A meta-analysis and systematic review of propofol on liver ischemia-reperfusion injury protection during hepatocellular carcinoma anesthesia surgery

Feng, Changsheng; Qian, Duo; Chen, Changlin

doi:10.21037/apm-21-1242

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…Therefore, the appearance of early evident injury after reperfusion may take about I-30 min; detection for the degree of WII within I-30 min is probably the key to evaluate graft quality. For I-60 min without reperfusion, no significant difference in apoptosis (Caspase-3 and TUNEL), oxidation (superoxide dismutase level, which is closely related to tissue oxidation level in WII 14 ), or optical morphology was found (Figure 1 A, C). Still, without reperfusion, there were no significant morphological, immunohistochemical, immunofluorescent under a light microscope, or western blot changes within I-30 min.…”

Section: Resultsmentioning

confidence: 94%

Mitochondrial miR-23b-5p is a new biomarker of warm ischemic injury in donor livers and a candidate for graft evaluation: experimental studies

Kong¹,

Zhou²,

Yuan³

et al. 2023

International Journal of Surgery

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Background and aims: Warm ischaemic injury (WII) stems from incorrect energy metabolism and is the main cause of graft dysfunction. Mitochondria, as the centre of cellular metabolic activities, may be the key in identifying accurate indicators for evaluating the quality of grafts. Our research focuses on the screening, clinical application, and mechanism of the optimal WII mitochondrion biomarker. Approach and results: Using a 100% hepatic warm ischaemia mouse model, without reperfusion, transmission electron microscopy demonstrated evident morphological changes of hepatic mitochondria at 15 min of ischaemia. However, all 13 mt-mRNAs could not display continuously upregulated consistency at 0–15–30–60 min during WII. High-throughput analysis of miRNA expression in both purified mitochondria and liver tissues suggested miR-23b-5p was a potential mitochondrial microRNA (mitomiR) biomarker with high sensitivity and 0-15-30-60 min change consistency. Fluorescence in-situ hybridization and reverse transcription quantitative polymerase chain reaction (RT-qPCR) further confirmed the results. Through overexpression and inhibition, the functionality of this mitomiR during WII was identified as a protective regulator in vitro and then verified in Dicer1 fl/fl Alb Cre mice by downregulation of other miRNAs and supplementation of mature mitomiR-23b-5p. Dual-luciferase reporter assay and the Seahorse XF analyzer determined that mitomiR-23b-5p reduced mitochondrial respiratory function by silencing mt-RNR2 (16S). Clinically, mitomiR-23b-5p was positively correlated with serum alanine aminotransferase levels 3 days after the operation ( P =0.032), and the C-statistic for 90-day graft survival rate was 0.698. Conclusions: MitomiR-23b-5p plays a protective regulatory role and implements a special mitochondrial regulation mechanism not yet reported in WII. These clinical results further support the experimental result that the expression of MitomiR-23b-5p is closely related to the prognosis of clinical liver transplantation patients. This is a promising new biomarker for WII evaluation of donor livers.

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Section: Resultsmentioning

confidence: 94%

Mitochondrial miR-23b-5p is a new biomarker of warm ischemic injury in donor livers and a candidate for graft evaluation: experimental studies

Kong¹,

Zhou²,

Yuan³

et al. 2023

International Journal of Surgery

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“…There was a meta-analysis found that propofol might also have a beneficial impact on HCC patients after liver ischemia reperfusion injury (LIRI), demonstrated by a lower level of malondialdehyde (MDA), alanine transaminase (ALT), aspartate transaminase (AST) and a higher level of superoxide dismutase (SOD) (77). Propofol could also lead to down-regulation of MMPs and increase of Ecadherin by impairing Twist1 expression, and inhibit HCC proliferation, migration, and invasion as a result (37).…”

Section: Figurementioning

confidence: 99%

Long-term effect of anesthesia choice on patients with hepatocellular carcinoma undergoing open liver resection

Zhao

Sun

et al. 2023

Front. Oncol.

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Clinical and experimental evidence suggested that anesthesia choice can influence cancer progression and patients’ outcomes by modulating tumor microenvironment and tumorigenic pathways. Curative resection is the mainstay of therapy for hepatocellular carcinoma (HCC), which is an intractable disease due to high recurrence and poor prognosis. However, different anesthetics may play different roles in alleviating surgery-induced stress response and inflammatory cytokines release that are considered to be closely associated with proliferation, invasion and metastasis of tumor cells. Propofol, sevoflurane, non-steroidal anti-inflammatory drugs and local anesthetics have shown to exert anti-tumor effect on HCC mainly through regulating microRNAs or signaling pathways, while other inhalational agents, dexmedetomidine and opioids have the potential to promote tumor growth. In terms of anesthetic methods and analgesia strategies, propofol based total intravenous anesthesia and thoracic epidural analgesia could be preferred for HCC patients undergoing open liver resection rather than inhalational anesthesia. Local anesthesia techniques have great potential to attenuate perioperative stress response, hence they may contribute to more favorable outcomes. This review summarized the relations between different anesthesia choices and HCC patients’ long-term outcomes as well as their underlying mechanisms. Due to the complexity of molecules interactions and signaling pathways, further studies are warranted to confirm these results so as to optimize anesthesia strategy for HCC patients.

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“…Propofol (2,6-diisopropylphenol) is one of the intravenous anaesthetic agents routinely used in veterinary clinical practice for the induction and maintenance of general anaesthesia, with affinity for γ-aminobutyric acid (GABA) receptors and producing sedative and hypnotic effects [134]. They possess neuroprotective [135], anti-apoptotic [136] and antiinflammatory actions in the central nervous system [137].…”

Section: Intravenous Anaesthetic Agentsmentioning

confidence: 99%

Anaesthesia in Veterinary Oncology: The Effects of Surgery, Volatile and Intravenous Anaesthetics on the Immune System and Tumour Spread

Pinheiro,

Petrucci,

Dourado

et al. 2023

Animals

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Throughout the course of oncological disease, the majority of patients require surgical, anaesthetic and analgesic intervention. However, during the perioperative period, anaesthetic agents and techniques, surgical tissue trauma, adjuvant drugs for local pain and inflammation and other non-pharmacological factors, such as blood transfusions, hydration, temperature and nutrition, may influence the prognosis of the disease. These factors significantly impact the oncologic patient’s immune response, which is the primary barrier to tumour progress, promoting a window of vulnerability for its dissemination and recurrence. More research is required to ascertain which anaesthetics and techniques have immunoprotective and anti-tumour effects, which will contribute to developing novel anaesthetic strategies in veterinary medicine.

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A meta-analysis and systematic review of propofol on liver ischemia-reperfusion injury protection during hepatocellular carcinoma anesthesia surgery

Cited by 6 publications

References 14 publications

Mitochondrial miR-23b-5p is a new biomarker of warm ischemic injury in donor livers and a candidate for graft evaluation: experimental studies

Mitochondrial miR-23b-5p is a new biomarker of warm ischemic injury in donor livers and a candidate for graft evaluation: experimental studies

Long-term effect of anesthesia choice on patients with hepatocellular carcinoma undergoing open liver resection

Anaesthesia in Veterinary Oncology: The Effects of Surgery, Volatile and Intravenous Anaesthetics on the Immune System and Tumour Spread

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