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He JX, Wang K, Zhou S, Fang XC, Zhang B, Yang Y, Wang N. Protective effect of ischemic postconditioning on ischemia reperfusion injury in steatotic rat livers. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1295. [PMID: 34532432 PMCID: PMC8422122 DOI: 10.21037/atm-21-2275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/06/2021] [Indexed: 11/19/2022]
Abstract
Background Hepatic steatosis creates a significant risk of liver resection and transplantation and is extremely susceptible to ischemia/reperfusion (I/R) injury. Ischemic postconditioning (IPostC) has been shown to attenuate I/R injury in normal livers; however, its role in steatotic livers remains unknown. The current study sought to explore whether IPostC could attenuate normothermic I/R injury in rats with steatotic livers and to investigate potential protective measures. Methods Hepatic steatosis was triggered in Wistar rats fed high-fat diets. The role of IPostC was detected in normal and steatotic livers with 30 min of ischemia and 6 h of reperfusion. Blood and liver tissues were collected to assess hepatocyte damage, lipid peroxidation, inflammatory factors, neutrophil accumulation, and adenosine triphosphate (ATP) content. Results Compared to normal livers, steatotic livers were more susceptible to I/R damage, as evidenced by incremental concentrations of liver enzymes in the blood and more severe pathological changes in the liver. Hepatic I/R injury was significantly reduced by IPostC in both normal and steatotic livers. We further found that endogenous protective measures moderated lipid peroxidation, inflammatory cytokine expression and neutrophil accumulation, and reduced follow-up hepatic injury. The ATP content of steatotic livers was also significantly lower than that of Normal livers before and after I/R injury. IPostC greatly preserved the ATP content of normal and steatotic livers with I/R injury. Conclusions IPostC appears to provide important protection against hepatic I/R injury in normal and steatotic livers under normothermic conditions. These data have important clinical implications for liver surgery and transplantation.
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Affiliation(s)
- Jia-Xing He
- Department of General Surgery, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Ke Wang
- Department of General Surgery, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Shuai Zhou
- Department of General Surgery, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Xiong-Chao Fang
- Department of General Surgery, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Bo Zhang
- Department of General Surgery, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Ying Yang
- Department of General Surgery, Tangdu Hospital, The Air Force Medical University, Xi'an, China
| | - Nan Wang
- Department of General Surgery, Tangdu Hospital, The Air Force Medical University, Xi'an, China
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Ali ES, Rychkov GY, Barritt GJ. Deranged hepatocyte intracellular Ca 2+ homeostasis and the progression of non-alcoholic fatty liver disease to hepatocellular carcinoma. Cell Calcium 2019; 82:102057. [PMID: 31401389 DOI: 10.1016/j.ceca.2019.102057] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/29/2019] [Accepted: 07/01/2019] [Indexed: 12/12/2022]
Abstract
Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths in men, and the sixth in women. Non-alcoholic fatty liver disease (NAFLD) is now one of the major risk factors for HCC. NAFLD, which involves the accumulation of excess lipid in cytoplasmic lipid droplets in hepatocytes, can progress to non-alcoholic steatosis, fibrosis, and HCC. Changes in intracellular Ca2+ constitute important signaling pathways for the regulation of lipid and carbohydrate metabolism in normal hepatocytes. Recent studies of steatotic hepatocytes have identified lipid-induced changes in intracellular Ca2+, and have provided evidence that altered Ca2+ signaling exacerbates lipid accumulation and may promote HCC. The aims of this review are to summarise current knowledge of the lipid-induced changes in hepatocyte Ca2+ homeostasis, to comment on the mechanisms involved, and discuss the pathways leading from altered Ca2+ homeostasis to enhanced lipid accumulation and the potential promotion of HCC. In steatotic hepatocytes, lipid inhibits store-operated Ca2+ entry and SERCA2b, and activates Ca2+ efflux from the endoplasmic reticulum (ER) and its transfer to mitochondria. These changes are associated with changes in Ca2+ concentrations in the ER (decreased), cytoplasmic space (increased) and mitochondria (likely increased). They lead to: inhibition of lipolysis, lipid autophagy, lipid oxidation, and lipid secretion; activation of lipogenesis; increased lipid; ER stress, generation of reactive oxygen species (ROS), activation of Ca2+/calmodulin-dependent kinases and activation of transcription factor Nrf2. These all can potentially mediate the transition of NAFLD to HCC. It is concluded that lipid-induced changes in hepatocyte Ca2+ homeostasis are important in the initiation and progression of HCC. Further research is desirable to better understand the cause and effect relationships, the time courses and mechanisms involved, and the potential of Ca2+ transporters, channels, and binding proteins as targets for pharmacological intervention.
