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Xiao F, Han W, Yue Q, Ke J, Jia B, Fu X. Perioperative omega-3 fatty acids for liver surgery: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2021; 100:e25743. [PMID: 34232163 PMCID: PMC8270594 DOI: 10.1097/md.0000000000025743] [Citation(s) in RCA: 1] [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] [Received: 06/23/2020] [Revised: 10/18/2020] [Accepted: 04/07/2021] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION The effect of perioperative omega-3 fatty acids for liver surgery remained controversial. We conducted a systematic review and meta-analysis to explore the influence of omega-3 fatty acids versus placebo in patients undergoing liver surgery. METHODS We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through May 2020, and included randomized controlled trials (RCTs) assessing the effect of omega-3 fatty acids versus placebo for liver surgery. This meta-analysis was performed using the random-effect model. RESULTS Five RCTs were included in the meta-analysis. Overall, compared with control group for liver surgery, omega-3 fatty acids were associated with substantially reduced incidence of infection (odd ratio [OR]=0.56; 95% confidence interval [CI] =0.34-0.91; P = .02), but revealed no remarkable influence on complications (OR = 0.60; 95% CI = 0.29-1.24; P = .17), mortality (OR = 0.76; 95% CI = 0.06-9.37; P = .83), liver failure (OR = 0.72; 95% CI = 0.10 to 5.00; P = 0.74), biliary leakage (OR=1.24; 95% CI = 0.41 to 3.76; P = .70), bleeding (OR = 1.76; 95% CI = 0.63-4.95; P = .28), or ileus (OR = 0.39; 95% CI = 0.07-2.05; P = .27). CONCLUSION Perioperative omega-3 fatty acids may be beneficial to reduce the incidence of infection after liver surgery.
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Affiliation(s)
- Fubin Xiao
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of BeiHua University, Jilin, Jilin, P.R. China
| | - Wei Han
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of BeiHua University, Jilin, Jilin, P.R. China
| | - Qing Yue
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of BeiHua University, Jilin, Jilin, P.R. China
| | - Jianji Ke
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of BeiHua University, Jilin, Jilin, P.R. China
| | - Baoxing Jia
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of BeiHua University, Jilin, Jilin, P.R. China
| | - Xiaojuan Fu
- Chongqing Medical and Pharmaceutical College, Chongqing, P.R. China
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2
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Álvarez-Mercado AI, Rojano-Alfonso C, Micó-Carnero M, Caballeria-Casals A, Peralta C, Casillas-Ramírez A. New Insights Into the Role of Autophagy in Liver Surgery in the Setting of Metabolic Syndrome and Related Diseases. Front Cell Dev Biol 2021; 9:670273. [PMID: 34141709 PMCID: PMC8204012 DOI: 10.3389/fcell.2021.670273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/23/2021] [Indexed: 01/18/2023] Open
Abstract
Visceral obesity is an important component of metabolic syndrome, a cluster of diseases that also includes diabetes and insulin resistance. A combination of these metabolic disorders damages liver function, which manifests as non-alcoholic fatty liver disease (NAFLD). NAFLD is a common cause of abnormal liver function, and numerous studies have established the enormously deleterious role of hepatic steatosis in ischemia-reperfusion (I/R) injury that inevitably occurs in both liver resection and transplantation. Thus, steatotic livers exhibit a higher frequency of post-surgical complications after hepatectomy, and using liver grafts from donors with NAFLD is associated with an increased risk of post-surgical morbidity and mortality in the recipient. Diabetes, another MetS-related metabolic disorder, also worsens hepatic I/R injury, and similar to NAFLD, diabetes is associated with a poor prognosis after liver surgery. Due to the large increase in the prevalence of MetS, NAFLD, and diabetes, their association is frequent in the population and therefore, in patients requiring liver resection and in potential liver graft donors. This scenario requires advancement in therapies to improve postoperative results in patients suffering from metabolic diseases and undergoing liver surgery; and in this sense, the bases for designing therapeutic strategies are in-depth knowledge about the molecular signaling pathways underlying the effects of MetS-related diseases and I/R injury on liver tissue. A common denominator in all these diseases is autophagy. In fact, in the context of obesity, autophagy is profoundly diminished in hepatocytes and alters mitochondrial functions in the liver. In insulin resistance conditions, there is a suppression of autophagy in the liver, which is associated with the accumulation of lipids, being this is a risk factor for NAFLD. Also, oxidative stress occurring in hepatic I/R injury promotes autophagy. The present review aims to shed some light on the role of autophagy in livers undergoing surgery and also suffering from metabolic diseases, which may lead to the discovery of effective therapeutic targets that could be translated from laboratory to clinical practice, to improve postoperative results of liver surgeries when performed in the presence of one or more metabolic diseases.
