the optimum concentration of HGF in an animal model of TPN-induced liver injury.
Twenty adult female Sprague-Dawley rats underwent 70% small bowel resection and placement of venous catheters connected to subcutaneous osmotic minipumps. Four groups (n=5 each) based on the contents of the osmotic pump were utilized as follows: group 1 (control): saline; group 2: HGF 75 mcg/kg/d; group 3: HGF 150 mcg/kg/d; and group 4: HGF 250 mcg/kg/d. Each rat received 14 d of TPN without enteral nutrition. After sacrifice, the liver was harvested. Hepatic inflammation was evaluated using antibodies for TNF-α and IL-6. Apoptosis was evaluated by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) technique.
All concentrations induced statistically significantly less IL-6 and TNF- α expression compared to the control animals. Increased efficacy was demonstrated with increasing dose concentration up to 150 mcg/kg/d but not 250 mcg/kg/d. Apoptotic activity was decreased statistically significantly for all dose concentrations compared with the controls, as well as to increases in dose concentration.
Increasing concentrations of HGF were directly correlated with increased modulation of inflammatory response and apoptotic index in this animal model for TPN-induced liver injury, up to 150 mcg/kg/d. Further increases were significant with respect to apoptotic index only. Further investigations are warranted to determine if HGF may be useful to minimize TPN-induced liver injury in children.
全胃肠外营养(TPN)诱导的肝衰竭是儿童肝移植的主要指征。我们之前的研究表明,特定剂量的肝细胞生长因子(HGF)静脉内给药可改善 TPN 诱导的肝损伤。本研究旨在确定 TPN 诱导肝损伤动物模型中 HGF 的最佳浓度。
20 只成年雌性 Sprague-Dawley 大鼠接受 70%小肠切除术,并放置静脉导管连接皮下渗透型迷你泵。根据渗透型迷你泵的内容物,将大鼠分为 4 组(每组 5 只):第 1 组(对照组):生理盐水;第 2 组:HGF 75 mcg/kg/d;第 3 组:HGF 150 mcg/kg/d;第 4 组:HGF 250 mcg/kg/d。每只大鼠接受 14 d 的 TPN 治疗,不给予肠内营养。处死大鼠后,采集肝脏。使用 TNF-α 和 IL-6 抗体评估肝炎症。采用末端脱氧核苷酸转移酶 dUTP 缺口末端标记(TUNEL)技术评估细胞凋亡。
与对照组相比,所有浓度均能显著降低 IL-6 和 TNF-α 的表达。随着剂量浓度的增加(最高达 150 mcg/kg/d),疗效逐渐增强,但增加至 250 mcg/kg/d 时效果不再增强。与对照组相比,所有剂量浓度的细胞凋亡活性均显著降低,且随着剂量浓度的增加而降低。
在本 TPN 诱导肝损伤动物模型中,HGF 浓度的增加与炎症反应和凋亡指数的调节直接相关,最高可达 150 mcg/kg/d。进一步增加浓度仅在凋亡指数方面有显著效果。需要进一步研究以确定 HGF 是否可用于减轻儿童 TPN 诱导的肝损伤。