El comportamiento del factor de necrosis tumoral alfa e interleucina 6 en lesiones de vías biliares postcolecistectomía

Miranda-Díaz, Alejandra Guillermina; Hermosillo-Sandoval, José Manuel; Huerta-Rosas, Gonzalo; López-Guillén, Germán G; Muñoz, Ernesto; García-Iglesias, Trinidad; Pacheco-Moisés, Fermín Paul; Alatorre-Carranza, María del Pilar

doi:10.4067/s0034-98872010001100008

Rev. méd. Chile

2010

DOI: 10.4067/s0034-98872010001100008

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El comportamiento del factor de necrosis tumoral alfa e interleucina 6 en lesiones de vías biliares postcolecistectomía

Alejandra Guillermina Miranda-Díaz

José Manuel Hermosillo-Sandoval

Gonzalo Huerta-Rosas

et al.

Abstract: Tumor necrosis factor-alpha and interleukin-6 levels among patients suffering a bile duct injury during cholecystectomy 3.0 ± 2.0 and 72.0 ± 94.7 pg/mL respectively, (p < 0,004). After one year of follow up, IL-6 levels decreased to 6.4 ± 0.3 pg/mL among patients. Conclusions: TNF-a and IL-6 levels were elevated before bile-enteric derivation among patients with bile duct injury and became normal one year later. (Rev Med Chile 2010; 138: 1259-1263.

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Strategies in secondary biliary fibrosis

Hermosillo-Sandoval¹,

Rodríguez-Carrizález²,

Miranda-Díaz³

2013

JBiSE

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The cellular and molecular mechanisms that mediate hepatic fibrosis have provided a framework of different therapeutic foci to prevent, delay or in such case revert fibrosis and cirrhosis. The fundamental event in development of hepatic fibrosis caused by secondary biliary cholestasis is based on activation of the hepatic stellar cells (HSC) which the primary function is forming fibrosis. The activated HSC cells transform into myofibroblasts with capacity to produce alpha smooth muscle actin (α-SMA). As a result, the HSC activates proliferation of the cholangiocytes and epithelial cells whose functions represent important anti-fibrotic objectives. Some strategies are described as targeting against molecule involved in fibrosis production; and some medications with anti-fibrotic functions that are actually available in the medical arsenal have been tested in experimental animal models and in few clinical studies, and their components act in relation to the fibrotic cascade. In the end, the treatment strategies for hepatic fibrosis can vary on an individual basis depending on the etiology, the risk of fibrosis progression and the predominant pathogenic medium, which indicates that a multi-factorial approach could be necessary. Orthotopic liver transplant continues being the last final alternative for hepatic insufficiency from any cause; however, in no way does it supersede healthy natural liver in survival and adequate function. The investigative arsenal continues to develop rapidly, giving rise to other possible objectives in pre-clinical studies of conceptual trials, such as the utilization of molecular, cellular, drugs therapy and Chinese herbs. Despite being aforementioned, there are no existing ideal alternatives that completely reverse fibrosis in humans. Future usefulness of the majority of management alternatives seems probable and could be feasible.

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Strategies in secondary biliary fibrosis

Hermosillo-Sandoval¹,

Rodríguez-Carrizález²,

Miranda-Díaz³

2013

JBiSE

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Alterations in fibrinolytic system proteins PAI-1, MMP-3, MMP-8, TIMP-1 and TIMP-2 in post-cholecystectomy bile duct injury

Hermosillo-Sandoval¹,

Román-Pintos²,

Rodríguez-Carrizález³

et al. 2013

JBiSE

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Introduction: In bile duct injuries (BDI), cholestasis and cholangitis can alter the fibrinolytic system by promoting an increase of extracellular matrix depositions which favor an imbalance between metalloproteinases (MMPs) and their tissue inhibitors (TIMPs). Materials and Methods: Levels of PAI-1, MMP-3, MMP-8, TIMP-1 and TIMP-2 in 35 patients with post-cholecystectomy BDI by complete biliary obstruction were measured and compared to a healthy control group. Sirius red staining and immune staining for MMP-3 and MMP-8 were also undertaken in liver biopsies. Results: Levels of PAI-1, TIMP-1, TIMP-2 and MMP-8 were higher in BDI than healthy controls: 15 ± 2 ng/mL vs 7.1 ± 2 ng/mL (p < 0.024); 539 ± 64 ng/mL vs 256 ± 13 ng/mL (p < 0.003); 178.4 ± 79.8 ng/mL vs 98.6 ± 2 ng/mL; and 90 ± 10 ng/mL vs 6.8 ± 2 ng/mL (p < 0.002), respectively. However, serum levels of MMP-3 expression in BDI were decreased 9.0 ± 1 vs. healthy controls 20.3 ± 6 ng/mL (p < 0.001). Morphometric analysis showed that Sirius red staining in BDI was increased 121548.6 ± 20545.4 μm2 vs. 22865.7 ± 3865 μm2 in healthy controls (p < 0.0001), MMP-8 deposition in liver was higher in BDI compared to controls: 233015.2 ± 32953.3 μm2 vs. 30744.2 ± 5810.2 μm2 (p < 0.0001). MMP-3 liver staining in BDI compared to healthy controls was not significant 130837.9 ± 17,484 μm2 vs. 116337.9 ± 24803.3 μm2 (p < 0.55). These results suggest an imbalance between fibrogenic/fibrinolytic protein levels. Interestingly, expression of the fibrinolytic protein MMP-8 was increased in serum and liver biopsies in BDI. Conclusion: We found an imb...

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El comportamiento del factor de necrosis tumoral alfa e interleucina 6 en lesiones de vías biliares postcolecistectomía

Cited by 2 publications

References 19 publications

Strategies in secondary biliary fibrosis

Strategies in secondary biliary fibrosis

Alterations in fibrinolytic system proteins PAI-1, MMP-3, MMP-8, TIMP-1 and TIMP-2 in post-cholecystectomy bile duct injury

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