Division of Hepato-Pancreato-Biliary and Transplantation Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Gastroenterological Surgery and Oncology, Kitano Hospital, Osaka, Japan.
JPEN J Parenter Enteral Nutr. 2019 Jan;43(1):133-144. doi: 10.1002/jpen.1308. Epub 2018 Jun 5.
Liver ischemia and reperfusion injury (IRI) is a major problem associated with liver surgery. This study is aimed to compare the preventive effect of an antioxidative nutrient-rich enteral diet (Ao diet) with an ordinal enteral diet (control diet) against liver IRI.
The Ao diet was an ordinary diet comprising polyphenols (catechin and proanthocyanidin) and enhanced levels of vitamins C and E. Male C57BL/6 mice were fed the Ao or control diet for 7 days before ischemic insult for 60 minutes, followed by reperfusion for 6 hours. The levels of inflammatory cytokines, chemokines, and antioxidant enzymes and oxidative stress were evaluated.
After 7 days of pretreatment with the Ao diet, the serum levels of vitamins C and E in mice were markedly elevated. The levels of serum aspartate aminotransferase and alanine aminotransferase, as well as the scores of liver necrosis caused by ischemia and reperfusion, were significantly lower in the Ao diet group than in the control diet group. The gene expression levels of inflammatory cytokines and chemokines, such as interleukin-6 and CXCL1, were significantly lower in the Ao diet group. In the liver, the levels of antioxidant enzymes superoxide dismutase 1 (SOD1) and SOD2 were significantly higher and the malondialdehyde levels were significantly lower in the Ao diet group. Cell adhesion molecule expression was significantly lower, and neutrophil and macrophage infiltration was less in the Ao diet group.
Antioxidative nutrient supplementation to an ordinary enteral diet may mitigate liver IRI by causing an antioxidant effect and suppressing inflammation.
肝缺血再灌注损伤(IRI)是与肝外科相关的主要问题。本研究旨在比较富含抗氧化营养素的肠内饮食(Ao 饮食)与常规肠内饮食(对照饮食)预防肝 IRI 的效果。
Ao 饮食为普通饮食,包含多酚(儿茶素和原花青素)和维生素 C 和 E 的强化水平。雄性 C57BL/6 小鼠在缺血 60 分钟前用 Ao 或对照饮食喂养 7 天,然后再进行 6 小时的再灌注。评估炎症细胞因子、趋化因子和抗氧化酶及氧化应激的水平。
Ao 饮食预处理 7 天后,小鼠血清维生素 C 和 E 水平明显升高。Ao 饮食组血清天冬氨酸转氨酶和丙氨酸转氨酶水平以及缺血再灌注引起的肝坏死评分均明显低于对照饮食组。Ao 饮食组促炎细胞因子和趋化因子(如白细胞介素-6 和 CXCL1)的基因表达水平明显降低。在肝脏中,Ao 饮食组超氧化物歧化酶 1(SOD1)和 SOD2 的抗氧化酶水平明显升高,丙二醛水平明显降低。Ao 饮食组细胞黏附分子表达水平降低,中性粒细胞和巨噬细胞浸润减少。
抗氧化营养素补充到普通肠内饮食中可能通过抗氧化作用和抑制炎症减轻肝 IRI。