Hefler Joshua, Pawlick Rena, Marfil-Garza Braulio A, Thiesen Aducio, Cuesta-Gomez Nerea, Hatami Sanaz, Freed Darren H, Karvellas Constantine, Bigam David L, Shapiro A M James
Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
Liver Res. 2024 Mar 5;8(1):46-53. doi: 10.1016/j.livres.2024.02.002. eCollection 2024 Mar.
The liver is susceptible to ischemia-reperfusion injury (IRI) during hepatic surgery, when the vessels are compressed to control bleeding, or liver transplantation, when there is an obligate period of ischemia. The hallmark of IRI comprises mitochondrial dysfunction, which generates reactive oxygen species, and cell death through necrosis or apoptosis. Cyclosporine (CsA), which is a well-known immunosuppressive agent that inhibits calcineurin, has the additional effect of inhibiting the mitochondrial permeability transition pore (mPTP), thereby, preventing mitochondrial swelling and injury. NIM-811, which is the nonimmunosuppressive analog of CsA, has a similar effect on the mPTP. In this study, we tested the effect of both agents on mitigating warm hepatic IRI in a murine model.
Before ischemic insult, the mice were administered with intraperitoneal normal saline (control); CsA at 2.5, 10, or 25 mg/kg; or NIM-811 at 10 mg/kg. Thereafter, the mice were subjected to partial warm hepatic ischemia by selective pedicle clamping for 60 min, followed by 6 h of recovery after reperfusion. Serum alanine transaminase (ALT) was measured, and the liver tissue was examined histologically for the presence of apoptosis and the levels of inflammatory cytokines.
Compared with the control mice, the mice treated with 10 and 25 mg/kg of CsA and NIM-811 had significantly lower ALT levels ( < 0.001, 0.007, and 0.031, respectively). Moreover, the liver tissue showed reduced histological injury scores after treatment with CsA at 2.5, 10, and 25 mg/kg and NIM-811 ( = 0.041, <0.001, 0.003, and 0.043, respectively) and significant decrease in apoptosis after treatment with CsA at all doses ( = 0.012, 0.007, and <0.001, respectively). Levels of the pro-inflammatory cytokines, particularly interleukin (IL)-1β, IL-2, IL-4, IL-10, and keratinocyte chemoattractant/human growth-regulated oncogene significantly decreased in the mice treated with the highest dose of CsA (25 mg/kg) than those in the control mice.
Premedication with CsA or NIM-811 mitigated hepatic IRI in mice, as evidenced by the decreased ALT and reduced injury on histology. These results have potential implications on mitigating IRI during liver transplantation and resection.
在肝脏手术期间,当血管被压迫以控制出血时,肝脏易受缺血再灌注损伤(IRI);在肝移植时,当存在一段必然的缺血期时,肝脏也易受IRI损伤。IRI的标志包括线粒体功能障碍,其会产生活性氧物种,并通过坏死或凋亡导致细胞死亡。环孢素(CsA)是一种众所周知的抑制钙调神经磷酸酶的免疫抑制剂,它还具有抑制线粒体通透性转换孔(mPTP)的额外作用,从而防止线粒体肿胀和损伤。NIM - 811是CsA的非免疫抑制类似物,对mPTP有类似作用。在本研究中,我们在小鼠模型中测试了这两种药物对减轻温热性肝脏IRI的效果。
在缺血性损伤前,给小鼠腹腔注射生理盐水(对照组);2.5、10或25mg/kg的CsA;或10mg/kg的NIM - 811。此后,通过选择性蒂夹闭使小鼠经历60分钟的部分温热性肝脏缺血,再灌注后恢复6小时。测量血清丙氨酸转氨酶(ALT)水平,并对肝组织进行组织学检查,以检测凋亡情况和炎性细胞因子水平。
与对照小鼠相比,用10mg/kg和25mg/kg的CsA以及NIM - 811处理的小鼠ALT水平显著更低(分别为<0.001、0.007和0.031)。此外,用2.5、10和25mg/kg的CsA以及NIM - 811处理后,肝组织的组织学损伤评分降低(分别为=0.041、<0.001、0.003和0.043),并且所有剂量的CsA处理后凋亡均显著减少(分别为=0.012、0.007和<0.001)。与对照小鼠相比,用最高剂量的CsA(25mg/kg)处理的小鼠中促炎细胞因子水平,特别是白细胞介素(IL)-1β、IL - 2、IL - 4、IL - 10和角质形成细胞趋化因子/人类生长调节致癌基因显著降低。
用CsA或NIM - 811进行预处理可减轻小鼠的肝脏IRI,ALT降低和组织学损伤减轻证明了这一点。这些结果对减轻肝移植和肝切除期间的IRI具有潜在意义。