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Huang Z, Bai Y, Chen Y, Chen Y, Jiang Y, Zhou J. Attenuation of intestinal ischemia-reperfusion-injury by anesthetics: a potentially protective effect of anesthetic management in experimental studies. Front Pharmacol 2024; 15:1367170. [PMID: 38444936 PMCID: PMC10912591 DOI: 10.3389/fphar.2024.1367170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/08/2024] [Indexed: 03/07/2024] Open
Abstract
Intestinal ischemia-reperfusion injury (IRI) is a potentially severe clinical syndrome after major surgical procedures. In addition to causing intestinal mucosa injury, intestinal IRI further damages distant organs, causing the severity of the condition in patients. So far, effective therapy for intestinal IRI is still absent, and the survival rate of the patients is low. Previous experimental studies have shown that some anesthetics can alleviate intestinal IRI and protect organs while exerting their pharmacological effects, indicating that reasonable perioperative anesthesia management may provide potential benefits for patients to avoid intestinal IRI. These meaningful findings drive scholars to investigate the mechanism of anesthetics in treating intestinal IRI in-depth to discuss the possible new clinical uses. In the present mini-review, we will introduce the protective effects of different anesthetics in intestinal IRI to help us enrich our knowledge in this area.
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Affiliation(s)
- Zhan Huang
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, China
- Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, China
- Department of Anesthesiology, Dazhou Integrated TCM & Western Medicine Hospital, Dazhou Second People’s Hospital, Dazhou, China
| | - Yiping Bai
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, China
- Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, China
| | - Ying Chen
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, China
- Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, China
| | - Ye Chen
- Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, China
- Department of Traditional Chinese Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, China
| | - Yuan Jiang
- Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Jun Zhou
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, China
- Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, China
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2
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Targeting AMPK signaling in ischemic/reperfusion injury: From molecular mechanism to pharmacological interventions. Cell Signal 2022; 94:110323. [DOI: 10.1016/j.cellsig.2022.110323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 12/16/2022]
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3
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Kulkarni V. Anesthetic concerns in resection of liver: Case series. Anesth Essays Res 2022; 16:278-282. [DOI: 10.4103/aer.aer_91_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 12/18/2021] [Accepted: 07/13/2022] [Indexed: 11/04/2022] Open
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Wang L, Tang X, Li S. Propofol promotes migration, alleviates inflammation, and apoptosis of lipopolysaccharide-induced human pulmonary microvascular endothelial cells by activating PI3K/AKT signaling pathway via upregulating APOM expression. Drug Dev Res 2021; 83:397-406. [PMID: 34418885 DOI: 10.1002/ddr.21869] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 01/17/2023]
Abstract
Propofol (PRO), a clinical potent intravenous anesthetic, plays a significant role in relieving inflammatory diseases by repressing the release of inflammatory cytokines. The present study was aimed to reveal a novel mechanism by which PRO alleviates acute lung injury (ALI). Lipopolysaccharide (LPS) was utilized to induce human pulmonary microvascular endothelial cells (HPMECs) so as to simulate the microenvironment of ALI, and the expression of apolipoprotein M (APOM) was examined with western blotting. Then, APOM was silenced and profopol was used to treat the LPS-injured HPMECs. The cell viability, migration, and apoptosis were respectively observed after the processes of cell counting kit-8, wound healing, transwell, and TUNEL assay. Meanwhile, the inflammatory response was detected by determining the contents of inflammatory cytokines. Subsequently, the relationship between phosphoinositide-3 kinase (PI3K)/protein kinase B (AKT) signaling pathway and PRO was analyzed by western blotting. PI3K/AKT inhibitor LY294002 was employed to evaluate whether the effects of PRO on LPS-challenged HPMECs injury were mediated by this pathway. Results revealed that APOM was notably downregulated in HPMECs after LPS exposure. PRO treatment promoted cell proliferation and migration while alleviated inflammation and apoptosis of LPS-treated HPMECs, which was reversed by APOM-downregulation. PRO brought about the upregulation of proteins in PI3K/AKT signaling pathway, and LY294002 intervention further accentuated the impacts of APOM-knockdown on LPS-challenged HPMECs injury. To conclude, PRO promotes migration and alleviates inflammation and apoptosis of LPS-treated HPMECs by PI3K/AKT signaling pathway via upregulating APOM, which laid an experimental foundation for the future study and clinical application of PRO.
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Affiliation(s)
- Li Wang
- Department of Anesthesiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Xingming Tang
- Department of Anesthesiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Shuping Li
- Department of Emergency, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
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Intestinal congestion and reperfusion injury: Damage caused to the intestinal tract and distal organs. Biosci Rep 2021; 41:229487. [PMID: 34369557 PMCID: PMC8421592 DOI: 10.1042/bsr20211560] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/01/2021] [Accepted: 08/05/2021] [Indexed: 11/17/2022] Open
Abstract
In clinical practice, intestinal autologous diseases, ailments and organ transplants can cause severe congestive damage to the intestinal tract. However, after the etiological factor is gotten rid of and blood flow is free without any hinderance, further damage to the intestinal wall often occurs, causing other related organ dysfunctions. This ultimately results in intestinal congestion reperfusion injury (ICRI). When the structure and function of the intestine are destroyed, bacteria, metabolites and endotoxins in the intestinal tract perfuse and enter the portal vein through the already compromised intestinal mucosa, to the other organs via the liver. Nevertheless, this gives rise to further aggravation of the injury, and reperfusion injury syndrome occurs. ICRI is a very common complication encountered by clinicians, and its harm is more severe and serious as compared with that caused by ischemia–reperfusion. Quite a few number of studies on ICRI have been reported to date. The exact mechanism of the injury is still idiopathic, and effective treatment strategies are still limited. Based on recent studies, this article is aimed at reviewing the destruction, damage mechanisms resulting from ICRI to the intestinal anatomical sites and distant organs. It is geared towards providing new ideas for the prevention and therapeutic approaches of ICRI.
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Propofol intravenous anaesthesia with desflurane compared with desflurane alone on postoperative liver function after living-donor liver transplantation. Eur J Anaesthesiol 2019; 36:656-666. [DOI: 10.1097/eja.0000000000001018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Li Q, Cui S, Jing G, Ding H, Xia Z, He X. The role of PI3K/Akt signal pathway in the protective effects of propofol on intestinal and lung injury induced by intestinal ischemia/reperfusion1. Acta Cir Bras 2019; 34:e20190010000005. [PMID: 30785506 PMCID: PMC6585923 DOI: 10.1590/s0102-865020190010000005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 12/15/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose To investigate the role of PI3k/Akt signal pathway in the protective effects
of propofol on intestinal and lung injury induced by intestinal
ischemia/reperfusion(I/R). Methods Male Sprague-Dawley rats were subjected to 45 min of ischemia by occluding
the superior mesenteric artery and to 2h of reperfusion to establish the
model of I/R. Twenty four rats were randomly divided into four groups: Sham,
intestinal I/R (II/R), propofol (P), wortmannin (W). In groups P, W,
propofol was injected intravenously and continuously at the onset of
reperfusion via infusion pump. PI3K inhibitor (wortmannin) was administered
intravenously in group W 25 min before ischemia. Intestinal tissues and lung
tissues were obtained for determination of histologic injury, wet/dry weight
ratio, malondialdehyde (MDA) levels, superoxide dismutase (SOD) and
myeloperoxidase (MPO) activities. Meanwhile, the expressions of caspase-3
and phosphorylated Akt (p-Akt) in intestines and lungs were detected by
western blot. Results Propofol treatment alleviated intestinal and lung morphological changes which
were observed in II/R group , Moreover, wet/dry weight ratio, the MDA level,
MPO activity and expression of caspase-3 were significantly decreased
whereas the SOD activity and p-Akt expression were significantly increased.
