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Somatostatin and the "Small-For-Size" Liver. Int J Mol Sci 2019; 20:ijms20102512. [PMID: 31121844 PMCID: PMC6566601 DOI: 10.3390/ijms20102512] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/07/2019] [Accepted: 05/14/2019] [Indexed: 02/07/2023] Open
Abstract
“Small-for-size” livers arising in the context of liver resection and transplantation are vulnerable to the effects of increased portal flow in the immediate postoperative period. Increased portal flow is an essential stimulus for liver regeneration. If the rise in flow and stimulus for regeneration are excessive; however, liver failure and patient death may result. Somatostatin is an endogenous peptide hormone that may be administered exogenously to not only reduce portal blood flow but also offer direct protection to different cells in the liver. In this review article, we describe key changes that transpire in the liver following a relative size reduction occurring in the context of resection and transplantation and the largely beneficial effects that peri-operative somatostatin therapy may help achieve in this setting.
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Carrapita J, Abrantes AM, Campelos S, Gonçalves AC, Cardoso D, Sarmento-Ribeiro AB, Rocha C, Santos JN, Botelho MF, Tralhão JG, Farges O, Barbosa JM. Impact of splenic artery ligation after major hepatectomy on liver function, regeneration and viability. Sci Rep 2016; 6:34731. [PMID: 27725728 PMCID: PMC5057079 DOI: 10.1038/srep34731] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 09/15/2016] [Indexed: 12/20/2022] Open
Abstract
It was reported that prevention of acute portal overpressure in small-for-size livers by inflow modulation results in a better postoperative outcome. The aim is to investigate the impact of portal blood flow reduction by splenic artery ligation after major hepatectomy in a murine model. Forty-eight rats were subjected to an 85% hepatectomy or 85% hepatectomy and splenic artery ligation. Both groups were evaluated at 24, 48, 72 and 120 post-operative hours: liver function, regeneration and viability. All methods and experiments were carried out in accordance with Coimbra University guidelines. Splenic artery ligation produces viability increase after 24 h, induces a relative decrease in oxidative stress during the first 48 hours, allows antioxidant capacity increment after 24 h, which is reflected in a decrease of half-time normalized liver curve at 48 h and at 72 h and in an increase of mitotic index between 48 h and 72 h. Splenic artery ligation combined with 85% hepatectomy in a murine model, allows portal inflow modulation, promoting an increase in hepatocellular viability and regeneration, without impairing the function, probably by inducing a less marked elevation of oxidative stress at first 48 hours.
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Affiliation(s)
- Jorge Carrapita
- General Surgery Department of Vila Nova de Gaia/Espinho Hospital, Portugal.,Institute of Biomedical Sciences Abel Salazar, University of Oporto, Portugal
| | - Ana Margarida Abrantes
- Biophysics Institute, Faculty of Medicine, University of Coimbra, Portugal.,CNC.IBILI, Faculty of Medicine, University of Coimbra, Portugal.,Centre of Investigation on Environment, Genetics and Oncobiology (CIMAGO), Portugal
| | - Sofia Campelos
- Pathologic Anatomy Department of Vila Nova de Gaia/Espinho Hospital, Portugal
| | - Ana Cristina Gonçalves
- CNC.IBILI, Faculty of Medicine, University of Coimbra, Portugal.,Centre of Investigation on Environment, Genetics and Oncobiology (CIMAGO), Portugal.,Laboratory of Oncobiology and Hematology (LOH), University Clinic of Hematology and Appied Molecular Biology Unit, Faculty of Medicine, University of Coimbra, Portugal
| | - Dulce Cardoso
- Nuclear Medicine Department, University Hospital of Coimbra, Portugal
| | - Ana Bela Sarmento-Ribeiro
- CNC.IBILI, Faculty of Medicine, University of Coimbra, Portugal.,Centre of Investigation on Environment, Genetics and Oncobiology (CIMAGO), Portugal.,Laboratory of Oncobiology and Hematology (LOH), University Clinic of Hematology and Appied Molecular Biology Unit, Faculty of Medicine, University of Coimbra, Portugal.,Clinical Hematology Department, Coimbra University Hospital Centre (CHUC), Portugal
| | - Clara Rocha
- ESTESC-Coimbra Health School Department Complementary Sciences, Polytechnic Institute of Coimbra, Portugal.,Institute for Systems Engineering and Computers at Coimbra (INESCC), Portugal
| | - Jorge Nunes Santos
- Institute of Biomedical Sciences Abel Salazar, University of Oporto, Portugal
| | - Maria Filomena Botelho
- Biophysics Institute, Faculty of Medicine, University of Coimbra, Portugal.,CNC.IBILI, Faculty of Medicine, University of Coimbra, Portugal.,Centre of Investigation on Environment, Genetics and Oncobiology (CIMAGO), Portugal
| | - José Guilherme Tralhão
- Biophysics Institute, Faculty of Medicine, University of Coimbra, Portugal.,CNC.IBILI, Faculty of Medicine, University of Coimbra, Portugal.,Centre of Investigation on Environment, Genetics and Oncobiology (CIMAGO), Portugal.,Surgery A, Surgery Department of Coimbra University Hospital, Faculty of Medicine, University of Coimbra, Portugal
