Ishikawa Takahisa, Shimada Shingo, Fukai Moto, Kimura Taichi, Umemoto Kouhei, Shibata Kengo, Fujiyoshi Masato, Fujiyoshi Sunao, Hayasaka Takahiro, Kawamura Norio, Kobayashi Nozomi, Shimamura Tsuyoshi, Taketomi Akinobu
Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, N-15, W-7, Kita-Ku, Sapporo, 060-8638, Japan.
Laboratory of Cancer Research, Department of Pathology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Surg Today. 2018 Dec;48(12):1081-1088. doi: 10.1007/s00595-018-1693-0. Epub 2018 Jul 6.
We reported previously that hydrogen gas (H) reduced hepatic ischemia and reperfusion injury (IRI) after prolonged cold storage (CS) of livers retrieved from heart-beating donors. The present study was designed to assess whether H reduced hepatic IRI during donation of a cardiac death (DCD) graft with subsequent CS.
Rat livers were harvested after 30-min cardiac arrest and stored for 4 h in University of Wisconsin solution. The graft was reperfused with oxygenated buffer, with or without H (H or NT groups, respectively), at 37° for 90 min on isolated perfused rat liver apparatus.
In the NT group, liver enzyme leakage, apoptosis, necrosis, energy depletion, redox status, impaired microcirculation, and bile production were indicative of severe IRI, whereas in the H group these impairments were significantly suppressed. The phosphorylation of cytoplasmic MKK4 and JNK were enhanced in the NT group and suppressed in the H group. NFkB-p65 and c-Fos in the nucleus were unexpectedly unchanged by IRI regardless of H treatment, indicating the absence of inflammation in this model.
H was observed to ameliorate IRI in the DCD liver by maintaining microcirculation, mitochondrial functions, and redox status, as well as suppressing the cytoplasmic MKK4-JNK-mediated cellular death pathway.
我们之前报道过,氢气(H₂)可减轻从心脏跳动供体获取的肝脏经过长时间冷保存(CS)后的肝缺血再灌注损伤(IRI)。本研究旨在评估H₂是否能减轻心脏死亡(DCD)供肝在捐献及随后冷保存过程中的肝IRI。
大鼠肝脏在心脏骤停30分钟后获取,并在威斯康星大学溶液中保存4小时。在离体灌注大鼠肝脏装置上,将移植物用含氧缓冲液再灌注,分别添加或不添加H₂(分别为H₂组和非H₂组),在37℃下持续90分钟。
在非H₂组中,肝酶泄漏、细胞凋亡、坏死、能量耗竭、氧化还原状态、微循环受损和胆汁生成均提示存在严重的IRI,而在H₂组中这些损伤得到显著抑制。非H₂组中细胞质MKK4和JNK的磷酸化增强,而在H₂组中受到抑制。无论是否进行H₂处理,细胞核中的NFkB-p65和c-Fos在IRI后均未发生变化,表明该模型中不存在炎症反应。
观察到H₂通过维持微循环、线粒体功能和氧化还原状态,以及抑制细胞质MKK4-JNK介导的细胞死亡途径,改善了DCD肝脏的IRI。