Notably, the protections were significantly reversed by pretreatment of
wortmannin. Conclusion: PI3K/Akt pathway activation play a critical role in the protective effects of
propofol on intestinal and lung injury induced by ischemia/reperfusion.
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Affiliation(s)
- Qingwen Li
- MD, Department of Anesthesiology, Renmin Hospital of Wuhan University, Hubei, China. Manuscript preparation and writng
| | - Shanshan Cui
- MD, Department of Anesthesiology, Renmin Hospital of Wuhan University, Hubei, China. Conception and design of the study, acquisiton of data
| | - Guoqing Jing
- MD, Department of Anesthesiology, Renmin Hospital of Wuhan University, Hubei, China. Analysis and interpretation of data, technical procedures
| | - Huang Ding
- MD, Department of Anesthesiology, Renmin Hospital of Wuhan University, Hubei, China. Histopathological examinations, statistics analysis
| | - Zhongyuan Xia
- MD, Department of Anesthesiology, Renmin Hospital of Wuhan University, Hubei, China. Final approval
| | - Xianghu He
- MD, Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Hubei, China. Critical revision
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The effect of Verapamil on ischaemia/reperfusion injury in mouse ovarian tissue transplantation. Biomed Pharmacother 2018; 108:1313-1319. [DOI: 10.1016/j.biopha.2018.09.130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 09/23/2018] [Accepted: 09/24/2018] [Indexed: 01/25/2023] Open
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Jing HR, Luo FW, Liu XM, Tian XF, Zhou Y. Fish oil alleviates liver injury induced by intestinal ischemia/reperfusion via AMPK/SIRT-1/autophagy pathway. World J Gastroenterol 2018; 24:833-843. [PMID: 29467553 PMCID: PMC5807941 DOI: 10.3748/wjg.v24.i7.833] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 12/25/2017] [Accepted: 01/15/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate whether fish oil (FO) can protect liver injury induced by intestinal ischemia/reperfusion (I/R) via the AMPK/SIRT-1/autophagy pathway.
METHODS Ischemia in Wistar rats was induced by superior mesenteric artery occlusion for 60 min and reperfusion for 240 min. One milliliter per day of FO emulsion or normal saline was administered by intraperitoneal injection for 5 consecutive days to each animal. Animals were sacrificed at the end of reperfusion. Blood and tissue samples were collected for analyses. AMPK, SIRT-1, and Beclin-1 expression was determined in lipopolysaccharide (LPS)-stimulated HepG2 cells with or without FO emulsion treatment.
RESULTS Intestinal I/R induced significant liver morphological changes and increased serum alanine aminotransferase and aspartate aminotransferase levels. Expression of p-AMPK/AMPK, SIRT-1, and autophagy markers was decreased whereas tumor necrosis factor-α (TNF-α) and malonaldehyde (MDA) were increased. FO emulsion blocked the changes of the above indicators effectively. Besides, in LPS-stimulated HepG2 cells, small interfering RNA (siRNA) targeting AMPK impaired the FO induced increase of p-AMPK, SIRT-1, and Beclin-1 and decrease of TNF-α and MDA. SIRT-1 siRNA impaired the increase of SIRT-1 and Beclin-1 and the decrease of TNF-α and MDA.
CONCLUSION Our study indicates that FO may protect the liver against intestinal I/R induced injury through the AMPK/SIRT-1/autophagy pathway.
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Affiliation(s)
- Hui-Rong Jing
- Department of General Surgery, Second Affiliated Hospital of Dalian Medical University, Dalian 116023, Liaoning Province, China
| | - Fu-Wen Luo
- Department of General Surgery, Second Affiliated Hospital of Dalian Medical University, Dalian 116023, Liaoning Province, China
| | - Xing-Ming Liu
- Department of General Surgery, Second Affiliated Hospital of Dalian Medical University, Dalian 116023, Liaoning Province, China
| | - Xiao-Feng Tian
- Department of General Surgery, Second Affiliated Hospital of Dalian Medical University, Dalian 116023, Liaoning Province, China
| | - Yun Zhou
- Department of Clinical Nutrition, Second Affiliated Hospital of Dalian Medical University, Dalian 116023, Liaoning Province, China
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Saidi SA, Ncir M, Chaaben R, Jamoussi K, van Pelt J, Elfeki A. Liver injury following small intestinal ischemia reperfusion in rats is attenuated by Pistacia lentiscus oil: antioxidant and anti-inflammatory effects. Arch Physiol Biochem 2017; 123:199-205. [PMID: 28338348 DOI: 10.1080/13813455.2017.1302961] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
CONTEXT Intestinal ischemia-reperfusion (IIR) not only leads to severe intestine damage but also induced subsequent destruction of remote organs. OBJECTIVE We investigated the protective effect of Pistascia lentiscus L. (Anacardiaceae) oil on IIR. MATERIALS AND METHODS Wistar rats were divided into three groups: sham, intestinal IR and P. lentiscus pretreatment (n = 18 each). In the pretreatment group, oil was administered 1 h before induction of warm ischemia. RESULTS IIR led to severe liver damage manifested as a significant (p < .05) increase of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Pistacia lentiscus oil decreased the visible intestinal damage, as well as a significant decrease in serum AST and ALT levels. In addition, Pistacia lentiscus reduce liver injury, as evidenced by the decrease in liver tissue myeloperoxidase activity and lipoperoxidation (MDA) level. CONCLUSION Pistascia lentiscus attenuates liver injury induced by IIR, attributable to the antioxidant and anti-inflammatory effect.