| | - Olivier Farges
- Hepatobiliary and pancreatic unit, Beaujon Hospital, AP-HP, Université Paris Clichy, France
| | - Jorge Maciel Barbosa
- General Surgery Department of Vila Nova de Gaia/Espinho Hospital, Portugal.,Fernando Pessoa University, Oporto, Portugal
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Du Z, Zhou Y, Lu X, Li L, Lu C, Li L, Li B, Bu H, Yang J, Shi Y. Octreotide prevents liver failure through upregulating 5'-methylthioadenosine in extended hepatectomized rats. Liver Int 2016; 36:212-22. [PMID: 25944273 DOI: 10.1111/liv.12863] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/01/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND & AIMS Insufficient liver regeneration and hepatocyte injury caused by excessive portal perfusion are considered to be responsible for post-hepatectomy liver failure (PLF) or small-for-size syndrome in living-donor liver transplantation. Somatostatin can decrease portal vein pressure (PVP) but simultaneously inhibits liver regeneration. This interesting paradox motivated us to investigate the outcome of PLF in response to somatostatin treatment. METHODS Rats receiving extended partial hepatectomy (90% PH) were treated with octreotide, a somatostatin analogue, or placebo. Animal survival, serum parameters and hepatic histology were evaluated. Metabolomic analysis was performed to investigate the effect of octreotide on hepatocyte metabolism. RESULTS Despite significantly inhibiting early regeneration, octreotide application noticeably improved the hepatic histology, liver function and survival after PH but did not decrease the PVP level. Metabolomic analysis exhibited that octreotide profoundly and exclusively altered the levels of five metabolites that participate in or closely associate with the methionine cycle, a biochemical reaction that uniquely produces S-adenosylmethionine (SAMe), an active methyl residual donor for methyltransferase reactions. Among these metabolites, 5'-methylthioadenosine (MTA), a derivate of SAMe, increased three-fold and was found independently improve the hepatic histology and reduce inflammatory cytokines in hepatectomized rats. CONCLUSIONS Octreotide exclusively regulates the methionine cycle reaction and augments the MTA level in hepatocytes. MTA prominently protects hepatocytes against shear stress injury and reduces the secondary inflammation, thereby protecting rats from PLF.
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Affiliation(s)
- Zhenggui Du
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, China.,Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, China.,Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yongjie Zhou
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Xufeng Lu
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Li
- Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Changli Lu
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Li Li
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Li
- Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Bu
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, China.,Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiayin Yang
- Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yujun Shi
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, China
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Tsagarakis NJ, Drygiannakis I, Batistakis AG, Kolios G, Kouroumalis EA. Octreotide induces caspase activation and apoptosis in human hepatoma HepG2 cells. World J Gastroenterol 2011; 17:313-21. [PMID: 21253389 PMCID: PMC3022290 DOI: 10.3748/wjg.v17.i3.313] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2010] [Revised: 09/25/2010] [Accepted: 10/02/2010] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the role of octreotide on cellular proliferation and apoptosis of human hepatoma (HepG2) cells.
METHODS: We studied cellular proliferation, apoptosis and the possible internal caspase-mediated apoptosis pathway involved, after treatment of HepG2 carcinoma cells with octreotide in comparison with the apoptosis caused by tumor necrosis factor-α (TNF-α). Activities of caspase-3, caspase-9, caspase-8 and caspase-2 were studied, while apoptosis was investigated through detection of DNA fragmentation and through identification of apoptotic cells with the annexin-V/propidium iodide flow cytometric method.
RESULTS: After an initial increase in HepG2 cellular proliferation, a significant inhibition was observed with 10-8 mol/L octreotide, while TNF-α dose-dependently decreased proliferation. Early and late apoptosis was significantly increased with both substances. Octreotide significantly increased caspase-3, caspase-8 and caspase-2 activity. TNF-α significantly increased only caspase-2. Cellular proliferation was decreased after treatment with octreotide or TNF-α alone but, in contrast to TNF-α, octreotide decreased proliferation only at concentrations of 10-8 mol/L, while lower concentrations increased proliferation.
CONCLUSION: Our findings are suggestive of caspase-mediated signaling pathways of octreotide antitumor activity in HepG2 cells, and indicate that measurements of serum octreotide levels may be important, at least in clinical trials, to verify optimal therapeutic drug concentrations.
