Journal
EUROPEAN SURGICAL RESEARCH
Volume 38, Issue 6, Pages 503-512Publisher
KARGER
DOI: 10.1159/000096061
Keywords
liver surgery; medical pretreatment of the liver; apoptosis; tumor necrosis factor-a; glycine; alpha-lipoic acid
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Background/Aim: alpha-Lipoic (LA) acid pretreatment has previously been described to reduce ischemia/reperfusion injury (IRI) after warm liver ischemia, whereas glycine pretreatment has been shown to be protective mostly in models of cold hepatic ischemia. The aim of this study was to determine whether glycine decreases IRI after warm hepatic ischemia. Furthermore we investigated whether doses of LA other than those used previously are also protective against IRI after warm hepatic ischemia. Methods: Selective liver ischemia was maintained over a period of 90 min. In long-term as well as short-term experiments we studied IRI in several groups comparing animal survival as the pivotal endpoint. Results: Animal survival was improved by glycine and 5,000 mu mol LA, whereas all animals died within 3 days after pretreatment with 50 mu mol LA. In the glycine group we observed a tendency towards decreased apoptosis-related cell death measured by the activity of caspase-3 in liver tissue and the percentage of TUNEL-positive hepatocytes in comparison to the untreated group. Serum alpha-glutathione S-transferase, lipid peroxidation, and caspase-3 activity as well as the percentage of TUNEL-positive hepatocytes and the percentage of liver necrosis were only significantly decreased by 5,000 mu mol LA pretreatment. Liver tissue levels of tumor necrosis factor (TNF)alpha were reduced only in the glycine group whereas TNF alpha was increased in the untreated as well as the LA group. Levels of TNF alpha mRNA were upregulated in both the glycine- and LA-pretreated groups. Conclusion: Our data show that increased animal survival by glycine was accompanied by a reduced TNF alpha content in liver tissue. Protection by glycine is likely to result from a reduction in adverse TNF alpha effects. Administration of high-dose LA on the other hand led to a significant reduction in necrosis- and apoptosis-related cell death in IRI of the liver without a reduction in liver TNF alpha. Copyright (c) 2006 S. Karger AG, Basel.
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