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Starlinger P, Pereyra D, Hackl H, Ortmayr G, Braunwarth E, Santol J, Najarnia S, Driedger MR, Gregory L, Alva‐Ruiz R, Glasgow A, Assinger A, Nagorney DM, Habermann EB, Staetttner S, Cleary SP, Smoot RL, Gruenberger T. Consequences of Perioperative Serotonin Reuptake Inhibitor Treatment During Hepatic Surgery. Hepatology 2021; 73:1956-1966. [PMID: 33078426 PMCID: PMC8251772 DOI: 10.1002/hep.31601] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/14/2020] [Accepted: 10/01/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Platelet-stored serotonin critically affects liver regeneration in mice and humans. Selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenalin reuptake inhibitors (SNRIs) reduce intraplatelet serotonin. As SSRIs/SNRIs are now one of the most commonly prescribed drugs in the United States and Europe and given serotonin's impact on liver regeneration, we evaluated whether perioperative use of SSRIs/SNRIs affects outcome after hepatic resection. APPROACH AND RESULTS Consecutive patients undergoing hepatic resection (n = 754) were retrospectively included from prospectively maintained databases from two European institutions. Further, an independent cohort of 495 patients from the United States was assessed to validate our exploratory findings. Perioperative intake of SSRIs/SNRIs was recorded, and patients were followed up for postoperative liver dysfunction (LD), morbidity, and mortality. Perioperative intraplatelet serotonin levels were significantly decreased in patients receiving SSRI/SNRI treatment. Patients treated with SSRIs/SNRIs showed a higher incidence of morbidity, severe morbidity, LD, and LD requiring intervention. Associations were confirmed in the independent validation cohort. Combined cohorts documented a significant increase in deleterious postoperative outcome (morbidity odds ratio [OR], 1.56; 95% confidence interval [CI], 1.07-2.31; severe morbidity OR, 1.86; 95% CI, 1.22-2.79; LD OR, 1.96; 95% CI, 1.23-3.06; LD requiring intervention OR, 2.22; 95% CI, 1.03-4.36). Further, multivariable analysis confirmed the independent association of SSRIs/SNRIs with postoperative LD, which was closely associated with postoperative 90-day mortality and 1-year overall survival. CONCLUSIONS We observed a significant association of perioperative SSRI/SNRI intake with adverse postoperative outcome after hepatic resection. This indicates that SSRIs/SNRIs should be avoided perioperatively in patients undergoing hepatic resections.
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Affiliation(s)
- Patrick Starlinger
- Department of SurgeryMedical University of ViennaGeneral HospitalViennaAustria
- Department of SurgeryDivision of Hepatobiliary and Pancreas SurgeryMayo ClinicRochesterMN
| | - David Pereyra
- Department of SurgeryMedical University of ViennaGeneral HospitalViennaAustria
| | - Hubert Hackl
- Institute of BioinformaticsBiocenterMedical University of InnsbruckInnsbruckAustria
| | - Gregor Ortmayr
- Department of SurgeryMedical University of ViennaGeneral HospitalViennaAustria
| | - Eva Braunwarth
- Department of Visceral, Transplantation and Thoracic SurgeryMedical University InnsbruckInnsbruckAustria
| | - Jonas Santol
- Department of SurgeryMedical University of ViennaGeneral HospitalViennaAustria
| | - Sina Najarnia
- Department of SurgeryMedical University of ViennaGeneral HospitalViennaAustria
| | - Michael R. Driedger
- Department of SurgeryDivision of Hepatobiliary and Pancreas SurgeryMayo ClinicRochesterMN
| | - Lindsey Gregory
- Department of SurgeryDivision of Hepatobiliary and Pancreas SurgeryMayo ClinicRochesterMN
| | - Roberto Alva‐Ruiz
- Department of SurgeryDivision of Hepatobiliary and Pancreas SurgeryMayo ClinicRochesterMN
| | - Amy Glasgow
- Robert D. and Patricia E. Kern Center for the Science of Health Care DeliverMayo ClinicRochesterMN
| | - Alice Assinger
- Center of Physiology and PharmacologyMedical University of ViennaViennaAustria
| | - David M. Nagorney
- Department of SurgeryDivision of Hepatobiliary and Pancreas SurgeryMayo ClinicRochesterMN
| | - Elizabeth B. Habermann
- Robert D. and Patricia E. Kern Center for the Science of Health Care DeliverMayo ClinicRochesterMN
| | - Stefan Staetttner
- Department of Visceral, Transplantation and Thoracic SurgeryMedical University InnsbruckInnsbruckAustria
- Department of General, Visceral and Vascular SurgerySKG KlinikumVöcklabruckAustria
| | - Sean P. Cleary
- Department of SurgeryDivision of Hepatobiliary and Pancreas SurgeryMayo ClinicRochesterMN
| | - Rory L. Smoot
- Department of SurgeryDivision of Hepatobiliary and Pancreas SurgeryMayo ClinicRochesterMN
