Mendes-Braz Mariana, Elias-Miró Maria, Kleuser Burkhard, Fayyaz Susann, Jiménez-Castro Mónica B, Massip-Salcedo Marta, Gracia-Sancho Jordi, Ramalho Fernando S, Rodes Juan, Peralta Carmen
Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Departamento de Patologia e Medicina Legal, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
Liver Int. 2014 Aug;34(7):e271-89. doi: 10.1111/liv.12348. Epub 2013 Nov 20.
Steatosis is a risk factor in partial hepatectomy (PH) under ischaemia-reperfusion (I/R), which is commonly applied in clinical practice to reduce bleeding. Nutritional support strategies, as well as the role of peripheral adipose tissue as energy source for liver regeneration, remain poorly investigated.
To investigate whether the administration of either glucose or a lipid emulsion could protect steatotic and non-steatotic livers against damage and regenerative failure in an experimental model of PH under I/R. The relevance of peripheral adipose tissue in liver regeneration following surgery is studied.
Steatotic and non-steatotic rat livers were subjected to surgery and the effects of either glucose or lipid treatment on damage and regeneration, and part of the underlying mechanisms, were investigated.
In non-steatotic livers, treatment with lipids or glucose provided the same protection against damage, regeneration failure and ATP drop. Adipose tissue was not required to regenerate non-steatotic livers. In the presence of hepatic steatosis, lipid treatment, but not glucose, protected against damage and regenerative failure by induction of cell cycle, maintenance of ATP levels and elevation of sphingosine-1-phosphate/ceramide ratio and phospholipid levels. Peripheral adipose tissue was required for regenerating the steatotic liver but it was not used as an energy source.
Lipid treatment in non-steatotic livers provides the same protection as that afforded by glucose in conditions of PH under I/R, whereas the treatment with lipids is preferable to reduce the injurious effects of liver surgery in the presence of steatosis.
脂肪变性是缺血再灌注（I/R）下部分肝切除术（PH）的一个风险因素，PH在临床实践中常用于减少出血。营养支持策略以及外周脂肪组织作为肝脏再生能量来源的作用仍未得到充分研究。
在I/R下PH的实验模型中，研究给予葡萄糖或脂质乳剂是否能保护脂肪变性和非脂肪变性肝脏免受损伤和再生失败。研究外周脂肪组织在术后肝脏再生中的相关性。
对脂肪变性和非脂肪变性大鼠肝脏进行手术，并研究葡萄糖或脂质治疗对损伤和再生的影响以及部分潜在机制。
在非脂肪变性肝脏中，脂质或葡萄糖治疗对损伤、再生失败和ATP下降提供相同的保护。非脂肪变性肝脏的再生不需要脂肪组织。在存在肝脂肪变性的情况下，脂质治疗而非葡萄糖治疗通过诱导细胞周期、维持ATP水平以及提高鞘氨醇-1-磷酸/神经酰胺比值和磷脂水平来保护肝脏免受损伤和再生失败。脂肪变性肝脏的再生需要外周脂肪组织，但它不作为能量来源。
在I/R下PH的情况下，非脂肪变性肝脏中的脂质治疗提供与葡萄糖相同的保护，而在存在脂肪变性的情况下，脂质治疗更有利于减少肝脏手术的有害影响。