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Affiliation(s)
- Ana Isabel Álvarez-Mercado
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, Granada, Spain.,Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, Parque Tecnológico Ciencias de la Salud, Granada, Spain.,Instituto de Investigación Biosanitaria ibs. GRANADA, Complejo Hospitalario Universitario de Granada, Granada, Spain
| | - Carlos Rojano-Alfonso
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marc Micó-Carnero
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Carmen Peralta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Araní Casillas-Ramírez
- Hospital Regional de Alta Especialidad de Ciudad Victoria "Bicentenario 2010", Ciudad Victoria, Mexico.,Facultad de Medicina e Ingeniería en Sistemas Computacionales de Matamoros, Universidad Autónoma de Tamaulipas, Matamoros, Mexico
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Linecker M, Frick L, Kron P, Limani P, Kambakamba P, Tschuor C, Langiewicz M, Kachaylo E, Tian Y, Schneider MA, Ungethüm U, Calo N, Foti M, Dufour JF, Graf R, Humar B, Clavien PA. Exercise Improves Outcomes of Surgery on Fatty Liver in Mice: A Novel Effect Mediated by the AMPK Pathway. Ann Surg 2020; 271:347-355. [PMID: 30138163 DOI: 10.1097/sla.0000000000002904] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To investigate whether exercise improves outcomes of surgery on fatty liver, and whether pharmacological approaches can substitute exercising programs. SUMMARY OF BACKGROUND DATA Steatosis is the hepatic manifestation of the metabolic syndrome, and decreases the liver's ability to handle inflammatory stress or to regenerate after tissue loss. Exercise activates adenosine monophosphate-activated kinase (AMPK) and mitigates steatosis; however, its impact on ischemia-reperfusion injury and regeneration is unknown. METHODS We used a mouse model of simple, diet-induced steatosis and assessed the impact of exercise on metabolic parameters, ischemia-reperfusion injury and regeneration after hepatectomy. The same parameters were evaluated after treatment of mice with the AMPK activator 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR). Mice on a control diet served as age-matched controls. RESULTS A 4-week-exercising program reversed steatosis, lowered insulin levels, and improved glucose tolerance. Exercise markedly enhanced the ischemic tolerance and the regenerative capacity of fatty liver. Replacing exercise with AICAR was sufficient to replicate the above benefits. Both exercise and AICAR improved survival after extended hepatectomy in mice challenged with a Western diet, indicating protection from resection-induced liver failure. CONCLUSIONS Exercise efficiently counteracts the metabolic, ischemic, and regenerative deficits of fatty liver. AICAR acts as an exercise mimetic in settings of fatty liver disease, an important finding given the compliance issues associated with exercise. Exercising, or its substitution through AICAR, may provide a feasible strategy to negate the hepatic consequences of energy-rich diet, and has the potential to extend the application of liver surgery if confirmed in humans.
