The effect of methylprednisolone on warm ischemia-reperfusion injury in the liver

Saidi, Reza F.; Chang, Jennifer; Verb, Steve; Brooks, S E; Nalbantoglu, ILKe; Adsay, Volkan; Jacobs, Michael J.

doi:10.1016/j.amjsurg.2006.09.017

Cited by 49 publications

(25 citation statements)

References 16 publications

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“…Prednisolone a glucocorticoid steroid, acts as an antiinflammatory agent, reducing inflammatory markers and apoptotic cell count in experimental liver IRI (58). It decreased hospital stay and blood transfusion requirements, and improved liver function and showed a trend favoring a decreased postoperative complication rate (58).…”

Section: Prednisolonementioning

confidence: 99%

Hepatic Ischemia and Reperfusion Injury and Trauma: Current Concepts

Papadopoulos¹,

Siempis²,

Theodorakou³

et al. 2013

Arch Trauma Res

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Context: Ischemia-reperfusion injury is a fascinating topic which has drawn a lot of interest in the last several years. Hepatic ischemia reperfusion injury may occur in a variety of clinical situations. These include transplantation, liver resection, trauma, and vascular surgery. Evidence Acquisition: The purpose of this review was to outline the molecular mechanisms underlying hepatic I/R injury and present the latest approaches, both surgical and pharmacological, regarding the prevention of it. A comprehensive electronic literature search in MEDLINE/PubMed was performed to identify relative articles published within the last 2 years. Results: The basic mechanism of hepatic ischemia -reperfusion injury is one of blood deprivation during ischemia, followed by the return of flow during reperfusion. It involves a complex series of events, such as mitochondrial deenergization, adenosine-5'-triphosphate depletion, alterations of electrolyte homeostasis, as well as Kupffer cell activation, oxidative stress changes and upregulation of proinflammatory cytokine signaling. The great number of variable pathways, with several mediators interacting with each other, leads to a high number of candidates for potential therapeutic intervention. As far as surgical approaches are concerned, the modification of existing clamping techniques and the ischemic preconditioning are the most promising techniques till recently. In the search for novel techniques of protecting against hepatic ischemia reperfusion injury, many different strategies have been used in experimental models. The biggest part of this research lies around antioxidant therapy, but other potential solutions have been explored as well. Conclusions:The management of hepatic trauma, in spite of the fact that it has become increasingly nonoperative, there still remains the possibility of hepatic resection in the hepatic trauma setting, especially in severe injuries. Hence, clinicians should be familiar with the concept of hepatic ischemia-reperfusion injury and respond appropriately and timely.Keywords: Reperfusion Injury; Ischemia; Pathophysiology; Prevention Implication for health policy/practice/research/medical education: Hepatic ischemia and reperfusion injury is a complex phenomenon which is commonplace in clinical practice such as the operative management of hepatic trauma, liver transplantation and liver resection. Hence, surgeons should be familiar with it and apply the necessary methods to prevent it.

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Section: Prednisolonementioning

confidence: 99%

Hepatic Ischemia and Reperfusion Injury and Trauma: Current Concepts

Papadopoulos¹,

Siempis²,

Theodorakou³

et al. 2013

Arch Trauma Res

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show abstract

“…After 90 min of warm ischemia, the clamps were removed to allow reperfusion for 18 h. The rats received approximately 5 ml of NS intraperitoneally before closure of the incision. 6,7,29 And, the rats were allowed to regain consciousness during TLR4-mediated ALI after liver I/R injury Z Yang et al reperfusion period. The sham procedure was performed identically without vascular occlusion.…”

Section: Experimental Animals and Groupsmentioning

confidence: 99%

TLR4 as receptor for HMGB1-mediated acute lung injury after liver ischemia/reperfusion injury

