Department of General Surgery, University of Health Sciences, Van Training and Research Hospital, Van, Türkiye.
Department of General Surgery, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Türkiye.
Ulus Travma Acil Cerrahi Derg. 2024 Feb;30(2):80-89. doi: 10.14744/tjtes.2024.32728.
The aim of this study was to quantify serum levels of elafin, a serine protease inhibitor, and to assess its effects on histopathological and biochemical parameters in hepatic ischemia-reperfusion injury.
Forty female Wistar albino rats were divided into five groups: Group 1 served as the control group. Liver ischemia was induced for 30 minutes in the other four groups. An additional 1-hour, 2-hour, and 3-hour reperfusion was induced in Groups 3, 4, and 5, respectively. At the end of the experiment, intracardiac blood samples were obtained for biochemical examination, and tissue samples from the liver were taken for histopathological examination. Levels of elafin, ischemia-modified albumin (IMA), total antioxi-dant status (TAS), and total oxidant status (TOS) were also examined.
Serum elafin levels decreased beginning from Group 2, with the lowest level reached in Group 5 (p<0.01). The IMA level was the lowest in the control group and the highest in Group 5 (p<0.01). TOS, aspartate aminotransferase (AST), and alanine amino-transferase (ALT) levels were lowest in the control group and highest in Group 5 (p<0.01). Group 5 had the highest IMA/albumin ratio, although no significant differences were found between these four groups. The lowest TAS level was found in the control group, but a stable and significant increase was not detected in the other groups. No significant differences were found between the groups in terms of alkaline phosphatase (ALP) and albumin levels. A negative correlation was observed between serum elafin levels and AST, ALT, and TOS levels (p<0.01). The number of Grade 1 histopathological results was found to be higher in the groups with reperfusion (Groups 3, 4, 5). In histopathological subgroup analysis, while the elafin level was lower in Grade 1 group, AST, ALT, and TOS levels were higher (p<0.01). Additionally, the IMA/albumin ratio was found to be higher in the Grade 1 group (p=0.02).
In hepatic ischemia-reperfusion injury, elafin levels decreased as the reperfusion time increased. As the reperfusion time increased, both hepatocyte damage and oxidant capacity increased, with a negative correlation observed between these findings and elafin levels. Therefore, elafin may play a protective role in hepatic ischemia-reperfusion injury and could assist clinicians in assessing liver injury.
本研究旨在定量检测丝氨酸蛋白酶抑制剂——分泌型白细胞蛋白酶抑制剂（elafin）在血清中的水平，并评估其在肝缺血再灌注损伤中的组织病理学和生化参数中的作用。
将 40 只雌性 Wistar 白化大鼠分为 5 组：第 1 组为对照组。其他 4 组诱导 30 分钟的肝脏缺血，然后分别在第 3、4 和 5 组中进行 1 小时、2 小时和 3 小时的再灌注。实验结束时，从心内取血样进行生化检查，并取肝组织样本进行组织病理学检查。还检查了 elafin、缺血修饰白蛋白（IMA）、总抗氧化状态（TAS）和总氧化状态（TOS）的水平。
血清 elafin 水平从第 2 组开始下降，第 5 组（p<0.01）达到最低水平。对照组 IMA 水平最低，第 5 组（p<0.01）最高。TOS、天冬氨酸氨基转移酶（AST）和丙氨酸氨基转移酶（ALT）水平在对照组中最低，在第 5 组中最高（p<0.01）。第 5 组的 IMA/白蛋白比值最高，尽管这 4 组之间没有显著差异。对照组的 TAS 水平最低，但其他组没有稳定的显著升高。碱性磷酸酶（ALP）和白蛋白水平在各组之间没有差异。血清 elafin 水平与 AST、ALT 和 TOS 水平呈负相关（p<0.01）。有再灌注的组（第 3、4 和 5 组）的组织病理学分级 1 结果数量更高。在组织病理学亚组分析中，虽然 1 级组的 elafin 水平较低，但 AST、ALT 和 TOS 水平较高（p<0.01）。此外，1 级组的 IMA/白蛋白比值较高（p=0.02）。
在肝缺血再灌注损伤中，随着再灌注时间的延长，elafin 水平下降。随着再灌注时间的延长，肝细胞损伤和氧化能力均增加，与 elafin 水平呈负相关。因此，elafin 可能在肝缺血再灌注损伤中发挥保护作用，并有助于临床医生评估肝损伤。
