An Jiang, Chang Liu, Liang Yu, Yi Lv, Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710061, Shannxi Province, China.
World J Gastroenterol. 2012 Jan 28;18(4):323-30. doi: 10.3748/wjg.v18.i4.323.
To investigate the relationship between donor liver cold preservation, lung surfactant (LS) changes and acute lung injury (ALI) after liver transplantation.
Liver transplantation models were established using male Wistar rats. Donor livers were preserved in University of Wisconsin solution at 4 °C for different lengths of time. The effect of ammonium pyrrolidinedithiocarbamate (PDTC) on ALI was also detected. All samples were harvested after 3 h reperfusion. The severity of ALI was evaluated by lung weight/body weight ratio, lung histopathological score, serum nitric oxide (NO) and endothelin (ET)-1 levels, lung tumor necrosis factor (TNF)-α and interleukin (IL)-1β levels. Lung surfactants (LSs) were determined by micellar electrokinetic capillary chromatography.
With extended donor liver cold preservation time (CPT), lung histopathological scores, serum ET-1 levels, lung weight/body weight ratio and the level of TNF-α and IL-1β in lung were increased significantly in the 180-min group compared with the sham group (3.16 ± 0.28 vs 1.12 ± 0.21, P < 0.001; 343.59 ± 53.97 vs 141.53 ± 48.48, P < 0.001; 0.00687 ± 0.00037 vs 0.00557 ± 0.00056, P < 0.001; 17.5 ± 3.0 vs 1.3 ± 0.3, P < 0.001; 10.8 ± 2.3 vs 1.8 ± 0.4, P < 0.001), but serum NO levels decreased remarkably (74.67 ± 10.01 vs 24.97 ± 3.18, P < 0.001). The expression of lung phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylinositol (PI) and phosphatidylserine (PS) increased when CPT was < 120 min, and decreased when CPT was > 180 min (PC: 1318.89 ± 54.79 vs 1011.18 ± 59.99, P < 0.001; PE: 1504.45 ± 119.96 vs 1340.80 ± 76.39, P = 0.0019; PI: 201.23 ± 34.82 vs 185.88 ± 17.04, P = 0.2265; PS: 300.43 ± 32.95 vs 286.55 ± 55.55, P = 0.5054). All these ALI-associated indexes could be partially reversed by PDTC treatment.
Prolonged CPT could induce or inhibit the expression of LSs at the compensation or decompensation stage, and some antioxidants (e.g., PDTC) may reverse the pathological process partially.
研究供体肝脏冷保存、肺表面活性剂 (LS) 变化与肝移植后急性肺损伤 (ALI) 的关系。
使用雄性 Wistar 大鼠建立肝移植模型。供体肝脏在 4℃下用威斯康星大学溶液保存不同时间。还检测了氨甲酰吡咯烷二硫代氨基甲酸盐 (PDTC) 对 ALI 的影响。所有样本均在再灌注后 3 h 采集。通过肺重量/体重比、肺组织病理学评分、血清一氧化氮 (NO) 和内皮素 (ET)-1 水平、肺肿瘤坏死因子 (TNF)-α 和白细胞介素 (IL)-1β 水平评估 ALI 的严重程度。通过胶束电动毛细管色谱法测定肺表面活性剂 (LS)。
随着供体肝脏冷保存时间 (CPT) 的延长，与假手术组相比，180 分钟组的肺组织病理学评分、血清 ET-1 水平、肺重量/体重比以及 TNF-α 和 IL-1β 水平均显著升高（3.16±0.28 比 1.12±0.21，P<0.001；343.59±53.97 比 141.53±48.48，P<0.001；0.00687±0.00037 比 0.00557±0.00056，P<0.001；17.5±3.0 比 1.3±0.3，P<0.001；10.8±2.3 比 1.8±0.4，P<0.001），但血清 NO 水平显著降低（74.67±10.01 比 24.97±3.18，P<0.001）。当 CPT<120 min 时，肺磷脂酰胆碱 (PC)、磷脂酰乙醇胺 (PE)、磷脂酰肌醇 (PI) 和磷脂酰丝氨酸 (PS) 的表达增加，而当 CPT>180 min 时，它们的表达减少（PC：1318.89±54.79 比 1011.18±59.99，P<0.001；PE：1504.45±119.96 比 1340.80±76.39，P=0.0019；PI：201.23±34.82 比 185.88±17.04，P=0.2265；PS：300.43±32.95 比 286.55±55.55，P=0.5054）。所有这些与 ALI 相关的指标都可以通过 PDTC 治疗部分逆转。
长时间的 CPT 可以在代偿或失代偿阶段诱导或抑制 LS 的表达，一些抗氧化剂（如 PDTC）可能部分逆转病理过程。
