一氧化氮在肝脏缺血再灌注损伤中的作用新进展。
New progress in roles of nitric oxide during hepatic ischemia reperfusion injury.
作者信息
Zhang Ya-Qi, Ding Ning, Zeng Yong-Fen, Xiang Yuan-Yuan, Yang Mei-Wen, Hong Fen-Fang, Yang Shu-Long
机构信息
Ya-Qi Zhang, Ning Ding, Yong-Fen Zeng, Yuan-Yuan Xiang, Mei-Wen Yang, Shu-Long Yang, Department of Physiology, Basic Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China.
出版信息
World J Gastroenterol. 2017 Apr 14;23(14):2505-2510. doi: 10.3748/wjg.v23.i14.2505.
Hepatic ischemia reperfusion injury (HIRI) is a clinical condition which may lead to cellular injury and organ dysfunction. The role of nitric oxide (NO) in HIRI is complicated and inconclusive. NO produced by endothelial nitric oxide synthase (eNOS) activation plays a protective role during early HIRI. But eNOS overexpression and the resulting excessive NO bioavailability can aggravate liver injury. NO induced by inducible nitric oxide synthase (iNOS) may have either a protective or a deleterious effect during the early phase of HIRI, but it may protect the liver during late HIRI. Here, we reviewed the latest findings on the role of NO during HIRI: (1) NO exerts a protective effect against HIRI by increasing NO bioavailability, downregulating p53 gene expression, decreasing inflammatory chemokines, reducing ROS inhibiting the mitochondrial respiratory chain, activating sGC-GTP-cGMP signal pathway to reduce liver cell apoptosis, and regulating hepatic immune functions; (2) eNOS protects against HIRI by increasing NO levels, several eNOS/NO signal pathways (such as Akt-eNOS/NO, AMPK-eNOS/NO and HIF-1α-eNOS/NO) participating in the anti-HIRI process, and inhibiting over-expression of eNOS also protects against HIRI; and (3) the inhibition of iNOS prevents HIRI. Thus, the adverse effects of NO should be avoided, but its positive effect in the clinical treatment of diseases associated with HIRI should be recognized.
肝缺血再灌注损伤(HIRI)是一种可能导致细胞损伤和器官功能障碍的临床病症。一氧化氮(NO)在HIRI中的作用复杂且尚无定论。内皮型一氧化氮合酶(eNOS)激活产生的NO在早期HIRI中起保护作用。但eNOS过表达及由此导致的NO生物利用度过高会加重肝损伤。诱导型一氧化氮合酶(iNOS)诱导产生的NO在HIRI早期阶段可能具有保护作用或有害作用,但在HIRI后期可能对肝脏起到保护作用。在此,我们综述了关于NO在HIRI中作用的最新研究结果:(1)NO通过提高NO生物利用度、下调p53基因表达、减少炎症趋化因子、降低活性氧、抑制线粒体呼吸链、激活sGC - GTP - cGMP信号通路以减少肝细胞凋亡以及调节肝脏免疫功能,对HIRI发挥保护作用;(2)eNOS通过提高NO水平对HIRI起到保护作用,几条eNOS/NO信号通路(如Akt - eNOS/NO、AMPK - eNOS/NO和HIF - 1α - eNOS/NO)参与抗HIRI过程,并且抑制eNOS过表达也可预防HIRI;(3)抑制iNOS可预防HIRI。因此,应避免NO的不良影响,但也应认识到其在与HIRI相关疾病临床治疗中的积极作用。