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Affiliation(s)
- Saber Abdelkader Saidi
- a Department of Life Sciences , Laboratory of Animal Ecophysiology, University of Sfax , Sfax , Tunisia
- b Department of Hepatology , University Hospitals KU Leuven , Leuven , Belgium
- c Department of Biology, Faculty of Science and Arts - Khulais , University of Jeddah , Jeddah , Saudi Arabia
| | - Marwa Ncir
- a Department of Life Sciences , Laboratory of Animal Ecophysiology, University of Sfax , Sfax , Tunisia
| | - Rim Chaaben
- d Department of Biochemistry , CHU Habib Bourguiba of Sfax , Sfax , Tunisia
| | - Kamel Jamoussi
- d Department of Biochemistry , CHU Habib Bourguiba of Sfax , Sfax , Tunisia
| | - Jos van Pelt
- b Department of Hepatology , University Hospitals KU Leuven , Leuven , Belgium
| | - Abdelfattah Elfeki
- a Department of Life Sciences , Laboratory of Animal Ecophysiology, University of Sfax , Sfax , Tunisia
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Takasu C, Vaziri ND, Li S, Robles L, Vo K, Takasu M, Pham C, Farzaneh SH, Shimada M, Stamos MJ, Ichii H. Treatment with dimethyl fumarate ameliorates liver ischemia/reperfusion injury. World J Gastroenterol 2017; 23:4508-4516. [PMID: 28740339 PMCID: PMC5504366 DOI: 10.3748/wjg.v23.i25.4508] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/18/2017] [Accepted: 06/12/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the hypothesis that treatment with dimethyl fumarate (DMF) may ameliorate liver ischemia/reperfusion injury (I/RI).
METHODS Rats were divided into 3 groups: sham, control (CTL), and DMF. DMF (25 mg/kg, twice/d) was orally administered for 2 d before the procedure. The CTL and DMF rats were subjected to ischemia for 1 h and reperfusion for 2 h. The serum alanine aminotransferase (ALT) and malondialdehyde (MDA) levels, adenosine triphosphate (ATP), NO × metabolites, anti-oxidant enzyme expression level, anti-inflammatory effect, and anti-apoptotic effect were determined.
RESULTS Histological tissue damage was significantly reduced in the DMF group (Suzuki scores: sham: 0 ± 0; CTL: 9.3 ± 0.5; DMF: 2.5 ± 1.2; sham vs CTL, P < 0.0001; CTL vs DMF, P < 0.0001). This effect was associated with significantly lower serum ALT (DMF 5026 ± 2305 U/L vs CTL 10592 ± 1152 U/L, P = 0.04) and MDA (DMF 18.2 ± 1.4 μmol/L vs CTL 26.0 ± 1.0 μmol/L, P = 0.0009). DMF effectively improved the ATP content (DMF 20.3 ± 0.4 nmol/mg vs CTL 18.3 ± 0.6 nmol/mg, P = 0.02), myeloperoxidase activity (DMF 7.8 ± 0.4 mU/mL vs CTL 6.0 ± 0.5 mU/mL, P = 0.01) and level of endothelial nitric oxide synthase expression (DMF 0.38 ± 0.05-fold vs 0.17 ± 0.06-fold, P = 0.02). The higher expression levels of anti-oxidant enzymes (catalase and glutamate-cysteine ligase modifier subunit and lower levels of key inflammatory mediators (nuclear factor-kappa B and cyclooxygenase-2 were confirmed in the DMF group.
CONCLUSION DMF improved the liver function and the anti-oxidant and inflammation status following I/RI. Treatment with DMF could be a promising strategy in patients with liver I/RI.
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El-Sayyad SM, Soubh AA, Awad AS, El-Abhar HS. Mangiferin protects against intestinal ischemia/reperfusion-induced liver injury: Involvement of PPAR-γ, GSK-3β and Wnt/β-catenin pathway. Eur J Pharmacol 2017; 809:80-86. [PMID: 28506911 DOI: 10.1016/j.ejphar.2017.05.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 05/05/2017] [Accepted: 05/10/2017] [Indexed: 12/13/2022]
Abstract
AIM Mangiferin (MF), a xanthonoid from Mangifera indica, possesses anti-inflammatory, immunomodulatory, and potent antioxidant effects; however, its protective effect against mesenteric ischemia/reperfusion (I/R)-induced liver injury has not been fully clarified. The study was designed to assess the possible mechanism of action of MF against mesenteric I/R model. MAIN METHODS Male Wister rats were treated with MF (20mg/kg, i.p) or the vehicle for 3 days before I/R, which was induced by clamping the superior mesenteric artery for 30min followed by declamping for 60min. KEY FINDINGS The mechanistic studies revealed that MF protected the 2 organs studied, viz., liver and intestine partly via increasing the content of β-catenin and PPAR-γ along with decreasing that of GSK-3β and the phosphorylated NF-қB-p65. MF antioxidant effect was evidenced by increasing contents of total antioxidant capacity and GST, besides normalizing that of MDA. Regarding the anti-inflammatory effect, MF reduced IL-1β and IL-6, effects that were mirrored on the tissue content of MPO. Moreover, MF possessed anti-apoptotic character evidenced by elevating Bcl-2 content and reducing that of caspase-3. In the serum, intestinal I/R increased the activity of ALT, AST, and creatine kinase. SIGNIFICANCE The intimated protective mechanisms of MF against mesenteric I/R are mediated, partially, by modulation of oxidative stress, inflammation, and apoptosis possibly via the involvement of Wnt/β-catenin/NF-қβ/ PPAR-γ signaling pathways.
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Affiliation(s)
- Shorouk M El-Sayyad
- Department of Pharmacology & Toxicology, October 6 University,12585 Giza, Egypt
| | - Ayman A Soubh
- Department of Pharmacology & Toxicology, Ahram Canadian University, 12566 Giza, Egypt.
| | - Azza S Awad
- Department of Pharmacology & Toxicology, Ahram Canadian University, 12566 Giza, Egypt
| | - Hanan S El-Abhar
- Department of Pharmacology & Toxicology, Cairo University, 11562 Cairo, Egypt
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Kalimeris K, Briassoulis P, Ntzouvani A, Nomikos T, Papaparaskeva K, Politi A, Batistaki C, Kostopanagiotou G. N-acetylcysteine ameliorates liver injury in a rat model of intestinal ischemia reperfusion. J Surg Res 2016; 206:263-272. [DOI: 10.1016/j.jss.2016.08.049] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/07/2016] [Accepted: 08/10/2016] [Indexed: 02/07/2023]
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Li DY, Shi XJ, Li W, Du XH, Wang GY. Key Points in Establishing a Model of Mouse Liver Transplantation. Transplant Proc 2016; 47:2683-9. [PMID: 26680072 DOI: 10.1016/j.transproceed.2015.07.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 07/14/2015] [Indexed: 12/14/2022]
Abstract
The explosion of interest in research into the mouse genome and immune system has meant that the mouse orthotopic liver transplantation (MOLT) model has become a popular means of studying transplantation immunity, organ preservation, ischemia-reperfusion injury, and surgical techniques, among others. Although numerous modifications and refinements of surgical techniques have simplified the operation, the relatively short duration of postoperative survival after MOLT remains an obstacle to longer-term follow-up studies. Here, we summarize the scientific basis of MOLT and our experience improving and refining the model in six key areas: anesthesia, operative technique, perfusion and preservation of the liver, cuff technique, anhepatic time, and the value of rearterialization for the liver graft. We also compare the characteristics of different surgical techniques, and give recommendations for the best means of tailoring technique to the objectives of a study. In doing so, we aim to assist other investigators in establishing and perfecting the MOLT model in their routine research practice.
