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Kaffarnik MF, Ahmadi N, Lock JF, Wuensch T, Pratschke J, Stockmann M, Malinowski M. Correlation between plasma endothelin-1 levels and severity of septic liver failure quantified by maximal liver function capacity (LiMAx test). A prospective study. PLoS One 2017; 12:e0178237. [PMID: 28542386 PMCID: PMC5441649 DOI: 10.1371/journal.pone.0178237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 04/28/2017] [Indexed: 12/26/2022] Open
Abstract
Aim To investigate the relationship between the degree of liver dysfunction, quantified by maximal liver function capacity (LiMAx test) and endothelin-1, TNF-α and IL-6 in septic surgical patients. Methods 28 septic patients (8 female, 20 male, age range 35–80y) were prospectively investigated on a surgical intensive care unit. Liver function, defined by LiMAx test, and measurements of plasma levels of endothelin-1, TNF-α and IL-6 were carried out within the first 24 hours after onset of septic symptoms, followed by day 2, 5 and 10. Patients were divided into 2 groups (group A: LiMAx ≥100 μg/kg/h, moderate liver dysfunction; group B: LiMAx <100 μg/kg/h, severe liver dysfunction) for analysis and investigated regarding the correlation between endothelin-1 and the severity of liver failure, quantified by LiMAx test. Results Group B showed significant higher results for endothelin-1 than patients in group A (P = 0.01, d5; 0.02, d10). For TNF-α, group B revealed higher results than group A, with a significant difference on day 10 (P = 0.005). IL-6 showed a non-significant trend to higher results in group B. The Spearman's rank correlation coefficient revealed a significant correlation between LiMAx and endothelin-1 (-0.434; P <0.001), TNF-α (-0.515; P <0.001) and IL-6 (-0.590; P <0.001). Conclusions Sepsis-related hepatic dysfunction is associated with elevated plasma levels of endothelin-1, TNF-α and IL-6. Low LiMAx results combined with increased endothelin-1 and TNF-α and a favourable correlation between LiMAx and cytokine values support the findings of a crucial role of Endothelin-1 and TNF-α in development of septic liver failure.
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Affiliation(s)
- Magnus F. Kaffarnik
- Charité–Universitätsmedizin Berlin, Department of General, Visceral and Transplantation Surgery, Augustenburger Platz 1, Berlin, Germany
- * E-mail:
| | - Navid Ahmadi
- Charité–Universitätsmedizin Berlin, Department of General, Visceral and Transplantation Surgery, Augustenburger Platz 1, Berlin, Germany
| | - Johan F. Lock
- Charité–Universitätsmedizin Berlin, Department of General, Visceral and Transplantation Surgery, Augustenburger Platz 1, Berlin, Germany
- University Hospital of Wuerzburg, Department of General-, Visceral-, Vascular- and Paediatric Surgery, Wuerzburg, Germany
| | - Tilo Wuensch
- Charité–Universitätsmedizin Berlin, Department of General, Visceral and Transplantation Surgery, Augustenburger Platz 1, Berlin, Germany
| | - Johann Pratschke
- Charité–Universitätsmedizin Berlin, Department of General, Visceral and Transplantation Surgery, Augustenburger Platz 1, Berlin, Germany
| | - Martin Stockmann
- Charité–Universitätsmedizin Berlin, Department of General, Visceral and Transplantation Surgery, Augustenburger Platz 1, Berlin, Germany
| | - Maciej Malinowski
- Charité–Universitätsmedizin Berlin, Department of General, Visceral and Transplantation Surgery, Augustenburger Platz 1, Berlin, Germany
- University Hospital of Homburg, Department of General-, Visceral-, Vascular- and Paediatric Surgery, Homburg, Germany
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Zhang Y, Wang J, Ji H, Lu H, Lu L, Wang J, Li Y. Effect of HSP27 and Cofilin in the injury of hypoxia/reoxygenation on hepatocyte membrane F-actin microfilaments. Medicine (Baltimore) 2017; 96:e6658. [PMID: 28422872 PMCID: PMC5406088 DOI: 10.1097/md.0000000000006658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Hypoxia-reoxygenation (H/R) injury hepatocyte models were established to simulate the ischemia/reperfusion injury of transplanted organ. Through the study of the molecular mechanism of H/R on the F-actin damage of the liver cytomembrane, the mechanism of F-actin damage induced by ischemia and reperfusion was studied from the level of cell and molecule.The hypoxic environment of cells in vitro was simulated by chemical hypoxia agent CoCl2. Liver cells were detected by MTT, H/R group was subdivided into 3 subgroups: H/R 2, 4, and 6 h. Changes of cell shape and the growth state, apoptosis, ultrastructural changes, and the changes in F-actin microfilament content were observed. Heat shock protein 27 (HSP27), Cofilin, and F-actin gene and protein levels were determined by real-time polymerase chain reaction and western blot assay, respectively.Cells showed circular adherence growth under normal circumstances, while the spindle cells and shedding cells were significantly increased in H/R groups. Apoptosis cells in H/R group were increased significantly with the extension of hypoxia time. The number of endoplasmic reticulum was decreased significantly in the H/R group, the mitochondrion hydropic was degenerated and the glycogen was disappeared. The F-actin fibers in the H/R group were disordered, the morphology of the fibers was obviously decreased, and the fluorescence staining decreased obviously (P < .05). The transcription and expression levels of HSP27, Cofilin, and F-actin were significantly lower than those in the control group (P < .05).These results demonstrate that H/R can affect the correct assembly of F-actin microfilaments and weakens the normal cycle of F-actin microfilaments through inhibiting the protein expression and gene transcription of HSP27 and Cofilin in hepatocytes, thereby changing the skeleton of F-actin microfilaments.