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Msaouel P, Galanis E, Koutsilieris M. Somatostatin and somatostatin receptors: implications for neoplastic growth and cancer biology. Expert Opin Investig Drugs 2010; 18:1297-316. [PMID: 19678799 DOI: 10.1517/13543780903176399] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Somatostatin agonists (SM-As) are capable of achieving durable symptomatic relief and significant clinical responses in certain tumours. Herein, we review the diverse direct and indirect mechanisms of antineoplastic activity elicited by SM-As as well as the hurdles that complicate their use as monotherapies in a broader range of malignancies. Emphasis is placed on recent clinical attempts to neutralise the IGF-mediated survival factor effects in the bone metastasis microenvironment in advanced prostate cancer. The first clinical trials of this 'anti-survival factor manipulation' strategy utilised the ability of SM-As to suppress the growth hormone-dependent liver-derived IGF-I bioavailability in combination with other drugs, such as dexamethasone, zolendronate and oestrogens, acting systemically and at the bone metastasis microenvironment. These regimens restored androgen ablation responsiveness in stage D3 prostate cancer patients and successfully produced objective clinical responses while only mild toxicities were observed. Furthermore, we focus on the preclinical experimental data of a targeted SM-A coupled to the super-potent doxorubicin derivative AN-201. The resulting conjugate (AN-238) has shown increased antitumour potency with a favourable toxicity profile. The potential use of novel SM-As as anticancer drugs is discussed in relation to data suggesting other direct and indirect treatment approaches pertaining to the somatostatin system.
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Affiliation(s)
- Pavlos Msaouel
- National & Kapodistrian University of Athens, Medical School, Department of Experimental Physiology, 75 Micras Asias St, Goudi-Athens 11527, Greece
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Pintér E, Helyes Z, Szolcsányi J. Inhibitory effect of somatostatin on inflammation and nociception. Pharmacol Ther 2006; 112:440-56. [PMID: 16764934 DOI: 10.1016/j.pharmthera.2006.04.010] [Citation(s) in RCA: 170] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2006] [Accepted: 04/27/2006] [Indexed: 10/24/2022]
Abstract
The present review focuses on promising new opportunities for anti-inflammatory and analgesic therapy. The theoretical background is an original observation based on our own experimental results. These data demonstrate that somatostatin is released from capsaicin-sensitive, peptidergic sensory nerve endings in response to noxious heat and chemical stimuli such as vanilloids, protons or lipoxygenase products. It reaches distant parts of the body via the circulation and exerts systemic anti-inflammatory and analgesic effects. Somatostatin binds to G-protein-coupled membrane receptors (sst(1)-sst(5)) and diminishes neurogenic inflammation by prejunctional action on sensory-efferent nerve terminals, as well as by postjunctional mechanisms on target cells. It decreases the release of pro-inflammatory neuropeptides from sensory nerve endings and also acts on receptors of vascular endothelial, inflammatory and immune cells. Analgesic effect is mediated by an inhibitory action on peripheral terminals of nociceptive neurons, since circulating somatostatin cannot exert central action. Somatostatin itself is not suitable for drug development because of its broad spectrum and short elimination half life, stable, receptor-selective agonists have been synthesized and investigated. The present overview is aimed at summarizing the physiological importance of somatostatin and sst receptors, pharmacological significance of synthetic agonists and their potential in the development of novel anti-inflammatory and analgesic drugs. These compounds might provide novel perspectives in the pharmacotherapy of acute and chronic painful inflammatory diseases, as well as neuropathic conditions.
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Affiliation(s)
- Erika Pintér
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Pécs, H-7624 Pécs, Szigeti u. 12, Hungary.
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Yuan L, Wang J, Shen WC. Reversible Lipidization Prolongs the Pharmacological Effect, Plasma Duration, and Liver Retention of Octreotide. Pharm Res 2005; 22:220-7. [PMID: 15783069 DOI: 10.1007/s11095-004-1189-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE Octreotide (OCT) was reversibly lipidized to improve the pharmacological effect and to increase the plasma half-life and the liver retention of OCT for greater therapeutic potential in the treatment of liver cancers such as hepatocellular carcinoma. METHODS OCT was chemically modified using reversible aqueous lipidization (REAL) technology. REAL-modified OCT (REAL-OCT) was characterized with high performance liquid chromatography (HPLC) and matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. A single dose of OCT or REAL-OCT or vehicle only was subcutaneously administered to male Sprague-Dawley rats, and the plasma growth hormone (GH) levels were measured after an intravenous injection of 2.5 microg/kg of growth hormone releasing factor (GRF) to assess the ability of REAL-OCT on GH inhibition. Radio-iodinated Tyr3-OCT (TOC) and REAL-TOC were used for pharmacokinetic studies. RESULTS At 0.1 mg/kg, REAL-OCT inhibited the GRF-induced GH surge in rats for a greater than 24-h period in comparison to the 6-h period for OCT. The distribution and elimination half-life for 125I-REAL-TOC were 1.4 h and 6.6 h, respectively, which were significantly longer than those of 125I-TOC. Sustained high blood concentrations and reduced in vivo degradation were observed for 125I-REAL-TOC. In addition, 125I-REAL-TOC appeared to be targeted to the liver with persistent high liver retention. CONCLUSIONS REAL-OCT has a significantly enhanced pharmacological effect, and this is most likely due to the favorable changes in the pharmacokinetic parameters upon lipidization. The observed liver targeting effect of REAL-TOC suggests that REAL-OCT might be advantageous over OCT in treating liver cancers.