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Affiliation(s)
- D-Y Li
- Department of Hepatobiliary & Pancreatic Surgery, the First Norman Bethune Hospital Affiliated to Jilin University, Jilin Province, China
| | - X-J Shi
- Department of Hepatobiliary & Pancreatic Surgery, the First Norman Bethune Hospital Affiliated to Jilin University, Jilin Province, China
| | - W Li
- Department of Hepatobiliary & Pancreatic Surgery, Third Hospital (China-Japan Union Hospital) of Jilin University, Jilin Province, China
| | - X-H Du
- Department of Hepatobiliary & Pancreatic Surgery, the First Norman Bethune Hospital Affiliated to Jilin University, Jilin Province, China
| | - G-Y Wang
- Department of Hepatobiliary & Pancreatic Surgery, the First Norman Bethune Hospital Affiliated to Jilin University, Jilin Province, China.
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Fayed NA, Sayed EI, Saleh SM, Ehsan NA, Elfert AY. Effect of dexmedetomidine on hepatic ischemia-reperfusion injury in the setting of adult living donor liver transplantation. Clin Transplant 2016; 30:470-82. [DOI: 10.1111/ctr.12713] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Nirmeen A. Fayed
- Anesthesia and Intensive Care; National Liver Institute; Menoufia University; ShebeenAlkoom Menoufia Egypt
| | - Eman I. Sayed
- Anesthesia and Intensive Care; National Liver Institute; Menoufia University; ShebeenAlkoom Menoufia Egypt
| | - Sherif M. Saleh
- Hepatobiliary Surgery; National Liver Institute; Menoufia University; ShebeenAlkoom Menoufia Egypt
| | - Nermen A. Ehsan
- Pathology; National Liver Institute; Menoufia University; ShebeenAlkoom Menoufia Egypt
| | - Ashraf Y. Elfert
- Clinical Biochemistry; National Liver Institute; Menoufia University; ShebeenAlkoom Menoufia Egypt
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Tsai YF, Liu FC, Sung WC, Lin CC, Chung PCH, Lee WC, Yu HP. Ischemic reperfusion injury-induced oxidative stress and pro-inflammatory mediators in liver transplantation recipients. Transplant Proc 2015; 46:1082-6. [PMID: 24815134 DOI: 10.1016/j.transproceed.2014.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 01/13/2014] [Accepted: 01/15/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Liver ischemic reperfusion injury is harmful to transplant recipients, and is associated with postoperative morbidity and mortality. Our study was designed to investigate the oxidative stress and pro-inflammatory mediators in liver transplant recipients. METHODS We prospectively analyzed 14 recipients who underwent liver transplantation by measuring their blood levels of malondialdehyde (MDA) and cytokines, such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6, at nine time points perioperatively. We also evaluated the correlations between oxidative stress (MDA levels) and the characteristics of the recipient or the donated graft. RESULTS These parameters significantly increased from 1 minute before reperfusion, and the values peaked within 3 to 30 minutes after reperfusion. On the time point at 5 minutes after reperfusion, the MDA levels which were the highest in the recipients correlated with the values of preoperative direct/and total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), model for end-stage liver disease (MELD) score, international normalized ratio (INR), and surgical blood loss. CONCLUSION The levels of MDA, TNF-α, IL-1β, and IL-6 greatly increased with the ischemic reperfusion insult. Recipients with higher values of preoperative direct/and total bilirubin, AST, ALT, MELD score, INR, and surgical blood loss tended to have higher levels of MDA and may suffer more injury from this insult.
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Affiliation(s)
- Y-F Tsai
- Department of Anesthesiology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan, Taiwan
| | - F-C Liu
- Department of Anesthesiology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan, Taiwan
| | - W-C Sung
- Department of Anesthesiology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - C-C Lin
- Department of Anesthesiology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan, Taiwan
| | - P C-H Chung
- Department of Anesthesiology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - W-C Lee
- College of Medicine, Chang Gung University, Tao-Yuan, Taiwan; Division of Transplantation and Liver Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - H-P Yu
- Department of Anesthesiology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan, Taiwan.
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Pandey CK, Nath SS, Pandey VK, Karna ST, Tandon M. Perioperative ischaemia-induced liver injury and protection strategies: An expanding horizon for anaesthesiologists. Indian J Anaesth 2013; 57:223-9. [PMID: 23983278 PMCID: PMC3748674 DOI: 10.4103/0019-5049.115576] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Liver resection is an effective modality of treatment in patients with primary liver tumour, metastases from colorectal cancers and selected benign hepatic diseases. Its aim is to resect the grossly visible tumour with clear margins and to ensure that the remnant liver mass has sufficient function which is adequate for survival. With the advent of better preoperative imaging, surgical techniques and perioperative management, there is an improvement in the outcome with decreased mortality. This decline in postoperative mortality after hepatic resection has encouraged surgeons for more radical liver resections, leaving behind smaller liver remnants in a bid to achieve curative surgeries. But despite advances in diagnostic, imaging and surgical techniques, postoperative liver dysfunction of varied severity including death due to liver failure is still a serious problem in such patients. Different surgical and non-surgical techniques like reducing perioperative blood loss and consequent decreased transfusions, vascular occlusion techniques (intermittent portal triad clamping and ischaemic preconditioning), administration of pharmacological agents (dextrose, intraoperative use of methylprednisolone, trimetazidine, ulinastatin and lignocaine) and inhaled anaesthetic agents (sevoflurane) and opioids (remifentanil) have demonstrated the potential benefit and minimised the adverse effects of surgery. In this article, the authors reviewed the surgical and non-surgical measures that could be adopted to minimise the risk of postoperative liver failure following liver surgeries with special emphasis on ischaemic and pharmacological preconditioning which can be easily adapted clinically.
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Affiliation(s)
- Chandra Kant Pandey
- Department of Anaesthesiology and Critical Care Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
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Protective effect of sildenafil on liver injury induced by intestinal ischemia/reperfusion. J Pediatr Surg 2013; 48:1707-15. [PMID: 23932610 DOI: 10.1016/j.jpedsurg.2012.12.054] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 11/26/2012] [Accepted: 12/25/2012] [Indexed: 12/29/2022]
Abstract
BACKGROUND This study evaluated the protective effect of sildenafil on liver injury induced by intestinal ischemia-reperfusion. METHODS Forty female Sprague Dawley rats were divided into 4 groups: sham-control (SC), ischemia (I), ischemia-reperfusion (IR), and ischemia-reperfusion+sildenafil (SIL; sildenafil gavaged at 50mg/kg before operating). A 2-h ischemia-reperfusion was performed by clamping the superior mesenteric artery. Liver function, plasma alanine (ALT) and aspartate (AST) aminotransferase, and intestinal and liver malondialdehyde (MDA) were measured at the end of the experiment. Intestinal and liver tissue damage was examined by histology. Liver samples were immunologically stained for endothelial nitric oxide synthase (eNOS) and proliferating cell nuclear antigen (PCNA). RESULTS The ALT and AST levels were highest in the IR group and were lower in the SIL group (p<0.05). Intestinal MDA levels were statistically higher in the IR group than in the SC, I and SIL groups. Liver MDA levels were significantly higher in the IR group than in the I and SC groups (p<0.05) and higher than in the SIL group (p>0.05). Intestinal damage based on Chiu scoring was more severe in the IR than in the SIL group (p<0.05). Sildenafil reduced damage and also increased eNOS and PCNA immunoreactivity in liver tissue. CONCLUSIONS Sildenafil shows a protective effect on intestinal ischemia-reperfusion-induced liver injury, possibly by decreasing vascular resistance through increased nitric oxide levels.
