Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Liver Transpl. 2011 Jan;17(1):60-9. doi: 10.1002/lt.22189.
After extended hepatectomy, excessive shear stress in the remnant liver causes postoperative liver failure. Olprinone (OLP), a selective phosphodiesterase inhibitor, has been reported to improve microcirculation and attenuate inflammation. The aim of this study was to investigate the effects of OLP on shear stress in rats with an excessive hepatectomy (EHx) model. In this study, EHx comprised 90% hepatectomy with ligation of the left and right Glisson's sheaths in Lewis rats. OLP or saline was intraperitoneally administered with an osmotic pump 48 hours before EHx. To evaluate the shear stress, we measured the portal vein (PV) pressure. We also assessed sinusoidal endothelial cell injury by immunohistochemistry and electron microscopy. Furthermore, we assessed apoptosis in the liver with the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling method. Treatment with OLP up-regulated hepatic endothelial nitric oxide synthase (eNOS) expression. The increase in the PV pressure due to Glisson's sheath ligation was attenuated in OLP-treated rats during a 30-minute period after ligation. Treatment with OLP preserved sinusoidal endothelial cells and reduced apoptosis in the remnant liver. The probability of survival in the OLP-treated rats was significantly better than that in the controls (33.3% versus 13.3%). Furthermore, the postoperative eNOS activity in the OLP-treated rats was higher than that in the controls. The administration of Nω-nitro-l-arginine methyl ester to OLP-treated rats eliminated the effects of OLP on PV pressure and survival after EHx. Therefore, we concluded that OLP attenuates excessive shear stress through the up-regulation of eNOS and improves the survival rate after EHx.
肝叶切除术后,残余肝脏的剪切力过大可导致术后肝功能衰竭。磷酸二酯酶抑制剂奥普力农(OLP)已被报道可改善微循环并减轻炎症。本研究旨在探讨 OLP 对肝叶切除(EHx)模型大鼠剪切力的影响。在本研究中,EHx 包括 90%的肝叶切除术,同时结扎左、右 Glisson 鞘。OLP 或生理盐水通过腹膜内渗透泵在 EHx 前 48 小时给药。为了评估剪切力,我们测量了门静脉(PV)压力。我们还通过免疫组织化学和电子显微镜评估了窦内皮细胞损伤。此外,我们通过末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸缺口末端标记法评估了肝脏细胞凋亡。OLP 治疗可上调肝内皮型一氧化氮合酶(eNOS)表达。在结扎后 30 分钟内,OLP 治疗大鼠的 Glisson 鞘结扎导致的 PV 压力升高得到缓解。OLP 治疗可保护窦内皮细胞并减少残余肝脏细胞凋亡。OLP 治疗大鼠的存活率明显优于对照组(33.3%对 13.3%)。此外,OLP 治疗大鼠的术后 eNOS 活性高于对照组。给予 Nω-硝基-L-精氨酸甲酯可消除 OLP 对 EHx 后 PV 压力和存活率的影响。因此,我们得出结论,OLP 通过上调 eNOS 来减轻过度的剪切力,并提高 EHx 后的存活率。