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Ratti F, Pulitanò C, Catena M, Paganelli M, Aldrighetti L. Serum levels of endothelin-1 after liver resection as an early predictor of postoperative liver failure. A prospective study. Hepatol Res 2016; 46:529-40. [PMID: 26331638 DOI: 10.1111/hepr.12585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 08/25/2015] [Accepted: 08/30/2015] [Indexed: 12/13/2022]
Abstract
AIM Besides the residual liver volume, damage of the microcirculation secondary to increased portal blood flow is a main determinant of postoperative liver failure (PLF). Endothelin-1 (ET-1), produced by sinusoidal endothelial cells, plays a key role in the regulation of hepatic microcirculation. The aim of this study was to determine whether ET-1 levels has any prognostic utility in predicting PLF. METHODS Patients undergoing liver resection for primary or secondary liver tumors at San Raffaele Hospital, Milan, were prospectively enrolled in the study. Serial postoperative serum ET-1 levels in patients undergoing liver resections were correlated with indices of inflammatory response, liver failure and death. RESULTS A total of 144 patients were included. ET-1 levels in patients who underwent major or extended liver resection were significantly higher than in patients who had a minor resection on postoperative day (POD) 1 (P = 0.003), POD 2 (P = 0.0001) and POD 5 (P = 0.0001). Eight patients developed PLF and ET-1 was significantly higher compared with patients without PLF on POD 2 (P = 0.002) and POD5 (P = 0.006). Serum ET-1 concentration on POD 2 was an independent predictor of PLF in multivariate analysis. CONCLUSION ET-1 is as an early index of PLF and provides a rationale for therapeutic manipulation, with many potential clinical implications to prevent PLF onset and reduce its severity.
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Affiliation(s)
- Francesca Ratti
- Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy
| | - Carlo Pulitanò
- Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy
| | - Marco Catena
- Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy
| | - Michele Paganelli
- Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy
| | - Luca Aldrighetti
- Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy
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Mancinelli R, Glaser S, Francis H, Carpino G, Franchitto A, Vetuschi A, Sferra R, Pannarale L, Venter J, Meng F, Alpini G, Onori P, Gaudio E. Ischemia reperfusion of the hepatic artery induces the functional damage of large bile ducts by changes in the expression of angiogenic factors. Am J Physiol Gastrointest Liver Physiol 2015; 309:G865-73. [PMID: 26451003 PMCID: PMC4669349 DOI: 10.1152/ajpgi.00015.2015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 09/08/2015] [Indexed: 02/06/2023]
Abstract
Liver transplantation and cholangiocarcinoma induce biliary dysfunction following ischemia reperfusion (IR). The function of the intrahepatic biliary tree is regulated by both autocrine and paracrine factors. The aim of the study was to demonstrate that IR-induced damage of cholangiocytes is associated with altered expression of biliary angiogenic factors. Normal and bile duct ligation rats underwent 24-h sham or hepatic reperfusion after 30 min of transient occlusion of the hepatic artery (HAIR) or portal vein (PVIR) before collecting liver blocks and cholangiocyte RNA or protein. We evaluated liver histology, biliary apoptosis, proliferation and expression of VEGF-A/C, VEGFR-2/3, Ang-1/2, and Tie-1/2 in liver sections and isolated small and large cholangiocytes. Normal rat intrahepatic cholangiocyte cultures (NRICC) were maintained under standard conditions in normoxic or under a hypoxic atmosphere for 4 h and then transferred to normal conditions for selected times. Subsequently, we measured changes in biliary proliferation and apoptosis and the expression of VEGF-A/C and VEGFR-2/3. In vivo, HAIR (but not PVIR) induced damage of large bile ducts and decreased proliferation and secretin-stimulated cAMP levels. HAIR-induced damage of large bile ducts was associated with increased expression of VEGF-A/C, VEGFR-2/3, Ang-1/2, and Tie-1/2. In vitro, under hypoxic conditions, there was increased apoptosis and reduced proliferation of NRICC concomitant with enhanced expression of VEGF-A/C and VEGFR-2/3. The functional damage of large bile ducts by HAIR and hypoxia is associated with increased expression of angiogenic factors in small cholangiocytes, presumably due to a compensatory mechanism in response to biliary damage.
