Radojkovic M, Stojanovic M, Stanojevic G, Radojkovic D, Gligorijevic J, Ilic I, Stojanovic N
Surgery Department, School of Medicine, University of Nis, Nis, Serbia.
Internal Medicine Department, School of Medicine, University of Nis, Nis, Serbia.
Braz J Med Biol Res. 2017 Jul 20;50(8):e6185. doi: 10.1590/1414-431X20176185.
Ischemia/reperfusion injury is still a major cause of morbidity and mortality during liver surgery and transplantation. A variety of surgical and pharmacological therapeutic strategies have been investigated to minimize the effects of ischemia/reperfusion. The aim of our study was to analyze and compare preventive influences of ischemic preconditioning, adenosine and prostaglandin E1 in the experimental model of hepatic ischemia/reperfusion injury. Adult chinchilla rabbits were divided into four groups: 10 rabbits subjected to liver ischemic preconditioning (3-min period of inflow occlusion followed by a 5-min period of reperfusion) followed by 45 min of Pringle maneuver; 10 rabbits subjected to pre-treatment with intraportal injection of adenosine followed by 45 min of Pringle maneuver; 10 rabbits subjected to pre-treatment with intraportal injection of prostaglandin E1 followed by 45 min of Pringle maneuver; and control group of 10 rabbits subjected to 45 min of inflow liver ischemia without any preconditioning. On the second postoperative day, blood samples were obtained and biochemical parameters of liver function were measured and compared. Liver tissue samples were also obtained and histopathological changes were compared. Based on biochemical and histopathological parameters, it was demonstrated that ischemic preconditioning provided the best protection against hepatic ischemia/reperfusion injury. This was probably due to a wider range of mechanisms of action of this method oriented to reduce oxidative stress and inflammation, and restore liver microcirculation and hepatocyte energy compared to the examined pharmacological strategies.
缺血/再灌注损伤仍然是肝脏手术和移植过程中发病和死亡的主要原因。人们已经研究了多种手术和药物治疗策略，以尽量减少缺血/再灌注的影响。我们研究的目的是分析和比较缺血预处理、腺苷和前列腺素E1在肝缺血/再灌注损伤实验模型中的预防作用。成年毛丝鼠兔分为四组：10只兔先进行肝脏缺血预处理（门静脉血流阻断3分钟，随后再灌注5分钟），然后进行45分钟的Pringle手法；10只兔先经门静脉注射腺苷预处理，然后进行45分钟的Pringle手法；10只兔先经门静脉注射前列腺素E1预处理，然后进行45分钟的Pringle手法；对照组10只兔进行45分钟的肝脏缺血，不进行任何预处理。术后第二天，采集血样，测量并比较肝功能的生化参数。还获取了肝组织样本并比较了组织病理学变化。基于生化和组织病理学参数，结果表明缺血预处理对肝缺血/再灌注损伤提供了最佳保护。这可能是由于与所研究的药物策略相比，该方法具有更广泛的作用机制，旨在减少氧化应激和炎症，并恢复肝脏微循环和肝细胞能量。