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Affiliation(s)
- Michael Linecker
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Lukas Frick
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Philipp Kron
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Perparim Limani
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Patryk Kambakamba
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Christoph Tschuor
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Magda Langiewicz
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Ekaterina Kachaylo
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Yinghua Tian
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Marcel A Schneider
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Udo Ungethüm
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Nicolas Calo
- Department of Cellular Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Michelangelo Foti
- Department of Cellular Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jean-François Dufour
- Hepatology Unit, Department of Clinical Research, University Hospital of Bern, Bern, Switzerland
| | - Rolf Graf
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Bostjan Humar
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
| | - Pierre-Alain Clavien
- Swiss HPB and Transplant Center, University Hospital of Zürich, Zürich, Switzerland
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Qiu S, Wang F, Hu J, Yang Y, Li D, Tian W, Yuan X, Lv Y, Yu M. Increased dietary fatty acids determine the fatty-acid profiles of human pancreatic cancer cells and their carrier's plasma, pancreas and liver. Endocr J 2020; 67:387-395. [PMID: 31827053 DOI: 10.1507/endocrj.ej19-0429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Primary contents of dietary fat are three or four types of fatty acids, namely saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), n6-polyunsaturated fatty acid (n6PUFA) and, to less extent, n3-polyunsaturated fatty acid (n3PUFA). Previous studies suggest that increased SFA, MUFA, and n6PUFA in high fat diets (HFDs) stimulate the origination, growth, and liver metastasis of pancreatic cancer cells, whereas increased n3PUFA has the opposite effects. It is unclear whether the fatty acid-induced effects are based on changed fatty-acid composition of involved cells. Here, we investigated whether increased SFA, MUFA, n6PUFA, and n3PUFA in different HFDs determine the FA profiles of pancreatic cancer cells and their carrier's plasma, pancreas, and liver. We transplanted MiaPaCa2 human pancreatic cancer cells in athymic mice and fed them normal diet or four HFDs enriched with SFA, MUFA, n6PUFA, and n3PUFA, respectively. After 7 weeks, fatty acids were profiled in tumor, plasma, pancreas, and liver, using gas chromatography. When tumor carriers were fed four HFDs, the fatty acids that were increased dietarily were also increased in the plasma. When tumor carriers were fed MUFA-, n6PUFA-, and n3PUFA-enriched HFDs, the dietarily increased fatty acids were also increased in tumor, pancreas, and liver. When tumor-carriers were fed the SFA-enriched HFD featuring lauric and myristic acids (C12:0 and C14:0), tumor, pancreas, and liver showed an increase not in the same SFAs but palmitic acid (C16:0) and/or stearic acid (C18:0). In conclusion, predominant fatty acids in HFDs determine the fatty-acid profiles of pancreatic cancer cells and their murine carriers.
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Affiliation(s)
- Shuai Qiu
- The Graduate School, Tianjin Medical University, Tianjin 300070, China
- The Laboratory of Acute Abdomen Disease Associated Organ Injury and Repair, Tianjin Hospital of Integrated Traditional Chinese and Western Medicine, Tianjin 300100, China
| | - Feng Wang
- The Laboratory of Acute Abdomen Disease Associated Organ Injury and Repair, Tianjin Hospital of Integrated Traditional Chinese and Western Medicine, Tianjin 300100, China
| | - Jiacai Hu
- The Graduate School, Tianjin Medical University, Tianjin 300070, China
- The Laboratory of Acute Abdomen Disease Associated Organ Injury and Repair, Tianjin Hospital of Integrated Traditional Chinese and Western Medicine, Tianjin 300100, China
| | - Yong Yang
- Centre of Disease Control, Jinnan, Tianjin 300350, China
| | - Dihua Li
- The Laboratory of Acute Abdomen Disease Associated Organ Injury and Repair, Tianjin Hospital of Integrated Traditional Chinese and Western Medicine, Tianjin 300100, China
| | - Wencong Tian
- The Laboratory of Acute Abdomen Disease Associated Organ Injury and Repair, Tianjin Hospital of Integrated Traditional Chinese and Western Medicine, Tianjin 300100, China
| | - Xiangfei Yuan
- The Laboratory of Acute Abdomen Disease Associated Organ Injury and Repair, Tianjin Hospital of Integrated Traditional Chinese and Western Medicine, Tianjin 300100, China
| | - Yuanshan Lv
- The Laboratory of Acute Abdomen Disease Associated Organ Injury and Repair, Tianjin Hospital of Integrated Traditional Chinese and Western Medicine, Tianjin 300100, China
