Zheng Wei, Zhang Zhiyong, Liu Sushun, Bi Jianbin, Zhang Jingyao, Du Lixue, Ding Xiaoming, Liu Chang
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University.
Department of Hepatobiliary Surgery, Shaanxi Provincial People's Hospital.
Hepatol Res. 2017 Feb;47(2):234-245. doi: 10.1111/hepr.12702. Epub 2016 May 4.
Acetaminophen (APAP) overdose is a major cause of drug-induced acute liver failure. Studies have shown that remote ischemic pre- and post-conditioning (R-IPC and R-IPOST) can protect the liver against ischemia-reperfusion (I/R) and lipopolysaccharide-induced injuries. The aim of this study was to investigate the effect of R-IPC and R-IPOST on APAP-induced hepatotoxicity in mice.
Mice were randomized (n = 6 per group) to seven major groups: (i) normal control; (ii) sham operated; (iii) APAP; (iv) R-IPC + APAP; (v) R-IPC + APAP + zinc protoporphyrin (ZnPP); (vi) R-IPOST + APAP; and (vii) R-IPOST + APAP + ZnPP. Sixteen hours after APAP treatment, mouse liver and serum were collected to determine the severity of liver injury.
The results showed that R-IPC and R-IPOST significantly decreased APAP-induced serum levels of alanine aminotransferase, aspartate aminotransferase, tumor necrosis factor-α, interleukin-6, and hepatic malondialdehyde, as well as nitrotyrosine formation. Both R-IPC and R-IPOST could improve the hepatic superoxide dismutase, glutathione, and glutathione peroxidase activities and depress the expressions of pro-inflammatory associated proteins, such as inducible nitric oxide synthetase and nuclear factor-κB. They could also increase heme oxygenase-1 expression; however, ZnPP could counteract this protective effect.
Remote ischemic conditioning has significant therapeutic potential in APAP-induced hepatotoxicity by inhibiting oxidative stress and inflammation and promoting heme oxygenase-1 expression.
对乙酰氨基酚(APAP)过量是药物性急性肝衰竭的主要原因。研究表明,远程缺血预处理和后处理(R-IPC和R-IPOST)可保护肝脏免受缺血再灌注(I/R)和脂多糖诱导的损伤。本研究旨在探讨R-IPC和R-IPOST对APAP诱导的小鼠肝毒性的影响。
将小鼠随机分为七个主要组(每组n = 6):(i)正常对照组;(ii)假手术组;(iii)APAP组;(iv)R-IPC + APAP组;(v)R-IPC + APAP + 锌原卟啉(ZnPP)组;(vi)R-IPOST + APAP组;(vii)R-IPOST + APAP + ZnPP组。APAP处理16小时后,收集小鼠肝脏和血清以确定肝损伤的严重程度。
结果表明,R-IPC和R-IPOST显著降低了APAP诱导的血清丙氨酸氨基转移酶、天冬氨酸氨基转移酶、肿瘤坏死因子-α、白细胞介素-6和肝丙二醛水平,以及硝基酪氨酸的形成。R-IPC和R-IPOST均可提高肝脏超氧化物歧化酶、谷胱甘肽和谷胱甘肽过氧化物酶活性,并抑制促炎相关蛋白如诱导型一氧化氮合酶和核因子-κB的表达。它们还可增加血红素加氧酶-1的表达;然而,ZnPP可抵消这种保护作用。
远程缺血预处理通过抑制氧化应激和炎症并促进血红素加氧酶-1表达,在APAP诱导的肝毒性中具有显著的治疗潜力。