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Shafik AN. Febuxostat improves the local and remote organ changes induced by intestinal ischemia/reperfusion in rats. Dig Dis Sci 2013; 58:650-9. [PMID: 23010742 DOI: 10.1007/s10620-012-2391-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Accepted: 08/25/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND Xanthine oxidase has been implicated in the pathogenesis of a wide spectrum of diseases, and is thought to be the most important source of oxygen-free radicals and cell damage during re-oxygenation of hypoxic tissues. AIMS The present study was undertaken to demonstrate whether febuxostat is superior to allopurinol in prevention of the local and remote harmful effects of small intestinal ischemia/reperfusion injury in rats. METHODS Intestinal ischemia was induced by superior mesenteric artery ligation. The rats were assigned to five groups: the sham control; the intestinal ischemia/reperfusion; the allopurinol; and the febuxostat 5 and 10 mg/kg pretreated ischemia/reperfusion groups. Treatment was administered from 7 days before ischemia induction. After the reperfusion, the serum and tissues were obtained for biochemical, pharmacological, and histological studies. RESULTS Intestinal reperfusion led to an elevation in the serum levels of alanine aminotransferase, aspartate aminotransferase, tumor necrosis factor-α, malondialdehyde, and xanthine oxidase as well as intestinal myeloperoxidase, malonadialdehyde, and xanthine oxidase/xanthine dehydrogenase activity. Furthermore, the ischemia/reperfusion induced a reduction in the contractile responsiveness to acetylcholine. These changes were significantly regulated by the pretreatment with febuxostat compared to allopurinol. The degree of pathological impairment in the intestinal mucosa, liver, and lung tissues were lighter in the pretreated groups. CONCLUSIONS Febuxostat may offer advantages over allopurinol in lessening local intestinal injury as well as remote hepatic and lung injuries induced by small intestinal ischemia/reperfusion.
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Affiliation(s)
- Amani Nabil Shafik
- Department of Pharmacology, Faculty of Medicine, Cairo University, 74 A Tereet Elzomor Haram, Giza, Egypt.
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Tüfek A, Tokgöz O, Aliosmanoglu I, Alabalik U, Evliyaoglu O, Çiftçi T, Güzel A, Yıldırım ZB. The protective effects of dexmedetomidine on the liver and remote organs against hepatic ischemia reperfusion injury in rats. Int J Surg 2012; 11:96-100. [PMID: 23261946 DOI: 10.1016/j.ijsu.2012.12.003] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 11/27/2012] [Accepted: 12/03/2012] [Indexed: 12/14/2022]
Abstract
AIM To investigate the protective effects of dexmedetomidine against hepatic ischemia/reperfusion (IR) injury and hepatic IR induced remote organ injury. METHODS Forty Wistar albino rats were divided into the following four groups: sham, dexmedetomidine, IR, and IR + dexmedetomidine. Hepatic ischemia was created by the Pringle maneuver for 30 min followed by a 30 min reperfusion period in the IR and IR + dexmedetomidine groups. The dexmedetomidine and IR + dexmedetomidine groups were administered dexmedetomidine (100 μg/kg, single dose) intraperitoneally after the anesthesia insult. Blood samples and hepatic, renal, and lung tissue specimens were obtained to measure serum and tissue total oxidative activity (TOA), total antioxidant capacity (TAC), paraoxonase (PON-1), and oxidative stress index (OSI) after 60 min in all groups. RESULTS According to the biochemical analyses of the samples taken from the serum and the liver, lung, and kidney tissues, when comparing the sham group and the IR group, TOA and OSI values were higher in the IR group, while TAC and PON-1 values were lower (p < 0.05). It was observed that TOA and OSI values were significantly lower, while TAC and PON-1 values increased with dexmedetomidine treatment (p < 0.05). In addition, dexmedetomidine ameliorated hepatic histopathological changes inducing IR, but there were no significant histopathological changes in the remote organs. CONCLUSION This study demonstrated that dexmedetomidine markedly reduced the oxidative stress in serum, liver, and remote organs induced by hepatic IR injury, and ameliorated the histopathological damage in the liver.
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Affiliation(s)
- Adnan Tüfek
- Department of Anesthesiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
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Collange O, Charles AL, Bouitbir J, Chenard MP, Zoll J, Diemunsch P, Thaveau F, Chakfé N, Piquard F, Geny B. Methylene blue protects liver oxidative capacity after gut ischaemia-reperfusion in the rat. Eur J Vasc Endovasc Surg 2012; 45:168-75. [PMID: 23246335 DOI: 10.1016/j.ejvs.2012.11.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 11/11/2012] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Mesenteric ischaemia/reperfusion (IR) may lead to liver mitochondrial dysfunction and multiple organ failure. We determined whether gut IR induces early impairment of liver mitochondrial oxidative activity and whether methylene blue (MB) might afford protection. DESIGN Controlled animal study. MATERIALS AND METHODS Rats were randomised into three groups: controls (n = 18), gut IR group (mesenteric ischaemia (60 min)/reperfusion (60 min)) (n = 18) and gut IR + MB group (15 mg kg(-1) MB intra-peritoneally) (n = 16). Study parameters were: serum liver function markers, blood lactate, standard histology and DNA fragmentation (apoptosis) on intestinal and liver tissue, maximal oxidative capacity of liver mitochondria (state 3) and activity of complexes II, III and IV of the respiratory chain measured using a Clark oxygen electrode. RESULTS Gut IR increased lactate deshydrogenase (+982%), aspartate and alanine aminotransferases (+43% and +74%, respectively) and lactate levels (+271%). It induced segmental loss of intestinal villi and cryptic apoptosis. It reduced liver state 3 respiration by 30% from 50.1 ± 3 to 35.2 ± 3.5 μM O(2) min(-1) g(-1) (P < 0.01) and the activity of complexes II, III and IV of the mitochondrial respiratory chain. Early impairment of liver mitochondrial respiration was related to blood lactate levels (r(2) = 0.45). MB restored liver mitochondrial function. CONCLUSIONS MB protected against gut IR-induced liver mitochondria dysfunction.
