Fujii T, Kuriyama N, Hayasaki A, Iizawa Y, Tanemura A, Kato H, Murata Y, Azumi Y, Kishiwada M, Mizuno S, Usui M, Sakurai H, Isaji S
Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
Transplant Proc. 2018 Nov;50(9):2807-2814. doi: 10.1016/j.transproceed.2018.03.044. Epub 2018 Mar 15.
In an attempt to increase the number of donor livers, there has been an increased use of marginal donor livers, such as steatotic (fatty) livers that increase susceptibility to ischemia and reperfusion injury (IRI). Inflammatory cell accumulation has a greater role in IRI in steatotic liver than in normal liver. Although the recombinant human soluble thrombomodulin (rhsTM) attracts attention as a new treatment for disseminated intravascular coagulation, the therapeutic efficacy of rhsTM in hepatic IRI remains uncertain, especially in fatty livers. We aimed to demonstrate the effect of rhsTM on hepatic IRI using well-established in vivo experimental models with steatotic liver.
C57/BL6 mice were divided into 2 groups: normal liver (NL) group and fatty liver (FL) group, in which the steatotic liver was induced by high-fat diet for 9 weeks. The mice in the NL and FL groups were premedicated with venous injection of rhsTM (TM) or saline (Control) as control groups. All 4 groups (NL-Control vs NL-TM, FL-Control vs FL-TM) were subjected to partial hepatic warm ischemia followed by reperfusion.
rhsTM significantly attenuated liver injury in the FL group as well as the NL group, as evidenced by transaminase levels and histologic finding after hepatic IRI. rhsTM remarkably decreased the accumulation of inflammatory cells, such as macrophages and neutrophils, in both NL and FL tissue after IRI. Furthermore, rhsTM depressed mRNA and protein expressions of adhesion molecules such as intracellular adhesion molecule-1 and vascular cell adhesion molecule-1 in both NL and FL groups after IRI.
Our results demonstrate that rhsTM has a protective effect on fatty liver as well as normal liver after hepatic IRI. They also suggest that rhsTM contributes to attenuation of leukocyte accumulation caused by depressing expressions of adhesion molecules that facilitate accumulation of leukocytes in liver tissue in hepatic IRI.
为了增加供肝数量,边缘供肝的使用有所增加,比如脂肪变性(脂肪肝)肝脏,这类肝脏对缺血再灌注损伤(IRI)的易感性增加。炎症细胞积聚在脂肪肝的IRI中比在正常肝脏中起更大作用。尽管重组人可溶性血栓调节蛋白(rhsTM)作为弥散性血管内凝血的一种新疗法受到关注,但其在肝脏IRI中的治疗效果仍不确定,尤其是在脂肪肝中。我们旨在使用成熟的脂肪肝体内实验模型来证明rhsTM对肝脏IRI的作用。
将C57/BL6小鼠分为2组:正常肝脏(NL)组和脂肪肝(FL)组,其中脂肪肝通过高脂饮食诱导9周。NL组和FL组的小鼠分别静脉注射rhsTM(TM)或生理盐水(作为对照组)进行预处理。所有4组(NL-对照组与NL-TM组,FL-对照组与FL-TM组)均接受部分肝脏热缺血,然后再灌注。
rhsTM显著减轻了FL组和NL组的肝损伤,肝IRI后的转氨酶水平和组织学结果证明了这一点。rhsTM显著减少了IRI后NL组和FL组组织中巨噬细胞和中性粒细胞等炎症细胞的积聚。此外,rhsTM降低了IRI后NL组和FL组中细胞间黏附分子-1和血管细胞黏附分子-1等黏附分子的mRNA和蛋白表达。
我们的结果表明,rhsTM对肝脏IRI后的脂肪肝和正常肝脏均有保护作用。它们还表明,rhsTM通过抑制促进肝组织中白细胞积聚的黏附分子表达,有助于减轻白细胞积聚。