Doi Junshi, Fujimoto Yasuhiro, Teratani Takumi, Kasahara Naoya, Maeda Masashi, Tsuruyama Tatsuaki, Iida Taku, Yagi Shintaro, Uemoto Shinji
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Center for Development of Advanced Technology, Jichi Medical University, Tochigi, Japan.
Eur Surg Res. 2019;60(1-2):63-73. doi: 10.1159/000497434. Epub 2019 May 3.
It was demonstrated that polyamines ameliorate ischemia-reperfusion injury (IRI) and promote regeneration in the liver. An optimal protocol of polyamine treatment remains unknown in the clinical setting. We examined 2 types of administration methods using rat models.
Experiment 1: evaluation of pharmacokinetics of polyamines. Experiment 2: for 3 days preoperatively and 5 days postoperatively, polyamines were given to male Lewis rats in the following three groups: the control group, no polyamine administration; the chow group, 0.05% polyamines mixed in chow; the bolus group, polyamines (200 μmol/kg) given by gastric tube once a day. All rats received 70% hepatectomy after 40 min of warm IRI. Postoperatively, IRI and regeneration were evaluated with assessment of serum levels of hepatic enzymes, histology and immunohistochemistry of liver tissue, and measurement of remnant liver weight.
The blood concentrations of polyamines in the portal vein increased at 1 h of bolus administration, while they did not increase without the bolus. The bolus group was significantly associated with lower serum levels of aspartate/alanine aminotransferases (p < 0.05), decreased hepatocyte congestion, vacuolization and necrosis in histopathological scoring (p < 0.05), a lower number of TUNEL-positive hepatocytes (p < 0.05), higher remnant liver weight at 24, 48, and 168 h (p < 0.05), and a higher Ki-67 labeling index (24 h, p < 0.01) compared with the chow group.
The bolus administration of polyamines was more effective in ameliorating IRI and promoting regeneration than chow administration. Perioperative bolus administration of polyamines might be an optimal treatment, when clinically applied.
已证实多胺可改善肝脏缺血再灌注损伤(IRI)并促进肝脏再生。在临床环境中,多胺治疗的最佳方案仍不明确。我们使用大鼠模型研究了两种给药方法。
实验1:评估多胺的药代动力学。实验2:在术前3天和术后5天,将雄性Lewis大鼠分为以下三组给予多胺:对照组,不给予多胺;饲料组,在饲料中混合0.05%的多胺;推注组,每天经胃管给予多胺(200 μmol/kg)。所有大鼠在温缺血40分钟后接受70%肝切除术。术后,通过评估血清肝酶水平、肝组织的组织学和免疫组化以及测量残余肝脏重量来评估IRI和再生情况。
推注给药1小时后门静脉中多胺的血药浓度升高,而未推注时则不升高。与饲料组相比,推注组血清天冬氨酸/丙氨酸转氨酶水平显著降低(p < 0.05),组织病理学评分中肝细胞充血、空泡化和坏死减少(p < 0.05),TUNEL阳性肝细胞数量减少(p < 0.05),在24、48和168小时时残余肝脏重量更高(p < 0.05),且Ki-6