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Affiliation(s)
- Eunus S Ali
- Department of Medical Biochemistry, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, 5001, Australia
| | - Grigori Y Rychkov
- School of Medicine, The University of Adelaide, and South Australian Health and Medical Research Institute, Adelaide, South Australia, 5005, Australia
| | - Greg J Barritt
- Department of Medical Biochemistry, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, 5001, Australia.
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Gabiatti G, Grezzana-Filho TDJM, Cerski CTS, Bofill C, Valle S, Corso CO. Topical hepatic hypothermia associated with ischemic preconditioning. Histopathological and biochemical analysis of ischemia reperfusion damage in a 24 hour model 1. Acta Cir Bras 2018; 33:924-934. [PMID: 30484502 DOI: 10.1590/s0102-865020180100000007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 09/09/2018] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To develop a new 24 hour extended liver ischemia and reperfusion (LIR) model analyzing the late biochemical and histopathological results of the isolated and combined application of recognized hepatoprotective mechanisms. In addition, we used a new stratification with zoning to classify the histological lesion. METHODS A modified animal model of severe hepatic damage produced through 90 minutes of segmental ischemia (70% of the organ) and posterior observation for 24 hours of reperfusion, submitted to ischemic preconditioning (IPC) and topical hypothermia (TH) at 26ºC, in isolation or in combination, during the procedure. Data from intraoperative biometric parameters, besides of late biochemical markers and histopathological findings, both at 24 hours evolution time, were compared with control (C) and normothermic ischemia (NI) groups. RESULTS All groups were homogeneous with respect to intraoperative physiological parameters. There were no losses once the model was stablished. Animals subjected to NI and IPC had worse biochemical (gamma-glutamyl transpeptidase, alkaline phosphatase, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, direct bilirubin, and total bilirubin) and histopathological scores (modified Suzuki score) compared to those of control groups and groups with isolated or associated TH (p < 0.05). CONCLUSION The new extended model demonstrates liver ischemia and reperfusion at 24 hour of evolution and, in this extreme scenario, only the groups subjected to topical hypothermia, combined with ischemic preconditioning or alone, had better outcomes than those subjected to only ischemic preconditioning and normothermic ischemia, reaching similar biochemical and histopathological scores to those of the control group.
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Affiliation(s)
- Gémerson Gabiatti
- Fellow PhD degree, Postgraduate Program of Surgical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre-RS, Brazil. Conception and design of the study, technical procedures, acquisition and analysis of data, manuscript writing
| | - Tomaz de Jesus Maria Grezzana-Filho
- PhD, Liver Transplantation Surgeon, Hospital de Clinicas de Porto Alegre (HCPA), Department of Surgery, UFRGS, Porto Alegre-RS, Brazil. Conception and design of the study, analysis of data, manuscript writing
| | - Carlos Thadeu Schmidt Cerski
- PhD, Associate Professor, Department of Pathology, UFRGS, Porto Alegre-RS, Brazil. Histopathological examinations
| | - Carlos Bofill
- Graduate student, Faculty of Medicine, UFRGS, Porto Alegre-RS, Brazil. Technical procedures, acquisition of data
| | - Stella Valle
- Coordinator, Laboratory of Veterinary Clinical Analysis (LACVet), Porto Alegre-RS, Brazil. Acquisition of data
| | - Carlos Otávio Corso
- PhD, Associate Professor, Postgraduate Program of Surgical Sciences, Department of Surgery, UFRGS, Porto Alegre-RS, Brazil. Manuscript writing, critical revision, final approval
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Tártaro RR, Jorge GL, Dianin AH, Escanhoela CAF, Boin IFSF. Ischemia With Preconditioning in Wistar Rats Maintains Mitochondrial Respiration, Even With Mild Hepatocellular Disturbance. Transplant Proc 2018; 50:848-852. [PMID: 29661451 DOI: 10.1016/j.transproceed.2018.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION In hepatectomy or liver transplantation, preconditioning is a procedure indicated to protect the organ from ischemia-reperfusion injury (I-R). OBJECTIVE Evaluate the effect of preconditioning after hepatic I-R in Wistar rats, through mitochondrial respiration, liver histology, and profile. METHOD Twenty male Wistar rats, weighing on average 307.1 g, were anesthetized with sodium thiopental (25 mg/kg) intravenously and xylazine hydrochloride (30 mg/kg) intramuscularly. The animals were divided into 2 groups: the preconditioning group (PCG), which contained 10 animals, and the hepatic pedicle was isolated and submitted to clamping with microvascular clamp (10 minutes of ischemia and 10 minutes of reperfusion, followed by 30 minutes of ischemia and 30 minutes of reperfusion); and the simulated operation group (SOG), which contained 10 animals submitted to manipulation of the hepatic pedicle and observation for the same length of time, with blood collected for transaminase dosage measurements, and liver biopsy for evaluation of mitochondrial respiration and histologic liver analysis and after sacrificed under anesthesia. The project was approved by the Ethics Committee on Animal Experimentation CEEA/UNICAMP under protocol number 3905-1. RESULT The PCG mitochondria showed the same respiration level as the SOG, when stimulated with the addition of adenosine diphosphate or carbonyl cyanide p-trifluoromethoxyphenylhydrazone. In the respiratory control ratio and resting of velocity of respiration the groups behaved in a similar way. The PCG presented high aspartate and alanine transaminases (P < .03) and about 60% of sinusoidal congestion and venous congestion in the histologic analysis when compared with SOG. CONCLUSION We found that ischemia with preconditioning in Wistar rats can lead to mild histologic and biochemical dysfunction without leading to impairment of mitochondrial respiration.