| | - Ming Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin 300070, China
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Linecker M, Botea F, Aristotele Raptis D, Nicolaescu D, Limani P, Alikhanov R, Kim P, Wirsching A, Kron P, Schneider MA, Tschuor C, Kambakamba P, Oberkofler C, De Oliveira ML, Bonvini J, Efanov M, Graf R, Petrowsky H, Khatkov I, Clavien PA, Popescu I. Perioperative omega-3 fatty acids fail to confer protection in liver surgery: Results of a multicentric, double-blind, randomized controlled trial. J Hepatol 2020; 72:498-505. [PMID: 31626819 DOI: 10.1016/j.jhep.2019.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS In a variety of animal models, omega-3 polyunsaturated fatty acids (Ω3-FAs) conferred strong protective effects, alleviating hepatic ischemia/reperfusion injury and steatosis, as well as enhancing regeneration after major tissue loss. Given these benefits along with its safety profile, we hypothesized that perioperative administration of Ω3-FAs in patients undergoing liver surgery may ameliorate the postoperative course. The aim of this study was to investigate the perioperative use of Ω3-FAs to reduce postoperative complications after liver surgery. METHODS Between July 2013 and July 2018, we carried out a multicentric, double-blind, randomized, placebo-controlled trial designed to test whether 2 single intravenous infusions of Omegaven® (Ω3-FAs) vs. placebo may decrease morbidity. The primary endpoints were postoperative complications by severity (Clavien-Dindo classification) integrated within the comprehensive complication index (CCI). RESULTS A total of 261 patients (132 in the Omegaven and 129 in the placebo groups) from 3 centers were included in the trial. Most cases (87%, n = 227) underwent open liver surgery and 56% (n = 105) were major resections (≥3 segments). In an intention-to-treat analysis including the dropout cases, the mortality rate was 4% and 2% in the Omegaven and placebo groups (odds ratio0.40;95% CI 0.04-2.51; p = 0.447), respectively. Any complications and major complications (Clavien-Dindo ≥ 3b) occurred in 46% vs. 43% (p = 0.709) and 12% vs. 10% (p = 0.69) in the Omegaven and placebo groups, respectively. The mean CCI was 17 (±23) vs.14 (±20) (p = 0.417). An analysis excluding the dropouts provided similar results. CONCLUSIONS The routine perioperative use of 2 single doses of intravenous Ω3-FAs (100 ml Omegaven) cannot be recommended in patients undergoing liver surgery (Grade A recommendation). LAY SUMMARY Despite strong evidence of omega-3 fatty acids having liver-directed, anti-inflammatory and pro-regenerative action in various rodent models, 2 single omega-3 fatty acid infusions given to patients before and during liver surgery failed to reduce complications. Because single omega-3 fatty acid infusions failed to confer liver protection in this trial, they cannot currently be recommended. TRIAL REGISTRATION ClinicalTrial.gov: ID: NCT01884948; Institution Ethical Board Approval: KEK-ZH-Nr. 2010-0038; Swissmedic Notification: 2012DR3215.
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Affiliation(s)
- Michael Linecker
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland
| | - Florin Botea
- Center of General Surgery and Liver Transplantation, Fundeni Institute Bucharest, Romania
| | - Dimitri Aristotele Raptis
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland; Department of HPB- and Liver Transplantation Surgery, University College London, Royal Free Hospitals, London, UK
| | - Diana Nicolaescu
- Center of General Surgery and Liver Transplantation, Fundeni Institute Bucharest, Romania
| | - Përparim Limani
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland
| | - Ruslan Alikhanov
- Department of Liver and Pancreatic Surgery, Moscow Clinical Scientific Center, Russia
| | - Pavel Kim
- Department of Liver and Pancreatic Surgery, Moscow Clinical Scientific Center, Russia
| | - Andrea Wirsching
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland
| | - Philipp Kron
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland; Department of HPB and Transplant Surgery, St. James's University Hospital NHS Trust, Leeds, UK
| | - Marcel A Schneider
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland
| | - Christoph Tschuor
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland
| | - Patryk Kambakamba
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland
| | - Christian Oberkofler
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland
| | | | - John Bonvini
- Department of Anesthesiology, University Hospital Zurich, Switzerland
| | - Michail Efanov
- Department of Liver and Pancreatic Surgery, Moscow Clinical Scientific Center, Russia
| | - Rolf Graf
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland
| | - Henrik Petrowsky
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland
| | - Igor Khatkov
- Department of Liver and Pancreatic Surgery, Moscow Clinical Scientific Center, Russia
| | - Pierre-Alain Clavien
- Department of Surgery and Transplantation, University Hospital Zurich, Switzerland.
