Department of Gastroenterology, Erzurum Training and Research Hospital, Erzurum-Türkiye.
Department of Pharmacology, Atatürk University Faculty of Medicine, Erzurum-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2023 Feb;29(2):133-139. doi: 10.14744/tjtes.2022.45605.
Sepsis is a complex syndrome which comes out after infection, characterized by activation of inflammation and infection and has a high morbidity and mortality. Sildenafil (SLD) is a selective phosphodiesterase Type 5 enzyme inhibitor and is used in the treatment of erectile dysfunction effectively all over the world. In this study, we investigated whether SLD had protective effect or not by studying the effect of SLD on reactive oxygen species and antioxidants in cecal ligation and puncture (CLP) polymicrobial sepsis model in rat liver histopathologically and biochemically.
Rats were divided into four groups: (1) 10 mg/kg SLD given CLP group; (2) 20 mg/kg SLD given CLP group; (3) CLP group; and (4) SHAM operated group. CLP polymicrobial sepsis model was applied to the rats. All rats in our study were sacrificed by overdose general anesthetic after 16 h (thiopental sodium, 50 mg/kg). Specimens of rat liver were analyzed histopathologically and biochemically. In the study, superoxide dismutase (SOD) and glutathione (GSH) parameters were measured to indicate the antioxidant activity in liver during sepsis. To evaluate the oxidant activity, myeloperoxidase (MPO) and lipid peroxidation (LPO) parameters were measured in liver tissue.
SOD and MPO activities and GSH and LPO levels were high in CLP polymicrobial sepsis model when compared to SHAM group (p<0.05). In all SLD groups, GSH levels were high when compared to CLP group. In 20 mg/kg SLD given sepsis group, high GSH levels were observed according to SHAM group. In addition, while all SLD dose groups had a significant decrease versus CLP group in LPO levels (p<0.05), they had a significant increase in MPO activities. In 20 mg/kg SLD administrated rats, an improvement observed in biochemical parameters. In this study, SOD and MPO activities which were low in SHAM group increased in CLP polymicrobial sepsis model. When SLD administrated, MPO activity increased in both SHAM and CLP groups. In this study, GSH and LPO levels also increase in septic liver tissue. When SLD administrated to SHAM group, it increased VI protective GSH level and decreased detrimental LPO level. In histopathological examination, it was observed that 10 mg/kg SLD administration had a curative effect in liver tissue partly.
It was shown that acute SLD administration decreased liver damage in septic rats dose-dependently in this study. In addition, it was observed that it corrected the broken oxidant-antioxidant balance. This might mediate the protective effect of SLD in liver. However, we believe that new experimental and clinical studies should be in the future to understand the protective effect of SLD in liver.
败血症是一种复杂的综合征,由感染引起,以炎症和感染的激活为特征,发病率和死亡率都很高。西地那非(SLD)是一种选择性磷酸二酯酶 5 酶抑制剂,在全球范围内有效地用于治疗勃起功能障碍。在这项研究中,我们通过研究 SLD 对大鼠肝组织病理学和生物化学中盲肠结扎和穿刺(CLP)多微生物败血症模型中活性氧和抗氧化剂的影响,来研究 SLD 是否具有保护作用。
将大鼠分为四组:(1)10mg/kg SLD 给予 CLP 组;(2)20mg/kg SLD 给予 CLP 组;(3)CLP 组;(4)SHAM 手术组。应用 CLP 多微生物败血症模型对大鼠进行处理。所有大鼠均在 16 小时后(硫喷妥钠,50mg/kg)过量全身麻醉下处死。分析大鼠肝组织的病理和生化变化。在研究中,测量超氧化物歧化酶(SOD)和谷胱甘肽(GSH)参数以指示败血症期间肝中的抗氧化活性。为了评估氧化剂活性,在肝组织中测量髓过氧化物酶(MPO)和脂质过氧化(LPO)参数。
与 SHAM 组相比,CLP 多微生物败血症模型中的 SOD 和 MPO 活性以及 GSH 和 LPO 水平均升高(p<0.05)。在所有 SLD 组中,与 CLP 组相比,GSH 水平升高。在 20mg/kg SLD 给予败血症组中,与 SHAM 组相比,观察到高 GSH 水平。此外,虽然所有 SLD 剂量组的 LPO 水平与 CLP 组相比均显著降低(p<0.05),但 MPO 活性显著升高。在 20mg/kg SLD 给药的大鼠中,生化参数得到改善。在这项研究中,SHAM 组中 SOD 和 MPO 活性较低的 CLP 多微生物败血症模型中增加。当给予 SLD 时,SHAM 和 CLP 组中的 MPO 活性均增加。在这项研究中,败血症肝组织中的 GSH 和 LPO 水平也增加。当 SLD 给予 SHAM 组时,它增加了保护性 GSH 水平并降低了有害的 LPO 水平。在组织病理学检查中,观察到 10mg/kg SLD 给药对肝组织有部分治疗作用。
本研究表明,急性 SLD 给药可剂量依赖性地降低败血症大鼠的肝损伤。此外,观察到它纠正了破坏的氧化剂-抗氧化剂平衡。这可能介导了 SLD 在肝脏中的保护作用。然而,我们认为,未来应该进行新的实验和临床研究,以了解 SLD 在肝脏中的保护作用。