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Affiliation(s)
- Romina Mancinelli
- 1Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza, Rome, Italy;
| | - Shannon Glaser
- 2Research, Central Texas Veterans Health Care System, Temple, Texas; ,3Scott & White Digestive Disease Research Center, Baylor Scott & White, Temple, Texas; ,4Department of Medicine, Division Gastroenterology, Texas A&M University Health Science Center, College of Medicine, Temple, Texas;
| | - Heather Francis
- 2Research, Central Texas Veterans Health Care System, Temple, Texas; ,3Scott & White Digestive Disease Research Center, Baylor Scott & White, Temple, Texas; ,4Department of Medicine, Division Gastroenterology, Texas A&M University Health Science Center, College of Medicine, Temple, Texas;
| | - Guido Carpino
- 1Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza, Rome, Italy;
| | - Antonio Franchitto
- 1Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza, Rome, Italy; ,6Eleonora Lorillard Spencer Cenci Foundation, Rome, Italy
| | - Antonella Vetuschi
- 5Department of Biotechnological and Applied Clinical Sciences, University of L′Aquila, L′Aquila, Italy;
| | - Roberta Sferra
- 5Department of Biotechnological and Applied Clinical Sciences, University of L′Aquila, L′Aquila, Italy;
| | - Luigi Pannarale
- 1Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza, Rome, Italy;
| | - Julie Venter
- 4Department of Medicine, Division Gastroenterology, Texas A&M University Health Science Center, College of Medicine, Temple, Texas;
| | - Fanyin Meng
- 2Research, Central Texas Veterans Health Care System, Temple, Texas; ,3Scott & White Digestive Disease Research Center, Baylor Scott & White, Temple, Texas; ,4Department of Medicine, Division Gastroenterology, Texas A&M University Health Science Center, College of Medicine, Temple, Texas;
| | - Gianfranco Alpini
- 2Research, Central Texas Veterans Health Care System, Temple, Texas; ,3Scott & White Digestive Disease Research Center, Baylor Scott & White, Temple, Texas; ,4Department of Medicine, Division Gastroenterology, Texas A&M University Health Science Center, College of Medicine, Temple, Texas;
| | - Paolo Onori
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza, Rome, Italy;
| | - Eugenio Gaudio
- 1Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza, Rome, Italy;
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Fu YQ, Hua C, Zhou J, Cheng BR, Zhang J. Protective effects of ginseng total saponins against hepatic ischemia/reperfusion injury in experimental obstructive jaundice rats. PHARMACEUTICAL BIOLOGY 2013; 51:1545-1551. [PMID: 24004049 DOI: 10.3109/13880209.2013.802352] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
CONTEXT Ginseng, the root of Panax ginseng C.A. Meyer (Araliaceae), is one of the most extensively used herbs for stroke and chronic debilitating conditions in East Asian countries. Ginsenosides (GS) are the main bioactive compounds for ginseng's efficacy, but the mechanisms have not been fully clarified. OBJECTIVE To investigate hepatoprotective effects of GS against ischemia/reperfusion (IR) injury in the experimental obstructive jaundice rats. MATERIALS AND METHODS GS was fed to cholestatic rats with IR injury daily for 6 d at a dose of 1.10 g/kg. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), superoxide dismutase (SOD) and malondialdehyde (MDA) were determined by colorimetric method. Apoptosis was measured quantitatively by the terminal transferase UTP nick end-labeling method. Protein expression of Bax and Bcl-2 was detected by immunohistochemistry. RESULTS AND DISCUSSION After intervention of GS to cholestatic rats with IR injury, the levels of activating blood flow were significantly improved, and the levels of serum ALT were decreased 1.7-times, AST decreased 1.3-times, but SOD activities were increased 1.1-times compared with those of the model rats. It could also reverse histopathological changes and inhibit IR-induced apoptosis of hepatic tissues via decrease of Bax/Bcl-2 ratio (from 2.87 ± 0.57 to 1.65 ± 0.29). Oral administration of GS in a dosage of 26.4 g/kg did not lead to toxic effects in rats. CONCLUSION GS attenuated the IR injury in the presence of cholestasis and could be considered for the clinical treatment of cholestasis.
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Affiliation(s)
- Yong-qing Fu
- Zhejiang Chinese Medical Hospital, The First Affiliated Hospital of Zhejiang Chinese Medical University , Hangzhou , China
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Yoichi T, Takayashiki T, Shimizu H, Yoshidome H, Ohtsuka M, Kato A, Yoshitomi H, Furukawa K, Kuboki S, Okamura D, Suzuki D, Nakajima M, Miyazaki M. Protective effects of simultaneous splenectomy on small-for-size liver graft injury in rat liver transplantation. Transpl Int 2013; 27:106-13. [DOI: 10.1111/tri.12223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 04/20/2013] [Accepted: 10/20/2013] [Indexed: 12/17/2022]
Affiliation(s)
- Takuya Yoichi
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Tsukasa Takayashiki
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Hiroaki Shimizu
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Hiroyuki Yoshidome
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Masayuki Ohtsuka
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Atsushi Kato
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Hideyuki Yoshitomi
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Katsunori Furukawa
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Satoshi Kuboki
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Daiki Okamura
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Daisuke Suzuki
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Masayuki Nakajima
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Masaru Miyazaki
- Department of General Surgery; Graduate School of Medicine; Chiba University; Chiba Japan
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