Kamisako T, Miyawaki S, Gabazza E C, Ishihara T, Kamei A, Kawamura N, Adachi Y
Second Department of Internal Medicine, Kinki University School of Medicine, Osakayama, Japan.
J Hepatol. 1998 Sep;29(3):424-9. doi: 10.1016/s0168-8278(98)80060-3.
BACKGROUNDS/AIMS: No study has so far been conducted to clarify whether the presence of hyperbilirubinemia is detrimental to liver and renal functions. In the present study, the effects of polyethylene glycol-modified bilirubin oxidase (PEG-BOX) therapy on liver and renal function tests, hepatic energy charge and urinary prostaglandin levels were evaluated in a rat model of obstructive jaundice.
Sprague-Dawley rats were used in the experimental model of obstructive jaundice. PEG-BOX or an equivalent amount of PEG alone was intravenously injected into the animals and sampling of blood and urine, and liver harvesting were done sequentially after bile duct ligation.
Conventional liver function tests showed no difference between PEG-BOX and control groups. However, bilirubin concentrations in the peripheral blood and liver tissue specimens markedly decreased, and the hepatic energy charge significantly increased in the PEG-BOX group as compared to controls. The blood concentration of bile acid was lower, but its urinary excretion was higher in the PEG-BOX group than in the control group. In vitro incubation of PEG-BOX with serum from rats with obstructive jaundice decreased the concentration of bilirubin but not that of bile acid. The urinary levels of prostaglandin E2 and the thromboxane B2/6-keto-prostaglandin Fla ratio were significantly lower in the PEG-BOX group than in the control group.
The systemic reduction of bilirubin concentration may contribute to normalization of the urinary levels of prostaglandins and thromboxane B2, to decrease in serum bile acid levels, and to improvement of the hepatic energy charge in obstructive jaundice. These findings suggest that preoperative improvement of jaundice may be beneficial to patients with obstructive jaundice.
背景/目的:迄今为止,尚无研究阐明高胆红素血症的存在是否对肝脏和肾脏功能有害。在本研究中,在阻塞性黄疸大鼠模型中评估了聚乙二醇修饰的胆红素氧化酶(PEG - BOX)治疗对肝脏和肾脏功能测试、肝脏能量电荷及尿前列腺素水平的影响。
将Sprague - Dawley大鼠用于阻塞性黄疸实验模型。在胆管结扎后,将PEG - BOX或等量的单独聚乙二醇静脉注射到动物体内,然后依次进行血液和尿液采样以及肝脏摘取。
常规肝功能测试显示PEG - BOX组和对照组之间无差异。然而,与对照组相比,PEG - BOX组外周血和肝组织标本中的胆红素浓度显著降低,肝脏能量电荷显著增加。PEG - BOX组胆汁酸的血浓度较低,但其尿排泄量高于对照组。PEG - BOX与阻塞性黄疸大鼠血清的体外孵育降低了胆红素浓度,但未降低胆汁酸浓度。PEG - BOX组中前列腺素E2的尿水平以及血栓素B2/6 - 酮 - 前列腺素Fla比值显著低于对照组。
胆红素浓度的全身降低可能有助于阻塞性黄疸患者尿中前列腺素和血栓素B2水平正常化、血清胆汁酸水平降低以及肝脏能量电荷改善。这些发现表明术前改善黄疸可能对阻塞性黄疸患者有益。