Yang

Deng

et al. 2013

Laboratory Investigation

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Acute lung injury (ALI) frequently occurs after liver transplantation and major liver surgery. Proinflammatory mediators released by damaged liver after liver ischemia/reperfusion (I/R) injury might contribute to this form of ALI, but the underlying mechanisms have not been well characterized. High-mobility group box protein 1 (HMGB1), a recently identified proinflammatory cytokine, was found to be significantly higher in the serum after liver I/R injury. This study investigated whether HMGB1 was involved as a stimulating factor, and whether its downstream Toll-like receptor 4 (TLR4), p38 mitogen-activated protein kinase (p38MAPK), and activator protein-1 (AP-1) signaling pathways act as mediators in the development of liver I/R injury-induced ALI. Extensive ALI and lung inflammation was induced in a rat model of liver I/R injury. Serum HMGB1 was significantly higher after liver I/R injury, and more importantly, expression of HMGB1 mRNA and protein in the lung tissue was also significantly increased. We further found that liver I/R injury enhanced the expression of TLR4 mRNA and protein, and the activity of p38MAPK and AP-1 in the lung tissue. Inhibition of TLR4 expression in the lung tissue by infection with pGCSIL-GFP-lentivirus-expressing small hairpin RNAs targeting the TLR4 gene (TLR4-shRNA lentivirus) significantly attenuated ALI, lung inflammation, and activity of p38MAPK and AP-1 in the lung tissue. These findings indicate that HMGB1 might contribute to the underlying mechanism for liver I/R injuryinduced ALI and that its downstream TLR4, p38MAPK, and AP-1 signaling pathways are potentially important mediators in the development of ALI.

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“…Prednisolone a glucocorticoid steroid, acts as an anti-inflammatory agent, reducing inflammatory markers and apoptotic cell count in experimental liver IRI (58). It decreased hospital stay and blood transfusion requirements, and improved liver function and showed a trend favoring a decreased postoperative complication rate (58).…”

Section: Resultsmentioning

confidence: 99%

“…It decreased hospital stay and blood transfusion requirements, and improved liver function and showed a trend favoring a decreased postoperative complication rate (58). According to a 2013 systematic review and meta-analysis of the effect of perioperative steroids on IRI, perioperative steroids have a favorable impact on postoperative outcomes after liver resection.…”

Section: Resultsmentioning

confidence: 99%

Hepatic Ischemia and Reperfusion Injury and Trauma: Current Concepts

et al. 2013

View full text Add to dashboard Cite

ContextIschemia-reperfusion injury is a fascinating topic which has drawn a lot of interest in the last several years. Hepatic ischemia reperfusion injury may occur in a variety of clinical situations. These include transplantation, liver resection, trauma, and vascular surgery.Evidence AcquisitionThe purpose of this review was to outline the molecular mechanisms underlying hepatic I/R injury and present the latest approaches, both surgical and pharmacological, regarding the prevention of it. A comprehensive electronic literature search in MEDLINE/PubMed was performed to identify relative articles published within the last 2 years.ResultsThe basic mechanism of hepatic ischemia – reperfusion injury is one of blood deprivation during ischemia, followed by the return of flow during reperfusion. It involves a complex series of events, such as mitochondrial deenergization, adenosine-5'-triphosphate depletion, alterations of electrolyte homeostasis, as well as Kupffer cell activation, oxidative stress changes and upregulation of proinflammatory cytokine signaling. The great number of variable pathways, with several mediators interacting with each other, leads to a high number of candidates for potential therapeutic intervention. As far as surgical approaches are concerned, the modification of existing clamping techniques and the ischemic preconditioning are the most promising techniques till recently. In the search for novel techniques of protecting against hepatic ischemia reperfusion injury, many different strategies have been used in experimental models. The biggest part of this research lies around antioxidant therapy, but other potential solutions have been explored as well.ConclusionsThe management of hepatic trauma, in spite of the fact that it has become increasingly nonoperative, there still remains the possibility of hepatic resection in the hepatic trauma setting, especially in severe injuries. Hence, clinicians should be familiar with the concept of hepatic ischemia-reperfusion injury and respond appropriately and timely.

show abstract

The effect of methylprednisolone on warm ischemia-reperfusion injury in the liver

Cited by 49 publications

References 16 publications

Hepatic Ischemia and Reperfusion Injury and Trauma: Current Concepts

Hepatic Ischemia and Reperfusion Injury and Trauma: Current Concepts

TLR4 as receptor for HMGB1-mediated acute lung injury after liver ischemia/reperfusion injury

Hepatic Ischemia and Reperfusion Injury and Trauma: Current Concepts

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