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Affiliation(s)
- Liyun Yuan
- Department of Pharmaceutical Sciences, University of Southern California, Los Angeles, California 90033, USA
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N/A. N/A. Shijie Huaren Xiaohua Zazhi 2003; 11:1581-1587. [DOI: 10.11569/wcjd.v11.i10.1581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Isbert C, Boerner A, Ritz JP, Schuppan D, Buhr HJ, Germer CT. In situ ablation of experimental liver metastases delays and reduces residual intrahepatic tumour growth and peritoneal tumour spread compared with hepatic resection. Br J Surg 2002; 89:1252-9. [PMID: 12296892 DOI: 10.1046/j.1365-2168.2002.02205.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Background
The aim of this study was to evaluate the influence of in situ ablation and hepatic resection of experimental liver metastases on residual intrahepatic tumour growth and macroscopic peritoneal tumour spread.
Methods
Two colonic carcinomas (CC 531) were implanted into 90 WAG rat livers, one in the right liver lobe (untreated tumour) and one in the left liver lobe (treated tumour) of each rat. The animals were randomized into two test groups and a sham-operated control group. Animals in group 1 received in situ ablation (laser-induced thermotherapy) of the treated tumour. Rats in group 2 were submitted to partial hepatectomy. Untreated tumour volumes were calculated and the incidence of macroscopic peritoneal spread was determined at different times.
Results
After 21 days median (95 per cent confidence interval) volumes of untreated tumours were 507 (282) mm3 in group 1, 2096 (994) mm3 in group 2 and 1896 (755) mm3 in group 3. Compared with values obtained before treatment, growth of the untreated tumours had increased significantly after 4 days in group 2, after 7 days in group 3 and after 10 days in group 1. Macroscopic peritoneal tumour spread was detected in six of 30 animals in group 1 (laser), in 20 of 30 in group 2, and in 24 of 30 in group 3.
Conclusion
Compared with hepatic resection, in situ ablation of experimental liver metastases delays and reduces residual intrahepatic tumour growth and macroscopic peritoneal tumour spread.
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Affiliation(s)
- C Isbert
- Department of Surgery, University Medical Centre Benjamin Franklin, Freie Universität Berlin, Berlin, Germany.
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Shimizu H, Miyazaki M, Yoshioka S, Ito H, Nakagawa K, Ambiru S, Yoshidome H, Kusashio K, Nakajima N, Fukuda Y. Changes in hepatic venous oxygen saturation related to the extent of regeneration after partial hepatectomy in rats. Am J Surg 1999; 178:428-31. [PMID: 10612545 DOI: 10.1016/s0002-9610(99)00206-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Changes in hepatic oxygen metabolism in relation to the extent of liver regeneration are expected after partial hepatectomy. There are few reports, however, about hepatic oxygen metabolism during liver regeneration. In this study, we evaluated changes in hepatic oxygen metabolism related to the regeneration rate, and the relationship between hepatic venous oxygen saturation (Shvo2) and liver regeneration after partial hepatectomy. METHODS The work was done using 50% hepatectomized rats with continuous infusion of octreotide for inhibition of liver regeneration or with saline as control. The hepatic hemodynamics, oxygen metabolism, and Shvo2 levels as well as the regenerating liver status were evaluated for 3 days after hepatectomy. RESULTS Administration of octreotide resulted in a significant reduction of the regenerating liver weight on days 1 and 3 after hepatectomy compared with the control group. Significantly decreased DNA synthesis and proliferating cell nuclear antigen labeling index were also found on day 1. Meanwhile, hepatic oxygen consumption (HVO2) and oxygen extraction ratio were significantly decreased in the octreotide-treated group on day 1. In contrast, the Shvo2 levels in the octreotide-treated group were significantly higher than those in the control group, and were inversely correlated with the HVO2. CONCLUSION The remnant liver demands an increased amount of oxygen in relation to the extent of regeneration, and changes in the Shvo2 are inversely correlated with the HVo2. Therefore, monitoring the Shvo2 could be useful for estimating liver regeneration after partial hepatectomy.
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Affiliation(s)
- H Shimizu
- First Department of Surgery, School of Medicine, Chiba University, Japan
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