Chou An-Hsun, Liao Chia-Chih, Lee Hung-Chen, Liou Jiin-Tarng, Liu Fu-Chao
Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Drug Des Devel Ther. 2019 Nov 14;13:3887-3898. doi: 10.2147/DDDT.S215473. eCollection 2019.
Dexmedetomidine [DEX; (S)-4-[1-(2,3-dimethylphenyl)ethyl]-3H-imidazole] is a selective α-adrenergic receptor (α-AR) agonist that attenuates the liver damage associated with local or systemic inflammation. However, it remains unclear whether DEX has protective effects against acetaminophen (Paracetamol, PARA)-induced liver toxicity (PILT).
PILT mice were established by intraperitoneal administration of a hepatotoxic dose of acetaminophen (300 mg/kg). Thirty minutes later, the mice were treated with DEX at a concentration of 0, 5, 25, or 50 μg/kg. Blood and liver samples were obtained for further analysis.
DEX treatment significantly attenuated PILT in mice, with the strongest beneficial effects at a dose of 25 μg/kg. The levels of hepatic cytokines, tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), in addition to myeloperoxidase (MPO) activity, were significantly decreased following DEX treatment. Moreover, DEX treatment reduced macrophage recruitment around the area of hepatotoxicity and the expression levels of hepatic phosphorylated mitogen-activated protein kinase kinase 4 (MAP2K4), c-jun N-terminal kinase (JNK), and c-Jun expression induced by acetaminophen overdose.
The data suggest that DEX likely downregulates the JNK signaling pathway and its downstream effectors to promote its hepatoprotective effect, providing a clinical application of DEX for the attenuation of PILT.
右美托咪定[DEX;(S)-4-[1-(2,3-二甲基苯基)乙基]-3H-咪唑]是一种选择性α-肾上腺素能受体(α-AR)激动剂,可减轻与局部或全身炎症相关的肝损伤。然而,DEX对乙酰氨基酚(扑热息痛,PARA)诱导的肝毒性(PILT)是否具有保护作用仍不清楚。
通过腹腔注射肝毒性剂量的乙酰氨基酚(300 mg/kg)建立PILT小鼠模型。30分钟后,小鼠分别接受浓度为0、5、25或50 μg/kg的DEX治疗。采集血液和肝脏样本进行进一步分析。
DEX治疗显著减轻了小鼠的PILT,其中25 μg/kg剂量的效果最佳。DEX治疗后,肝组织中细胞因子、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)的水平以及髓过氧化物酶(MPO)活性均显著降低。此外,DEX治疗减少了肝毒性区域周围的巨噬细胞募集,以及乙酰氨基酚过量诱导的肝组织磷酸化丝裂原活化蛋白激酶激酶4(MAP2K4)、c-Jun氨基末端激酶(JNK)和c-Jun的表达水平。
数据表明,DEX可能通过下调JNK信号通路及其下游效应因子来发挥其肝保护作用,为DEX在减轻PILT方面的临床应用提供了依据。