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Affiliation(s)
- O Collange
- Pôle Anesthésie, Réanimation Chirurgicale, SAMU, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
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The effects of dexmedetomidine on mesenteric arterial occlusion-associated gut ischemia and reperfusion-induced gut and kidney injury in rabbits. J Surg Res 2012; 178:223-32. [PMID: 22560540 DOI: 10.1016/j.jss.2012.03.073] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 03/29/2012] [Accepted: 03/30/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We assessed the antioxidant activity of dexmedetomidine (Dex) administered during the ischemic period in a rabbit model of mesenteric ischemia/reperfusion (I/R) injury using biochemical and histopathological methods. METHODS A total of 24 male New Zealand white rabbits weighing between 2.5 and 3.0 kg were randomly divided into three groups: the sham group (Group S, n = 8), the I/R group (Group I/R, n = 8), and the I/R plus Dex treatment group (Group Dex, n = 8). In the I/R group, ischemia was achieved with 60 min of mesenteric occlusion. The sham group provided normal basal values. The rabbits in Group I/R were operated to achieve I/R. Group Dex received intravenous Dex 30 min after the commencement of reperfusion (10 μg/kg Dex was infused within 10 min, and then a maintenance dose of 10 μg/kg/h Dex was infused intravenously). For the measurement of tissue malondialdehyde, total antioxidant status, total oxidant status, lipid hydroperoxide levels, superoxide dismutase, catalase, and myeloperoxidase activity levels in the renal tissue samples of animals, the rabbits in each group were sacrificed 3 h after reperfusion. The histopathological examination scores were determined using the intestinal and renal tissues. RESULTS The mean malondialdehyde, total oxidant status, myeloperoxidase, and lipid hydroperoxide levels were significantly higher in Group I/R than in Groups S and Dex (P < 0.05). There also were significant decreases in the mean total antioxidant status, catalase, and superoxide dismutase activities in Group I/R compared with Groups S and Dex (P < 0.05). The histopathological examination scores of the intestinal and renal tissues were significantly higher in Group I/R compared with Groups S and Dex (P < 0.05). CONCLUSION Dex treatment may have biochemical and histopathological benefits by preventing I/R-related cellular damage of intestinal and renal tissues as shown in an experimental mesenteric ischemia model. The preference to use Dex for anesthesia during the mesenteric ischemia procedure may attenuate I/R injury in intestinal and renal tissues.
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Ozkan F, Senayli Y, Ozyurt H, Erkorkmaz U, Bostan B. Antioxidant effects of propofol on tourniquet-induced ischemia-reperfusion injury: an experimental study. J Surg Res 2011; 176:601-7. [PMID: 22261588 DOI: 10.1016/j.jss.2011.10.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 09/23/2011] [Accepted: 10/25/2011] [Indexed: 11/19/2022]
Abstract
PURPOSE This experimental study aimed to investigate the antioxidant effects of propofol anesthesia at induction doses in a rat skeletal muscle ischemia/reperfusion injury model. METHODS Twenty-six rats were randomly divided into three groups to receive one of the following interventions: sham operation (n = 6), ischemia/reperfusion (I/R) injury (n = 10), or propofol administration in addition to I/R injury (n = 10). I/R injury was attained by 2-h clamping of femoral artery followed by 3-h perfusion. Then blood and tissue samples were collected for biochemical analysis and histopathologic examination. Glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) enzyme activities and nitric oxide (NO) and malondialdehyde (MDA) levels were measured in both plasma and muscle tissue. In addition, catalase (CAT) activity and protein carbonyl (PC) content were measured in muscle tissue. RESULTS I/R group had significantly higher SOD activity (9.05 versus 5.63 and 6.18 U/mL, P < 0.05) and NO level (46.77 versus 30.62 and 33.90 μmol/L, P < 0.05) compared with sham-operated group and I/R plus propofol group. In addition, GSH-Px activity of the I/R group was significantly higher than sham-operated group (1.26 versus 1.05 U/mL, P < 0.05). I/R group had significantly higher tissue activities of CAT (0.11 versus 0.06 and 0.04 k/g protein, P < 0.05) and SOD (0.12 versus 0.08 and 0.07 U/mg protein, P < 0.05) compared with the sham and I/R plus propofol group. Histopathologic examination showed that I/R plus propofol group had significantly lower degeneration (P = 0.021) and inflammation (P = 0.028) scores compared with I/R group. CONCLUSION Propofol anesthesia seems to enhance the antioxidant capacity against tourniquet induced ischemia-reperfusion injury.
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Affiliation(s)
- Fatih Ozkan
- Department of Anesthesiology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey.
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Addition of a Water-Soluble Propofol Formulation to Preservation Solution in Experimental Kidney Transplantation. Transplantation 2011; 92:296-302. [DOI: 10.1097/tp.0b013e3182247b78] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Luo CF, Tsai YF, Chang CH, Wu CT, Yu HP. Increased oxidative stress and gut ischemia caused by prolonged pneumoperitoneum in patients undergoing robot-assisted laparoscopic radical prostatectomy. ACTA ACUST UNITED AC 2011; 49:46-9. [PMID: 21729809 DOI: 10.1016/j.aat.2011.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 04/28/2011] [Accepted: 05/04/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate changes in plasma oxidative stress markers associated with prolonged pneumoperitoneum during robot-assisted laparoscopic radical prostatectomy (RALP). METHODS In all, patients of ASA Physical Status II-III who intended to undergo RALP were enrolled in the study. Arterial plasma levels of malondialdehyde (MDA) and intramucosal pH were measured 1 minute before and at 1 hour, 2 hours, 3 hours, and 4 hours after the introduction of pneumoperitoneum at an insufflation pressure of 15 mmHg; likewise, they were again measured every 10 minutes after deflation for 60 minutes, at 2 hours and 12 hours after deflation. RESULTS The mean duration of pneumoperitoneum was around 4 hours. After induction of pneumoperitoneum, the MDA concentrations were significantly elevated at various time points as compared with the preinsufflation value. Significant increase of MDA value was noted also 30 minutes after deflation as compared with the pre-deflation levels. The intramucosal pH value decreased significantly after CO(2) insufflation compared with the preinsufflation values. It also increased significantly 2 hours after CO(2) deflation as compared with the pre-deflation values. CONCLUSION A prolonged pneumoperitoneum in RALP results in decreased splanchnic blood flow. Pneumoperitoneum itself produces oxidative stress, and ischemia-reperfusion model after deflation of pneumoperitoneum produces more oxidative stress.