| | - Irinel Popescu
- Center of General Surgery and Liver Transplantation, Fundeni Institute Bucharest, Romania
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6
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Lv Y, Patel N, Zhang HJ. The progress of non-alcoholic fatty liver disease as the risk of liver metastasis in colorectal cancer. Expert Rev Gastroenterol Hepatol 2019; 13:1169-1180. [PMID: 31774328 DOI: 10.1080/17474124.2019.1697231] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: The liver is the most common metastatic site of colorectal cancer (CRC), and the long-term survival rate of CRC patients who cannot resect liver metastatic lesions radically is extremely low. Early identification of risk factors for liver metastasis from CRC may be an effective strategy to reduce the incidence of liver metastasis. The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing in parallel with an increasing prevalence of obesity and metabolic syndrome (MS), which has become one of the main causes of chronic liver disease worldwide.Areas covered: An overview of the related research progress of the association between NAFLD and colorectal liver metastasis (CRLM).Expert opinion: Certain research proves that there is a close relationship between NAFLD and CRC, and the presence of NAFLD can promote the formation and development of CRC. Although the effect of liver diseases on the incidence of liver metastasis in CRC has been noted in recent years, the results are inconsistent and haven't reached a unified conclusion. Therefore, the association between liver metastasis and NAFLD remains the main focal point in the evolution of CRC.
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Affiliation(s)
- Yan Lv
- Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, P.R. China
| | - Nishant Patel
- Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, P.R. China
| | - Hai-Jun Zhang
- Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, P.R. China.,Precision Medicine Center, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, P.R. China
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7
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Baker MA, Nandivada P, Mitchell PD, Fell GL, Pan A, Cho BS, De La Flor DJ, Anez-Bustillos L, Dao DT, Nosé V, Puder M. Omega-3 fatty acids are protective in hepatic ischemia reperfusion injury in the absence of GPR120 signaling. J Pediatr Surg 2019; 54:2392-2397. [PMID: 31036368 PMCID: PMC6790164 DOI: 10.1016/j.jpedsurg.2019.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/13/2019] [Accepted: 04/08/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND A single dose of IV fish oil (FO) before hepatic ischemia reperfusion injury (HIRI) increases hepatocyte proliferation and reduces necrosis in wild type (WT) mice. It has been suggested that the GPR120 receptor on Kupffer cells mediates FO's ability to reduce HIRI. The purpose of this study was to determine whether GPR120 is required for FO to reduce HIRI. METHODS Sixty-four (n = 8/group) adult male WT (C57BL/6) and GPR120 knockout (KO) mice received IV FO (1 g/kg) or saline 1 h prior to HIRI or sham operation. Mice were euthanized 24 h postoperatively for analysis of hepatic histology, NFκB activity, and serum alanine transaminase (ALT) levels. RESULTS FO pretreated livers had less necrosis after HIRI than saline pretreated livers in both WT (mean ± SEM 25.9 ± 7.3% less, P = 0.007) and KO (36.6 ± 7.3% less, P < 0.0001) mice. There was no significant difference in percent necrosis between WT-FO and KO-FO groups. Sham groups demonstrated minimal necrosis (0-1.9%). Mean [95% CI] ALT after HIRI was significantly higher (P = 0.04) in WT-Saline mice (1604 U/L [751-3427]) compared to WT-FO (321 U/L [150-686]) but was not significantly higher in KO-Saline mice compared to KO-FO. There were no differences in ALT between WT-FO and KO-FO mice who underwent HIRI or between groups who underwent sham surgery. There were no differences in NFκB or IKKβ activation among groups as measured by Western blot analysis. CONCLUSIONS IV FO pretreatment was able to reduce HIRI in GPR120 KO mice, suggesting the hepatoprotective effects of FO are not mediated by GPR120 alone.
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Affiliation(s)
- Meredith A. Baker
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital
| | - Prathima Nandivada
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital
| | - Paul D. Mitchell
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital
| | - Gillian L. Fell
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital
| | - Amy Pan
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital
| | - Bennet S. Cho
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital
| | - Denis J. De La Flor
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital
| | | | - Duy T. Dao
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital
| | - Vania Nosé
- Department of Pathology, Massachusetts General Hospital
| | - Mark Puder
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital.
