Department of Surgical Gastroenterology L, Aarhus University Hospital, Aarhus, Denmark.
J Surg Res. 2013 Mar;180(1):e11-20. doi: 10.1016/j.jss.2012.03.036. Epub 2012 Apr 11.
Ischemic preconditioning (IPC) has been shown to protect the liver against ischemia-reperfusion (I/R) injuries. However, ischemic post-conditioning has received little attention. The aim of the present study was to quantify and compare the hepato-protective properties of IPC and IPO, for the first time, using unbiased design-based stereological methods.
We divided 67 rats into four groups: sham, liver ischemia (LI), IPC, and IPO. Rats were subjected to 60 min LI, followed by 4- or 24-h reperfusion. We performed quantification of (NVR) and apoptotic cell profile number.
We observed no significant differences in NVR between ischemic groups after 4 h. After 24-h reperfusion, NVR had increased to 70% in the LI group, compared with 51% (P = 0.02) and 49% (P = 0.01) in the IPC and IPO groups, respectively. After 4-h reperfusion, the apoptotic cell number was significantly higher in all ischemic groups than in the sham group; we detected no difference between ischemic groups. After 24-h reperfusion, we detected a significantly lower number of apoptotic cell profiles in the IPC group than in the LI group (P = 0.02). The mean number of apoptotic cell profiles decreased insignificantly in the IPO group (P = 0.06). Liver parameters were at all time comparable between groups.
After I/R, IPC and IPO reduce the degree of hepatocellular injury. Both methods are equally efficient at preventing hepatocellular necrosis. Furthermore, apoptosis is significantly lower after IPC.
缺血预处理 (IPC) 已被证明可保护肝脏免受缺血再灌注 (I/R) 损伤。然而,缺血后处理受到的关注较少。本研究的目的是首次使用无偏倚基于设计的体视学方法量化和比较 IPC 和 IPO 的肝保护特性。
我们将 67 只大鼠分为四组:假手术组、肝缺血组 (LI)、IPC 组和 IPO 组。大鼠接受 60 分钟的 LI,然后进行 4 或 24 小时的再灌注。我们进行了非缺血性区域 (NVR) 和凋亡细胞数量的定量。
我们观察到在 4 小时时,缺血组之间的 NVR 没有显著差异。在 24 小时再灌注后,LI 组的 NVR 增加到 70%,而 IPC 组和 IPO 组分别为 51%(P=0.02)和 49%(P=0.01)。在 4 小时再灌注后,所有缺血组的凋亡细胞数量明显高于假手术组;我们没有检测到缺血组之间的差异。在 24 小时再灌注后,我们在 IPC 组中检测到的凋亡细胞数量明显低于 LI 组(P=0.02)。在 IPO 组中,凋亡细胞数量略有下降(P=0.06)。在所有时间点,各组的肝参数均相当。
在 I/R 后,IPC 和 IPO 可降低肝细胞损伤程度。两种方法在预防肝细胞坏死方面同样有效。此外,IPC 后凋亡明显降低。