Division of Transplant Surgery, Department of Surgery, University of Colorado, Aurora, CO.
Hepatology. 2013 Nov;58(5):1766-78. doi: 10.1002/hep.26505. Epub 2013 Sep 24.
Ischemia and reperfusion-elicited tissue injury contributes to morbidity and mortality of hepatic surgery and during liver transplantation. Previous studies implicated extracellular adenosine signaling in liver protection. Based on the notion that extracellular adenosine signaling is terminated by uptake from the extracellular towards the intracellular compartment by way of equilibrative nucleoside transporters (ENTs), we hypothesized a functional role of ENTs in liver protection from ischemia. During orthotopic liver transplantation in humans, we observed higher expressional levels of ENT1 than ENT2, in conjunction with repression of ENT1 and ENT2 transcript and protein levels following warm ischemia and reperfusion. Treatment with the pharmacologic ENT inhibitor dipyridamole revealed elevations of hepatic adenosine levels and robust liver protection in a murine model of liver ischemia and reperfusion. Studies in gene-targeted mice for Ent1 or Ent2 demonstrated selective protection from liver injury in Ent1(-/-) mice. Treatment with selective adenosine receptor antagonists indicated a contribution of Adora2b receptor signaling in ENT-dependent liver protection.
These findings implicate ENT1 in liver protection from ischemia and reperfusion injury and suggest ENT inhibitors may be of benefit in the prevention or treatment of ischemic liver injury.
缺血再灌注引起的组织损伤导致肝外科手术和肝移植期间的发病率和死亡率升高。先前的研究表明细胞外腺苷信号在肝脏保护中起作用。基于细胞外腺苷信号通过平衡核苷转运体(ENTs)从细胞外向细胞内摄取而终止的观点,我们假设 ENT 在肝脏免受缺血损伤方面具有功能作用。在人体原位肝移植过程中,我们观察到 ENT1 的表达水平高于 ENT2,同时在热缺血和再灌注后 ENT1 和 ENT2 的转录本和蛋白水平受到抑制。在肝缺血再灌注的小鼠模型中,用药理学 ENT 抑制剂双嘧达莫治疗显示肝腺苷水平升高和强大的肝保护作用。针对 Ent1 或 Ent2 的基因靶向小鼠的研究表明,Ent1(-/-) 小鼠的肝损伤具有选择性保护作用。用选择性腺苷受体拮抗剂进行的研究表明,Adora2b 受体信号在 ENT 依赖性肝保护中起作用。
这些发现表明 ENT1 在肝脏免受缺血再灌注损伤中起作用,并表明 ENT 抑制剂可能有助于预防或治疗缺血性肝损伤。