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8
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Tan HL, Goh BKP. The effect of preoperative low-calorie diets on liver resection outcomes. Transl Gastroenterol Hepatol 2019; 4:29. [PMID: 31231696 DOI: 10.21037/tgh.2019.04.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 04/23/2019] [Indexed: 12/30/2022] Open
Affiliation(s)
- Hwee Leong Tan
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore, Singapore
| | - Brian K P Goh
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Graduate Medical School, Singapore, Singapore
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9
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Omega-3 fatty acid supplementation does not influence liver regeneration in rats after partial hepatectomy. Clin Exp Hepatol 2018; 4:253-259. [PMID: 30603673 PMCID: PMC6311744 DOI: 10.5114/ceh.2018.80127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 06/05/2018] [Indexed: 02/07/2023] Open
Abstract
Aim of the study In the initiation of liver regeneration, multiple stimulatory and inhibitory factors participate. In this study, we aimed to evaluate the effects of omega-3 fatty acids on liver regeneration after 30% partial hepatectomy in rats. Material and methods A total of 14 male Wistar Albino rats were included in this study. The animals were randomly allocated to two groups: the control group (n = 7) and the omega-3 group (n = 7). Rats in the control group were fed a standard rat chow and rats in the omega-3 group received 10 mg/kg/day omega-3 supplementation in addition to normal rat chow in the perioperative period. Rats were investigated seven days after 1/3 partial hepatectomy by liver weight change and hepatocyte proliferation. Results The mean liver regeneration rate was found to be slightly higher (p = 0.061) in the omega-3 group compared the control group. In addition, no significant difference was observed regarding binuclear hepatocyte ratio in pericentral and periportal areas between the two groups. However, livers from rats given omega-3 supplementation have less inflammatory cellular infiltrate in the portal space than livers from the control group. Conclusions Supplementation with omega-3 fatty acids showed no influence on the liver regeneration in rats undergoing 1/3 partial hepatectomy.
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10
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Baker MA, Nandivada P, Mitchell PD, Fell GL, Pan A, Anez-Bustillos L, Dao DT, Gura KM, Nosé V, Puder M. Pretreatment with intravenous fish oil reduces hepatic ischemia reperfusion injury in a murine model. Surgery 2018; 163:1035-1039. [PMID: 29358007 DOI: 10.1016/j.surg.2017.10.071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 09/23/2017] [Accepted: 10/31/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Ischemia reperfusion injury is a barrier to liver surgery and transplantation, particularly for steatotic livers. The purpose of this study was to determine if pretreatment with a single dose of intravenous fish oil decreases hepatic ischemia reperfusion injury and improves recovery of injured livers. METHODS Sixty adult male C57BL/6 mice received 1 g/kg intravenous fish oil (Omegaven, Fresenius Kabi) or isovolumetric 0.9% NaCl (saline) via tail vein 1 hour before 30 minutes of 70% hepatic ischemia. Animals were killed 4, 8, or 24 hours postreperfusion, and livers were harvested for histologic analysis. RESULTS Four hours postreperfusion, saline-treated livers demonstrated marked ischemia diffusely around the central veins, while intravenous fish oil-treated livers demonstrated only patchy necrosis with intervening normal parenchyma. Eight hours postreperfusion, all livers demonstrated pale areas of cell loss with surrounding regenerating hepatocytes. Ki67 staining confirmed 14.4/10 high-powered field (95% confidence interval, 3.2-25.6) more regenerating hepatocytes around areas of necrosis in intravenous fish oil-treated livers. Twenty-four hours postreperfusion, all livers demonstrated patchy areas of necrosis, with an 89% (95% confidence interval, 85-92) decrease in the area of necrosis in intravenous fish oil-treated livers. CONCLUSION Intravenous fish oil treatment prior to hepatic ischemia reperfusion injury decreased the area of hepatic necrosis and increased hepatocyte regeneration compared to saline treatment in a mouse model.
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Affiliation(s)
- Meredith A Baker
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Prathima Nandivada
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Paul D Mitchell
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA, USA
| | - Gillian L Fell
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Amy Pan
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Lorenzo Anez-Bustillos
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Duy T Dao
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Kathleen M Gura
- Department of Pharmacy, Boston Children's Hospital, Boston, MA, USA
| | - Vania Nosé
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Mark Puder
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, MA, USA.
