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肝大部切除术猪再生预处理的机制。

Mechanisms of regenerative preconditioning in pigs with subtotal hepatectomies.

机构信息

Department of General and Digestive Surgery, Transplant and Hepatobiliopancreatic Surgery Unit, Hospital General Universitario Gregorio Marañón.

Department of Surgery, School of Medicine, Universidad Complutense de Madrid.

出版信息

Cir Cir. 2022;90(S1):61-69. doi: 10.24875/CIRU.21000373.

Abstract

BACKGROUND

Portal vein occlusion shortly before extended hepatic resections has hepatoprotective properties, but its molecular effects have not been elucidated. We characterized the impact of regenerative preconditioning by portal vein embolization (PVE) on hepatic energy metabolism and cytokine expression.

MATERIALS AND METHODS

About 90% hepatectomies were performed in normal pigs (Control) and in pigs that underwent a PVE 24 h before the surgery (n = 10/group). Blood biochemistry and coagulation, liver damage, liver function (ICG), hepatic content of adenine nucleotides, and hepatic expression of inflammatory mediators (RT-PCR and WB) were determined before the hepatectomy, 15 min, and 24 h later.

RESULTS

All PVE and hepatectomies were successfully accomplished. The 90% hepatectomy resulted in: Immediate reduction of ATP, leading to persistent decreases of energy load and ATP/ADP ratio up to the 24-h time-point; and pro-inflammatory expression profile of cytokines in the remnant liver. Prior performance of PVE attenuated the bioenergetic alterations and prevented many of the changes in hepatic cytokine expression.

CONCLUSIONS

Regenerative preconditioning by PVE improved hepatic energy metabolism and modulated inflammatory mediators in the remnant liver in pigs undergoing major hepatectomies, potentially contributing to its hepatoprotective effects.

摘要

背景

在扩大肝切除术前不久发生的门静脉闭塞具有肝保护作用,但尚未阐明其分子作用。我们描述了门静脉栓塞(PVE)再生预处理对肝能量代谢和细胞因子表达的影响。

材料与方法

在正常猪(对照组)和 PVE 术前 24 小时进行 PVE 的猪中(每组 n = 10)进行了约 90%的肝切除术。在肝切除术前、15 分钟和 24 小时后测定了血液生化学和凝血功能、肝损伤、肝功能(ICG)、肝内腺嘌呤核苷酸含量和肝内炎症介质的表达(RT-PCR 和 WB)。

结果

所有 PVE 和肝切除术均成功完成。90%的肝切除术导致:ATP 立即减少,导致能量负荷和 ATP/ADP 比值持续下降至 24 小时;以及剩余肝脏中细胞因子的促炎表达谱。术前进行 PVE 可减轻生物能量变化,并防止肝内细胞因子表达的许多变化。

结论

PVE 的再生预处理改善了接受大肝切除术的猪的肝能量代谢,并调节了剩余肝脏中的炎症介质,这可能有助于其肝保护作用。

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