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Affiliation(s)
- Chiao-Fen Luo
- Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
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Laviolle B, Basquin C, Aguillon D, Compagnon P, Morel I, Turmel V, Seguin P, Boudjema K, Bellissant E, Mallédant Y. Effect of an anesthesia with propofol compared with desflurane on free radical production and liver function after partial hepatectomy. Fundam Clin Pharmacol 2011; 26:735-42. [PMID: 21692846 DOI: 10.1111/j.1472-8206.2011.00958.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Propofol has shown antioxidant properties, but no study has focused on liver resection surgery. The aim of this study was to investigate the effect of an anesthesia with propofol compared with desflurane on oxidative stress and hepatic function during and after partial hepatectomy. This was a prospective randomized study performed on two parallel groups. The primary endpoint was malondialdehyde (MDA) plasma concentration 30 min after hepatic vascular unclamping. Hepatic damages were evaluated by plasma levels of alpha-glutathione S-transferase (α-GST) 120 min after hepatic vascular unclamping and of aminotransferases at 120 min and on days 1, 2, 5, and 10. Liver function recovery was assessed by monoethylglycinexylidide (MEGX) formation 15 min after lidocaine injection on day 2 and by prothrombin time and plasma factor V at 120 min and on days 1, 2, 5, and 10. Thirty patients were analyzed (propofol group: 17; desflurane group: 13). There was no significant difference between groups for MDA plasma concentration 30 min after hepatic vascular unclamping (mean ± standard-deviation: 1.28 ± 0.40 and 1.21 ± 0.29 in propofol and desflurane groups, respectively, P = 0.608). Plasma levels of α-GST at 120 min were lower in propofol than in desflurane group (142.2 ± 75.4 vs. 205.7 ± 66.5, P = 0.023), and MEGX on day 2 was higher (0.092 ± 0.096 vs. 0.036 ± 0.020, P = 0.007). No differences between groups were observed with regard to plasma levels of aminotransferases, prothrombin time, and plasma factor V. Our study showed that in patients undergoing partial hepatectomy, propofol did not reduce MDA formation but seemed to display a protective effect on hepatic damages and liver function when compared to desflurane.
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Affiliation(s)
- Bruno Laviolle
- Service de Pharmacologie Clinique, Hôpital de Pontchaillou, CHU de Rennes, Université de Rennes 1, 35033 Rennes Cedex, France.
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Inhibition of Rho kinase by fasudil hydrochloride attenuates lung injury induced by intestinal ischemia and reperfusion. Life Sci 2011; 88:104-9. [PMID: 21056587 DOI: 10.1016/j.lfs.2010.10.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 10/07/2010] [Accepted: 10/27/2010] [Indexed: 02/05/2023]
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Zhao HD, Zhang F, Shen G, Li YB, Li YH, Jing HR, Ma LF, Yao JH, Tian XF. Sulforaphane protects liver injury induced by intestinal ischemia reperfusion through Nrf2-ARE pathway. World J Gastroenterol 2010; 16:3002-10. [PMID: 20572303 PMCID: PMC2890940 DOI: 10.3748/wjg.v16.i24.3002] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the effect of sulforaphane (SFN) on regulation of NF-E2-related factor-2 (Nrf2)-antioxidant response element (ARE) pathway in liver injury induced by intestinal ischemia/reperfusion (I/R).
METHODS: Rats were divided randomly into four experimental groups: control, SFN control, intestinal I/R and SFN pretreatment groups (n = 8 in each group). The intestinal I/R model was established by clamping the superior mesenteric artery for 1 h and 2 h reperfusion. In the SFN pretreatment group, surgery was performed as in the intestinal I/R group, with intraperitoneal administration of 3 mg/kg SFN 1 h before the operation. Intestine and liver histology was investigated. Serum levels of aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were measured. Liver tissue superoxide dismutase (SOD), myeloperoxidase (MPO), glutathione (GSH) and glutathione peroxidase (GSH-Px) activity were assayed. The liver transcription factor Nrf2 and heme oxygenase-1 (HO-1) were determined by immunohistochemical analysis and Western blotting analysis.
RESULTS: Intestinal I/R induced intestinal and liver injury, characterized by histological changes as well as a significant increase in serum AST and ALT levels (AST: 260.13 ± 40.17 U/L vs 186.00 ± 24.21 U/L, P < 0.01; ALT: 139.63 ± 11.35 U/L vs 48.38 ± 10.73 U/L, P < 0.01), all of which were reduced by pretreatment with SFN, respectively (AST: 260.13 ± 40.17 U/L vs 216.63 ± 22.65 U/L, P < 0.05; ALT: 139.63 ± 11.35 U/L vs 97.63 ± 15.56 U/L, P < 0.01). The activity of SOD in the liver tissue decreased after intestinal I/R (P < 0.01), which was enhanced by SFN pretreatment (P < 0.05). In addition, compared with the control group, SFN markedly reduced liver tissue MPO activity (P < 0.05) and elevated liver tissue GSH and GSH-Px activity (P < 0.05, P < 0.05), which was in parallel with the increased level of liver Nrf2 and HO-1 expression.
CONCLUSION: SFN pretreatment attenuates liver injury induced by intestinal I/R in rats, attributable to the antioxidant effect through Nrf2-ARE pathway.
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Catré D, Viana JS, Cabrita AM, Oliveira M, Felizes A, Lopes MF. Hydroxyethyl starch 130/0.4 attenuates early hepatic damage in ischemia/reperfusion injury. Can J Anaesth 2010; 57:439-45. [PMID: 20151340 DOI: 10.1007/s12630-010-9282-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2009] [Accepted: 02/01/2010] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Ischemia/reperfusion injury (IRI) remains a clinical challenge. We tested the hypothesis that fluid therapy using hydroxyethyl starch (HES) 130/0.4 during the early phase of IRI in rat liver decreases markers of hepatic injury. METHODS We induced liver IRI in three groups of rats anesthetized with ketamine and chlorpromazine by means of 60 min of segmental hepatic ischemia followed by 120 min of reperfusion. At the onset of reperfusion, Group 1 (IRI + HES; n = 12) was given 13 mL.kg(-1) of HES; Group 2 (IRI + HS; n = 12) received the same volume of 7.5% saline (HS), and Group 3 (IRI-only; n = 12) received no fluid. Three other groups of 12 animals each were sham-operated and received the same fluid as the test groups. We euthanized the animals after three hours, drew blood for alanine aminotransferase (ALT) quantification, and took ischemic liver samples for histomorphological study. RESULTS Serum ALT activity was greater in all of the IRI groups than in the sham-operated animals. The ALT activity was 1,081 +/- 575 IU.L(-1) in IRI + HES Group 1; 2,363 +/- 1,839 IU.L(-1) in IRI + HS Group 2; and 2,866 +/- 2,491 IU.L(-1) in IRI-only Group 3. There was a statistically significant difference between the IRI + HES and the IRI-only groups (P = 0.001), but not between the IRI + HS and the IRI-only groups (P > 0.05). Likewise, histological scores were greater in all IRI groups compared with the sham-operated animals. Scores were higher in the IRI-only group (median 3.5) than in the groups receiving fluid (IRI + HES median 2; IRI + HS median 3). The difference between IRI + HES and IRI-only was statistically significant (P = 0.008) but not so between IRI + HS and IRI-only (P > 0.05). CONCLUSIONS Giving HES 130/0.4 attenuates rat liver IRI compared with no fluid, while giving HS does not. This suggests a role for HES in hepatoprotection associated with liver IRI.