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The 150 most important questions in cancer research and clinical oncology series: questions 76-85 : Edited by Chinese Journal of Cancer. CHINESE JOURNAL OF CANCER 2017; 36:91. [PMID: 29151366 PMCID: PMC5694899 DOI: 10.1186/s40880-017-0259-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 11/07/2017] [Indexed: 12/14/2022]
Abstract
Since the beginning of 2017, Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology to promote cancer research and accelerate collaborations. In this article, 10 questions are presented as followed. Question 76. How to develop effective therapeutics for cancer cachexia? Question 77. How can we develop preclinical animal models to recapitulate clinical situations of cancer patients for more effective anti-cancer drug development? Question 78. How can we develop novel effective therapeutics for pancreatic cancer and hepatocellular carcinoma? Question 79. What are the true beneficial mechanisms of antiangiogenic therapy in cancer patients? Question 80. How to approach the complex mechanisms of interplay among various cellular and molecular components in the tumor microenvironment? Question 81. Can tissue oxygenation improve the efficacy of conventional chemotherapy on cancer? Question 82. Can tissue oxygenation improve the efficacy of radiotherapy on digestive system tumors including liver cancer? Question 83. Can we integrate metabolic priming into multimodal management of liver cancer? Question 84. Has the limit of anti-androgen strategy in prostate cancer treatment been reached by the new generation of anti-androgen drugs? Question 85. Can we identify individuals with early-stage cancers via analyzing their clinical and non-clinical information collected from social media, shopping history, and clinical, pathological, and molecular traces?
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Christ B, Dahmen U, Herrmann KH, König M, Reichenbach JR, Ricken T, Schleicher J, Ole Schwen L, Vlaic S, Waschinsky N. Computational Modeling in Liver Surgery. Front Physiol 2017; 8:906. [PMID: 29249974 PMCID: PMC5715340 DOI: 10.3389/fphys.2017.00906] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 10/25/2017] [Indexed: 12/13/2022] Open
Abstract
The need for extended liver resection is increasing due to the growing incidence of liver tumors in aging societies. Individualized surgical planning is the key for identifying the optimal resection strategy and to minimize the risk of postoperative liver failure and tumor recurrence. Current computational tools provide virtual planning of liver resection by taking into account the spatial relationship between the tumor and the hepatic vascular trees, as well as the size of the future liver remnant. However, size and function of the liver are not necessarily equivalent. Hence, determining the future liver volume might misestimate the future liver function, especially in cases of hepatic comorbidities such as hepatic steatosis. A systems medicine approach could be applied, including biological, medical, and surgical aspects, by integrating all available anatomical and functional information of the individual patient. Such an approach holds promise for better prediction of postoperative liver function and hence improved risk assessment. This review provides an overview of mathematical models related to the liver and its function and explores their potential relevance for computational liver surgery. We first summarize key facts of hepatic anatomy, physiology, and pathology relevant for hepatic surgery, followed by a description of the computational tools currently used in liver surgical planning. Then we present selected state-of-the-art computational liver models potentially useful to support liver surgery. Finally, we discuss the main challenges that will need to be addressed when developing advanced computational planning tools in the context of liver surgery.
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Affiliation(s)
- Bruno Christ
- Molecular Hepatology Lab, Clinics of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Uta Dahmen
- Experimental Transplantation Surgery, Department of General, Visceral and Vascular Surgery, University Hospital Jena, Jena, Germany
| | - Karl-Heinz Herrmann
- Medical Physics Group, Institute for Diagnostic and Interventional Radiology, University Hospital Jena, Friedrich Schiller University Jena, Jena, Germany
| | - Matthias König
- Department of Biology, Institute for Theoretical Biology, Humboldt University of Berlin, Berlin, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Institute for Diagnostic and Interventional Radiology, University Hospital Jena, Friedrich Schiller University Jena, Jena, Germany
| | - Tim Ricken
- Mechanics, Structural Analysis, and Dynamics, TU Dortmund University, Dortmund, Germany
| | - Jana Schleicher
- Experimental Transplantation Surgery, Department of General, Visceral and Vascular Surgery, University Hospital Jena, Jena, Germany.,Department of Bioinformatics, Friedrich Schiller University Jena, Jena, Germany
| | | | - Sebastian Vlaic
- Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany
| | - Navina Waschinsky
- Mechanics, Structural Analysis, and Dynamics, TU Dortmund University, Dortmund, Germany
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