| | - Thomas Gruenberger
- Department of SurgeryHPB CenterViennese Health NetworkClinic Favoriten and Sigmund Freud Private UniversityViennaAustria
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Baier FA, Sánchez-Taltavull D, Yarahmadov T, Castellà CG, Jebbawi F, Keogh A, Tombolini R, Odriozola A, Dias MC, Deutsch U, Furuse M, Engelhardt B, Zuber B, Odermatt A, Candinas D, Stroka D. Loss of Claudin-3 Impairs Hepatic Metabolism, Biliary Barrier Function, and Cell Proliferation in the Murine Liver. Cell Mol Gastroenterol Hepatol 2021; 12:745-767. [PMID: 33866021 PMCID: PMC8273426 DOI: 10.1016/j.jcmgh.2021.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Tight junctions in the liver are essential to maintain the blood-biliary barrier, however, the functional contribution of individual tight junction proteins to barrier and metabolic homeostasis remains largely unexplored. Here, we describe the cell type-specific expression of tight junction genes in the murine liver, and explore the regulation and functional importance of the transmembrane protein claudin-3 in liver metabolism, barrier function, and cell proliferation. METHODS The cell type-specific expression of hepatic tight junction genes is described using our mouse liver single-cell sequencing data set. Differential gene expression in Cldn3-/- and Cldn3+/+ livers was assessed in young and aged mice by RNA sequencing (RNA-seq), and hepatic tissue was analyzed for lipid content and bile acid composition. A surgical model of partial hepatectomy was used to induce liver cell proliferation. RESULTS Claudin-3 is a highly expressed tight junction protein found in the liver and is expressed predominantly in hepatocytes and cholangiocytes. The histology of Cldn3-/- livers showed no overt phenotype, and the canalicular tight junctions appeared intact. Nevertheless, by RNA-seq we detected a down-regulation of metabolic pathways in the livers of Cldn3-/- young and aged mice, as well as a decrease in lipid content and a weakened biliary barrier for primary bile acids, such as taurocholic acid, taurochenodeoxycholic acid, and taurine-conjugated muricholic acid. Coinciding with defects in the biliary barrier and lower lipid metabolism, there was a diminished hepatocyte proliferative response in Cldn3-/- mice after partial hepatectomy. CONCLUSIONS Our data show that, in the liver, claudin-3 is necessary to maintain metabolic homeostasis, retention of bile acids, and optimal hepatocyte proliferation during liver regeneration. The RNA-seq data set can be accessed at: https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE159914.
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Affiliation(s)
- Felix Alexander Baier
- Visceral Surgery and Medicine, Inselspital, Bern University Hospital, Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Daniel Sánchez-Taltavull
- Visceral Surgery and Medicine, Inselspital, Bern University Hospital, Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Tural Yarahmadov
- Visceral Surgery and Medicine, Inselspital, Bern University Hospital, Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Cristina Gómez Castellà
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Fadi Jebbawi
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Adrian Keogh
- Visceral Surgery and Medicine, Inselspital, Bern University Hospital, Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Riccardo Tombolini
- Visceral Surgery and Medicine, Inselspital, Bern University Hospital, Department for BioMedical Research, University of Bern, Bern, Switzerland
| | | | | | - Urban Deutsch
- Theodor Kocher Institute, University of Bern, Bern, Switzerland
| | - Mikio Furuse
- Division of Cell Structure, National Institute for Physiological Sciences, Okazaki, Japan
| | | | - Benoît Zuber
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | - Alex Odermatt
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Daniel Candinas
- Visceral Surgery and Medicine, Inselspital, Bern University Hospital, Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Deborah Stroka
- Visceral Surgery and Medicine, Inselspital, Bern University Hospital, Department for BioMedical Research, University of Bern, Bern, Switzerland.
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Kuscher S, Kronberger IE, Loizides A, Plaikner M, Ninkovic M, Brunner A, Auer H, Gassner EM, Öfner D, Schneeberger S. Exploring the limits of hepatic surgery for alveolar echinococcosis—10-years’ experience in an endemic area of Austria. Eur Surg 2019. [DOI: 10.1007/s10353-019-0596-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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