Lee J H, Park K M, Lee Y J, Kim J H, Kim S H
Department of Hepatobiliary and Pancreatic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
Department of Hepatobiliary and Pancreatic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
Transplant Proc. 2016 Dec;48(10):3406-3414. doi: 10.1016/j.transproceed.2016.09.046.
Necrotic cell death is common in a wide variety of pathologic conditions, including ischemia-reperfusion (IR) injury. The aim of this study was to develop an IR injury-induced hepatic necrosis model in dogs by means of selective left hepatic inflow occlusion and to test the efficacy of a new chemical compound, NecroX-7, against the IR injury-induced hepatic damage.
A group of male Beagle dogs received intravenous infusions of either vehicle or different doses of NecroX-7 (1.5, 4.5, or 13 mg/kg) for a 20-minute period before a 90-minute left hepatic inflow occlusion followed by reperfusion.
The gross morphology in the NecroX-7-treated groups after occlusion appeared to be less congested and less swollen than that in vehicle-treated control group. Circulating alanine transaminase and aspartate transaminase levels in the control group were elevated during the course of IR, and were effectively blocked in the 4.5 and 13 mg/kg NecroX-7-treated groups. The serum levels of high-mobility group box 1 protein showed a peak at 8 hours after occlusion in control group, and this elevation was significantly blunted by 4.5 mg/kg NecroX-7 treatment. Histologic analysis showed a marked ischemia or IR injury-induced hepatocytic degenerations, sinusoidal and portal vein congestions, and inflammatory cell infiltrations in the control group, whereas the treatment groups showed significantly diminished histopathology in a dose-dependent manner.
These results demonstrated that NecroX-7 attenuated the hepatocyte lethality caused by hepatic IR injury in a large animal setting. We conclude that NecroX-7 may provide a wide variety of therapeutic options for IR injury in human patients.
坏死性细胞死亡在包括缺血再灌注(IR)损伤在内的多种病理状况中很常见。本研究的目的是通过选择性左肝血流阻断建立犬IR损伤诱导的肝坏死模型,并测试一种新型化合物NecroX-7对IR损伤诱导的肝损伤的疗效。
一组雄性比格犬在进行90分钟的左肝血流阻断然后再灌注之前,静脉输注溶媒或不同剂量的NecroX-7(1.5、4.5或13mg/kg),持续20分钟。
阻断后,NecroX-7治疗组的大体形态学表现为充血和肿胀程度均低于溶媒治疗的对照组。对照组中循环丙氨酸转氨酶和天冬氨酸转氨酶水平在IR过程中升高,而在4.5和13mg/kg NecroX-7治疗组中有效阻断。对照组中高迁移率族蛋白B1的血清水平在阻断后8小时达到峰值,4.5mg/kg NecroX-7治疗可显著减弱这种升高。组织学分析显示,对照组有明显的缺血或IR损伤诱导的肝细胞变性、肝血窦和门静脉充血以及炎性细胞浸润,而治疗组的组织病理学改变呈剂量依赖性显著减轻。
这些结果表明,在大型动物模型中,NecroX-7减轻了肝IR损伤引起的肝细胞致死率。我们得出结论,NecroX-7可能为人类患者的IR损伤提供多种治疗选择。