Yadav S S, Howell D N, Gao W, Steeber D A, Harland R C, Clavien P A
Hepatobiliary and Liver Transplant Laboratory, Duke University Medical Center, Durham, North Carolina 27710, USA.
Am J Physiol. 1998 Dec;275(6):G1341-52. doi: 10.1152/ajpgi.1998.275.6.G1341.
Leukocytes recruited during ischemia-reperfusion to the liver are important mediators of injury. However, the mechanisms of leukocyte adhesion and the role of adhesion receptors in hepatic vasculature remain elusive. L-selectin may critically contribute to injury, priming adhesion for later action of intercellular adhesion molecule-1 (ICAM-1). Paired experiments were performed using mutant mice (L-selectin -/-, ICAM-1 -/-, and L-selectin/ICAM-1 -/-) and wild-type mice (C57BL/6) to investigate leukocyte adhesion in the ischemic liver. Leukocyte adhesion and infiltration were assessed histologically. Aspartate aminotransferase levels were significantly reduced (2- to 3-fold) in mutant vs. wild-type mice in most groups but most significantly after 90 min of partial hepatic ischemia. Leukocyte adhesion was significantly reduced in all mutant mice. Areas of microcirculatory failure, visualized by intravital microscopy, were prevalent in wild-type but virtually absent in L-selectin-deficient mice. After total hepatic ischemia for 75 or 90 min, survival was better in mutant L-selectin and L-selectin/ICAM-1 mice vs. wild-type mice and ICAM-1 mutants. In conclusion, L-selectin is critical in the pathogenesis of hepatic ischemia-reperfusion injury. Poor sinusoidal perfusion due to leukocyte adhesion and clot formation is a factor of injury and appears to involve L-selectin and ICAM-1 receptors.
在缺血再灌注期间募集到肝脏的白细胞是损伤的重要介质。然而,白细胞黏附的机制以及黏附受体在肝血管系统中的作用仍不清楚。L-选择素可能对损伤起关键作用,为细胞间黏附分子-1(ICAM-1)的后续作用引发黏附。使用突变小鼠(L-选择素-/-、ICAM-1-/-和L-选择素/ICAM-1-/-)和野生型小鼠(C57BL/6)进行配对实验,以研究缺血肝脏中的白细胞黏附。通过组织学评估白细胞黏附和浸润情况。在大多数组中,与野生型小鼠相比,突变小鼠的天冬氨酸转氨酶水平显著降低(2至3倍),但在部分肝缺血90分钟后最为显著。所有突变小鼠的白细胞黏附均显著降低。通过活体显微镜观察到的微循环衰竭区域在野生型小鼠中普遍存在,而在L-选择素缺陷小鼠中几乎不存在。在全肝缺血75或90分钟后,突变的L-选择素和L-选择素/ICAM-1小鼠的存活率高于野生型小鼠和ICAM-1突变小鼠。总之,L-选择素在肝缺血再灌注损伤的发病机制中起关键作用。由于白细胞黏附和血栓形成导致的肝窦灌注不良是损伤的一个因素,似乎涉及L-选择素和ICAM-1受体。