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Affiliation(s)
- R R Tártaro
- Hepatic Surgical Laboratory, Nucleus of Medicine and Experimental Surgery, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - G L Jorge
- Hepatic Surgical Laboratory, Nucleus of Medicine and Experimental Surgery, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - A H Dianin
- Hepatic Surgical Laboratory, Nucleus of Medicine and Experimental Surgery, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - C A F Escanhoela
- Department of Pathological Anatomy, Hospital de Clínicas, State University of Campinas, Campinas, Brazil
| | - I F S F Boin
- Unit of Liver Transplantation, Hospital de Clínicas, State University of Campinas, Campinas, Brazil.
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Steenks M, Peters J, Rademacher W, Nieuwenhuijs VB, Padbury RTA, Barritt GJ. Intermittent ischemia enhances the uptake of indocyanine green to livers subject to ischemia and reperfusion. J Gastroenterol Hepatol 2017; 32:701-707. [PMID: 22554202 DOI: 10.1111/j.1440-1746.2012.07169.x] [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] [Accepted: 02/01/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Intermittent ischemia is known to promote post perfusion bile flow, and hence recovery of liver function following ischemia reperfusion of the liver. However, the mechanisms involved are not well understood. The aim of this study was to identify the step(s) in the bile acid transport pathway altered by intermittent ischemia. METHODS Arat model of segmental hepatic ischemia in which the bilateral median and left lateral lobes were made ischemic by clamping the blood vessels was used. Indocyanine green (ICG), infrared spectroscopy, and compartmental kinetic analysis, were used to indirectly monitor the movement of bile acids across hepatocytes in situ. Rates of bile flow were measured gravimetrically. RESULTS In control livers (not subjected to ischemia), the movement of ICG from the blood to bile fluid could be described by a three compartment model comprising the blood, a rapidly-exchangeable compartment, and the hepatocyte cytoplasmic space. In livers subjected to continuous clamping, the rates of ICG uptake to the liver, and outflow from the liver, were greatly reduced compared with those in control livers. Intermittent clamping (three episodes of 15 min clamping) compared with continuous clamping substantially increased the rate of ICG uptake from the blood but had less effect on the rate of ICG outflow from hepatocytes. CONCLUSIONS It is concluded that intermittent ischemia promotes post reperfusion bile flow in the early phase of ischemia reperfusion injury principally by enhancing the movement of bile acids from the blood to hepatocytes.
