Rancan Lisa, Huerta Luis, Cusati Gabriel, Erquicia Iñaki, Isea Jesús, Paredes Sergio D, García Cruz, Garutti Ignacio, Simón Carlos, Vara Elena
1 Department of Biochemistry and Molecular Biology III, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain. 2 Department of Thoracic Surgery, Gregorio Marañón University General Hospital, Madrid, Spain. 3 Department of Anaesthesiology, Gregorio Marañón University General Hospital, Madrid, Spain. 4 Department of Physiology, Faculty of Medicine, Complutense University, Madrid, Spain. 5 Address correspondence to: Lisa Rancan, D.V.M., Department of Biochemistry and Molecular Biology III, Faculty of Medicine, Universidad Complutense de Madrid Avenida Complutense s/n 28040, Madrid, Spain.
Transplantation. 2014 Dec 15;98(11):1151-7. doi: 10.1097/TP.0000000000000408.
Transplants cause ischemia-reperfusion (IR) injury that can affect distant organs. Liver is particularly sensitive to IR injury. The present randomized experimental study was designed to investigate a possible protective effect of sevoflurane against liver inflammatory response to lung IR in a lung upper lobe left autotransplant model.
Two groups (sevoflurane and control) of eight swines each were submitted to upper lobe left lung autotransplant. Hypnotic maintenance was performed with sevoflurane 3% or propofol 8 to 10 mg/kg per hr until pneumonectomy was done; then propofol was used for all animals. Blood and liver samples were taken in four different moments: prepneumonectomy, prereperfusion, 10 min postreperfusion and 30 min postreperfusion to measure levels of interleukin (IL)-1β, IL-10, tumor necrosis factor (TNF)-α, monocyte chemotactic protein (MCP)-1, nuclear factor (NF)-κB, C-reactive protein, ferritin and caspase 3. Non-parametric test was used to find statistical meaning.
Lung IR markedly increased the expression of TNF-α, IL-1β, MCP-1, NF-κB and caspase activity in control livers compared with basal levels, whereas liver IL-10 expression decreased 10 and 30 min post-reperfusion. Sevoflurane significantly decreased TNF-α, IL-1β, MCP-1, NF-κB liver expression and caspase 3 activity. Sevoflurane also reverted the lung IR-induced decrease in IL-10 expression.
The present results indicate that lung IR caused hepatic injury. Sevoflurane attenuated liver injury in a model of upper lobe left lung autotransplant in pigs.
移植会导致缺血再灌注(IR)损伤,这种损伤可能会影响远处器官。肝脏对IR损伤尤为敏感。本随机实验研究旨在探讨在左肺上叶自体移植模型中,七氟醚对肝脏对肺IR炎症反应的可能保护作用。
两组(七氟醚组和对照组),每组八头猪,进行左肺上叶自体移植。用3%七氟醚或每小时8至10毫克/千克丙泊酚维持麻醉,直至肺切除完成;然后所有动物均使用丙泊酚。在四个不同时间点采集血液和肝脏样本:肺切除术前、再灌注前、再灌注后10分钟和再灌注后30分钟,以测量白细胞介素(IL)-1β、IL-10、肿瘤坏死因子(TNF)-α、单核细胞趋化蛋白(MCP)-1、核因子(NF)-κB、C反应蛋白、铁蛋白和半胱天冬酶3的水平。采用非参数检验来确定统计学意义。
与基础水平相比,肺IR显著增加了对照组肝脏中TNF-α、IL-1β、MCP-1、NF-κB的表达和半胱天冬酶活性,而肝脏IL-10表达在再灌注后10分钟和30分钟下降。七氟醚显著降低了TNF-α、IL-1β、MCP-1、NF-κB的肝脏表达和半胱天冬酶3活性。七氟醚还逆转了肺IR诱导的IL-10表达下降。
目前的结果表明肺IR会导致肝损伤。在猪左肺上叶自体移植模型中,七氟醚减轻了肝损伤。