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Affiliation(s)
- Dora Catré
- School of Medicine of the University of Coimbra, Coimbra, Portugal,
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The comparison of the effects of anesthetic doses of ketamine, propofol, and etomidate on ischemia-reperfusion injury in skeletal muscle. Fundam Clin Pharmacol 2009; 24:215-22. [PMID: 19678850 DOI: 10.1111/j.1472-8206.2009.00748.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The fact that a considerable amount of clinical conditions suffering from ischemia-reperfusion injury (IRI) occur under general anesthesia has triggered researchers to focus on the effects of anesthetic drugs on IRI. Hence, the aim of this study was to compare the use of different anesthetic drugs in a skeletal IRI model. Tourniquet IRI method was performed and two experimental groups were established as sham-control and IRI group. Rats in each group were anesthetized either with thiopental, ketamine, propofol or etomidate. Malondialdehyde, superoxide dismutase, catalase, and glutathione peroxidase were measured in skeletal muscle via a spectrophotometer. Zinc, iron, copper, and selenium were evaluated by atomic absorption spectrophotometer. In rats anesthetized with thiopental (40 mg/kg, i.p.), malondialdehyde values in IRI group were higher and glutathion peroxidase levels were lower compared to sham-control group. However, superoxide dismutase and catalase activities were identical. On the other hand, while the level of zinc in IRI group attenuated, no differences in iron and copper values were determined. Rats anesthetized with ketamine (60 mg/kg), propofol (100 mg/kg), or etomidate (20 mg/kg) did not show increased malondialdehyde levels in comparison with control levels. While the drugs did not cause a distinction in the levels of superoxide dismutase, catalase, glutathion peroxidase, iron, and copper, zinc was in a lower level in IRI group compared to sham-control. In conclusion, ketamine, propofol, and etomidate, with anesthetic doses, denoted efficacious effects on IRI; hence the drugs might be preferred in certain operations with the risk of IRI.
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Yao JH, Zhang XS, Zheng SS, Li YH, Wang LM, Wang ZZ, Chu L, Hu XW, Liu KX, Tian XF. Prophylaxis with carnosol attenuates liver injury induced by intestinal ischemia/reperfusion. World J Gastroenterol 2009; 15:3240-5. [PMID: 19598299 PMCID: PMC2710779 DOI: 10.3748/wjg.15.3240] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the possible protective effects of carnosol on liver injury induced by intestinal ischemia reperfusion (I/R).
METHODS: Rats were divided randomly into three experimental groups: sham, intestinal I/R and carnosol treatment (n = 18 each). The intestinal I/R model was established by clamping the superior mesenteric artery for 1 h. In the carnosol treatment group, surgery was performed as in the intestinal I/R group, with intraperitoneal administration of 3 mg/kg carnosol 1 h before the operation. At 2, 4 and 6 h after reperfusion, rats were killed and blood, intestine and liver tissue samples were obtained. Intestine and liver histology was investigated. Serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and interleukin (IL)-6 were measured. Liver tissue superoxide dismutase (SOD) and myeloperoxidase (MPO) activity were assayed. The liver intercellular adhesion molecule-1 (ICAM-1) and nuclear factor κB (NF-κB) were determined by immunohistochemical analysis and western blot analysis.
RESULTS: Intestinal I/R induced intestine and liver injury, characterized by histological changes, as well as a significant increase in serum AST and ALT levels. The activity of SOD in the liver tissue decreased after I/R, which was enhanced by carnosol pretreatment. In addition, compared with the control group, carnosol markedly reduced liver tissue MPO activity and serum IL-6 level, which was in parallel with the decreased level of liver ICAM-1 and NF-κB expression.
CONCLUSION: Our results indicate that carnosol pretreatment attenuates liver injury induced by intestinal I/R, attributable to the antioxidant effect and inhibition of the NF-κB pathway.
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Acetaminophen-induced liver injury and oxidative stress: protective effect of propofol. Eur J Anaesthesiol 2009; 26:548-53. [DOI: 10.1097/eja.0b013e32831c8a01] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Liu FC, Day YJ, Liao CH, Liou JT, Mao CC, Yu HP. Hemeoxygenase-1 Upregulation Is Critical for Sirtinol-Mediated Attenuation of Lung Injury After Trauma-Hemorrhage in a Rodent Model. Anesth Analg 2009; 108:1855-61. [DOI: 10.1213/ane.0b013e3181a1a194] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Zhang F, Wu R, Zhou M, Blau SA, Wang P. Human adrenomedullin combined with human adrenomedullin binding protein-1 is protective in gut ischemia and reperfusion injury in the rat. ACTA ACUST UNITED AC 2008; 152:82-7. [PMID: 18948146 DOI: 10.1016/j.regpep.2008.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Revised: 09/18/2008] [Accepted: 09/20/2008] [Indexed: 11/19/2022]
Abstract
Previous studies have demonstrated that co-administration of rat adrenomedullin (AM) and human AM binding protein-1 (AMBP-1) has various beneficial effects following adverse circulatory conditions. In order to reduce rat proteins to elicit possible immune responses in humans, we determined the effect of human AM combined with human AMBP-1 after intestinal ischemia and reperfusion (I/R). Intestinal ischemia was induced in the rat by occluding the superior mesenteric artery for 90 min. At 60 min after the beginning of reperfusion, human AM/AMBP-1 at 3 different dosages was administered intravenously over 30 min. At 240 min after the treatment, blood and tissue samples were harvested and measured for pro-inflammatory cytokines (i.e., TNF-alpha and IL-6), myeloperoxidase activities in the gut and lungs, and cleaved caspase-3 expression in the lungs, as well as serum levels of hepatic enzymes and lactate. In additional groups of animals, a 10-day survival study was conducted. Results showed that administration of human AM/AMBP-1 reduced pro-inflammatory cytokines, attenuated organ injury, and improved the survival rate in a seemingly dose-response fashion. Co-administration of the highest dose of human AM/AMBP-1 in this study had the optimal therapeutic effect in the rat model of intestinal I/R.
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Affiliation(s)
- Fangming Zhang
- Department of Surgery, North Shore University Hospital, USA
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Omar SH, Dessouki AM, Osman ES, El Hadidy AS, Kamel HH, Samhan YM. Effect of Propofol Fentanyl Anesthesia on Hepatocellular Integrity During Induced Hypotension. JOURNAL OF MEDICAL SCIENCES 2008. [DOI: 10.3923/jms.2008.275.280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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TSUCHIYA H, UENO T, MIZOGAMI M, TAKAKURA K. Antioxidant Activity Analysis by Liposomal Membrane System and Application to Anesthetics. ANAL SCI 2008; 24:1557-62. [DOI: 10.2116/analsci.24.1557] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Hironori TSUCHIYA
- Department of Dental Basic Education, Asahi University School of Dentistry
| | - Takahiro UENO
- Department of Anesthesiology, Asahi University School of Dentistry
| | - Maki MIZOGAMI
- Department of Anesthesiology, Asahi University School of Dentistry
| | - Ko TAKAKURA
- Department of Anesthesiology, Asahi University School of Dentistry
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