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Affiliation(s)
- Mathilde Steenks
- Department of Medical Biochemistry, Flinders University, Adelaide, South Australia, Australia.,The HPB and Liver Transplant Unit, Flinders Medical Centre, and School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Jeroen Peters
- Department of Medical Biochemistry, Flinders University, Adelaide, South Australia, Australia.,The HPB and Liver Transplant Unit, Flinders Medical Centre, and School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Willem Rademacher
- Department of Medical Biochemistry, Flinders University, Adelaide, South Australia, Australia.,The HPB and Liver Transplant Unit, Flinders Medical Centre, and School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | | | - Robert T A Padbury
- The HPB and Liver Transplant Unit, Flinders Medical Centre, and School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Greg J Barritt
- Department of Medical Biochemistry, Flinders University, Adelaide, South Australia, Australia
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Metabolic Disorders and Cancer: Hepatocyte Store-Operated Ca2+ Channels in Nonalcoholic Fatty Liver Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 993:595-621. [DOI: 10.1007/978-3-319-57732-6_30] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Chu MJJ, Vather R, Hickey AJR, Phillips ARJ, Bartlett ASJR. Impact of ischaemic preconditioning on experimental steatotic livers following hepatic ischaemia-reperfusion injury: a systematic review. HPB (Oxford) 2015; 17:1-10. [PMID: 24712641 PMCID: PMC4266433 DOI: 10.1111/hpb.12258] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 02/14/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Steatotic livers are vulnerable to the deleterious effects of ischaemia-reperfusion injury (IRI) that occur after hepatic surgery. Ischaemic preconditioning (IPC) has been shown to abrogate the effects of IRI in patients undergoing hepatic surgery. Experimental studies have suggested that IPC may be beneficial in steatotic livers subjected to IRI. OBJECTIVE The aim of this systematic review was to evaluate the effects of IPC on steatotic livers following hepatic IRI in experimental models. METHODS An electronic search of the OVID Medline and EMBASE databases was performed to identify studies that reported clinically relevant outcomes in animal models of hepatic steatosis subjected to IPC and IRI. RESULTS A total of 1093 articles were identified, of which 18 met the inclusion criteria. There was considerable heterogeneity in the type of animal model, and duration and type of IRI. Increased macrovesicular steatosis (> 30%) was associated with a poor outcome following IRI. Ischaemic preconditioning was found to be beneficial in > 30% steatotic livers and provided for decreased histological damage, improved liver function findings and increased survival. CONCLUSIONS Experimental evidence supports the use of IPC in steatotic livers undergoing IRI. These findings may be applicable to patients undergoing liver surgery. However, clinical studies are required to validate the efficacy of IPC in this setting.
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Affiliation(s)
- Michael J J Chu
- Department of Surgery, University of AucklandAuckland, New Zealand,Correspondence, Michael J. J. Chu, Department of Surgery, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. Tel: + 64 2134 5320. Fax: + 64 9 377 9656. E-mail:
| | - Ryash Vather
- Department of Surgery, University of AucklandAuckland, New Zealand
| | - Anthony J R Hickey
- Maurice Wilkins Centre for Biodiscovery, University of AucklandAuckland, New Zealand,School of Biological Sciences, University of AucklandAuckland, New Zealand
| | - Anthony R J Phillips
- Department of Surgery, University of AucklandAuckland, New Zealand,Maurice Wilkins Centre for Biodiscovery, University of AucklandAuckland, New Zealand,School of Biological Sciences, University of AucklandAuckland, New Zealand,New Zealand Liver Transplant Unit, Auckland City HospitalAuckland, New Zealand
| | - Adam S J R Bartlett
- Department of Surgery, University of AucklandAuckland, New Zealand,School of Biological Sciences, University of AucklandAuckland, New Zealand,New Zealand Liver Transplant Unit, Auckland City HospitalAuckland, New Zealand
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Kist A, Wakkie J, Madu M, Versteeg R, ten Berge J, Nikolic A, Nieuwenhuijs VB, Porte RJ, Padbury RT, Barritt GJ. Rapamycin Induces Heme Oxygenase-1 in Liver but Inhibits Bile Flow Recovery after Ischemia. J Surg Res 2012; 176:468-75. [DOI: 10.1016/j.jss.2011.10.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Revised: 10/14/2011] [Accepted: 10/25/2011] [Indexed: 01/15/2023]
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Wilson CH, Zeile S, Chataway T, Nieuwenhuijs VB, Padbury RTA, Barritt GJ. Increased expression of peroxiredoxin 1 and identification of a novel lipid‐metabolizing enzyme in the early phase of liver ischemia reperfusion injury. Proteomics 2011; 11:4385-96. [DOI: 10.1002/pmic.201100053] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 08/08/2011] [Accepted: 08/24/2011] [Indexed: 12/25/2022]
Affiliation(s)
- Claire H. Wilson
- Departments of Medical Biochemistry and Physiology, Flinders Medical Centre and School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Susanne Zeile
- Departments of Medical Biochemistry and Physiology, Flinders Medical Centre and School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Tim Chataway
- Departments of Medical Biochemistry and Physiology, Flinders Medical Centre and School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | | | - Robert T. A. Padbury
- The HPB and Liver Transplant Unit, Flinders Medical Centre and School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Greg J. Barritt
- Departments of Medical Biochemistry and Physiology, Flinders Medical Centre and School of Medicine, Flinders University, Adelaide, South Australia, Australia
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