Attenuation of Ischemic Injury by N-Acetylcysteine Preconditioning of the Liver

Smyrniotis, Vassilios; Arkadopoulos, Nikolaos; Kostopanagiotou, Georgia; Theodoropoulos, Theodoros; Theodoraki, Kassiani; Farantos, Charalampos; Kairi, Evi; Paphiti, Agathi

doi:10.1016/j.jss.2005.07.028

Cited by 33 publications

(29 citation statements)

References 49 publications

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“…Ischemia-reperfusion (I/R) frequently is encountered during liver transplantation and hepatectomies performed under vascular exclusion. Restoration of blood flow after a period of liver ischemia is associated with a series of events that aggravate the ischemic injury (Smyrniotis et al 2005).…”

Section: Discussionmentioning

confidence: 99%

Preventive role of gallic acid on hepatic ischemia and reperfusion injury in rats

et al. 2014

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There is little information about the hepatoprotective effects of gallic acid against ischemiareperfusion (I/R) damage. Animals were subjected to I/R. Gallic acid at doses of 50 and 100 mg/kg body weight (bw) were injected as a single dose prior to ischemia. Liver tissue homogenates were used for the measurement of malondialdehyde (MDA), catalase (CAT) and glutathione peroxidase (GPx) levels. At the same time alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were assayed in serum samples and compared statistically. While the ALT, AST, LDH activities and MDA levels were significantly increased, CAT and GPx activities significantly decreased in only I/Rinduced control rats compared to normal control rats (P \ 0.05). Treatment with gallic acid at a dose of 100 mg/kg bw significantly decreased the ALT, AST, LDH activities and MDA levels, and markedly increased activities of CAT and GPx in tissue homogenates compared to I/R-induced rats with no treatment group (P \ 0.05). In oxidative stress generated by hepatic ischemia-reperfusion, gallic acid contributes partially an alteration in the delicate balance between the scavenging capacity of antioxidant defense systems and free radicals in favour of the antioxidant defense systems in the body.

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Section: Discussionmentioning

confidence: 99%

Preventive role of gallic acid on hepatic ischemia and reperfusion injury in rats

et al. 2014

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“…Considering from the pharmacokinetic properties, maintaining the plasma concentration for a certain period like the NAC2 treatment may be required to distribute a sufficient amount of NAC quantity to recover the glutathione antioxidant system in the heart. On the contrary, bolus injection of NAC seems to recover the glutathione content in the liver and limit the hepatic I / R injury (4,19) because NAC is easily distributed in liver (18).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Protective Effect of N-Acetylcysteine by Different Treatments on Rat Myocardial Ischemia-Reperfusion Injury

et al. 2008

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Abstract. Reactive oxygen species have been known as important contributors to ischemia / reperfusion (I / R) injury. Studies on the beneficial effect of N-acetylcysteine (NAC), a potent antioxidant, on limiting infarct size induced by I / R yielded contrasting results. The present study was undertaken to compare the effect of NAC by different administration methods on infarct size in a rat myocardial I/ R model. Rats underwent 30 min of left coronary occlusion followed by 4 h of reperfusion. Treatment with continuous infusion of NAC (150 mg / kg per hour) from 30 min before occlusion for 2 h (until 1 h after the start of reperfusion) produced a significant limitation of the infarct size as a percentage of the ischemic area (8%) compared to the non-treated control (60%). However, bolus injection of 150 mg / kg at 30 min prior to occlusion and 5 min prior to reperfusion failed to reduce it (56%) although the total dose is the same. The decreased total glutathione content and glutathione peroxidase activity in the ischemic region were recovered in the continuous infusion group, but not in the bolus injection group. The increased myeloperoxidase activity and phosphorylation of inhibitor κB after I / R were inhibited by the continuous treatment. These results indicate that the protective effect of NAC on myocardial infarction induced by I / R was different depending on the administration method. It is necessary to maintain blood concentration during the early period of reperfusion to obtain the beneficial effect of NAC.

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“…The hepatectomy procedures performed included segmentectomy, lobectomy and extended lobectomy (trisegmentectomy). Our technique of hepatectomy has been described previously [15] , using the Pringle maneuver, vascular outflow obstruction and sharp parenchymal dissection. For major hepatectomies (lobectomy-extended lobectomy) hilar dissection was performed to divide the correspondent vessels [16] .…”

Section: Methodsmentioning

confidence: 99%

Managing injuries of hepatic duct confluence variants after major hepatobiliary surgery: An algorithmic approach

Fragulidis

Marinis²,

Polydorou³

et al. 2008

WJG

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AIM:To investigate injuries of anatomy variants of hepatic duct confluence during hepatobiliary surgery a n d t h e i r i m p a c t o n m o r b i d i ty a n d m o r t a l i ty o f these procedures. An algorithmic approach for the management of these injuries is proposed. METHODS:During a 6-year period 234 patients who had undergone major hepatobiliary surgery were retrospectively reviewed in order to study postoperative bile leakage. Diagnostic workup included endoscopic and magnetic retrograde cholangiopancreatography (E/MRCP), scintigraphy and fistulography.RESULTS: Thirty (12.8%) patients who developed postoperative bile leaks were identified. Endoscopic stenting and percutaneous drainage were successful in 23 patients with bile leaks from the liver cut surface. In the rest seven patients with injuries of hepatic duct confluence, biliary variations were recognized and a stepwise therapeutic approach was considered. Conservative management was successful only in 2 patients. Volume of the liver remnant and functional liver reserve as well as local sepsis were used as criteria for either resection of the corresponding liver segment or construction of a biliary-enteric anastomosis. Two deaths occurred in this group of patients with hepatic duct confluence variants (mortality rate 28.5%). CONCLUSION:Management of major biliary fistulae that are disconnected from the mainstream of the biliary tree and related to injury of variants of the hepatic duct confluence is extremely challenging. These patients have a grave prognosis and an early surgical procedure has to be considered.

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Attenuation of Ischemic Injury by N-Acetylcysteine Preconditioning of the Liver

Cited by 33 publications

References 49 publications

Preventive role of gallic acid on hepatic ischemia and reperfusion injury in rats

Preventive role of gallic acid on hepatic ischemia and reperfusion injury in rats

Comparison of the Protective Effect of N-Acetylcysteine by Different Treatments on Rat Myocardial Ischemia-Reperfusion Injury

Managing injuries of hepatic duct confluence variants after major hepatobiliary surgery: An algorithmic approach

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