Heme Oxygenase-1 Induction by the Clinically Used Anesthetic Isoflurane Protects Rat Livers From Ischemia/Reperfusion Injury

Abstract

This study provides first evidence that pretreatment with the nontoxic and clinically approved anesthetic isoflurane induces hepatic HO-1 expression, and thereby protects rat livers from ischemia/reperfusion injury.

Ischemic preconditioning of the liver: A few perspectives from the bench to bedside translation

“…The merits of this composite endpoint were discussed in the Severity of Ischemia and RP Injury section, subsection Liver Transplantation. Remote preconditioning via limb ischemia 81,82 (1) Applicable to DCD donors; (2) Inexpensive Hypertonic saline dextran 83,84 (1) Volume enhancement, especially in donors and applicable to DCD donors; (2) Inexpensive Anesthetic preconditioning (volatile anesthetics, nitric oxide) 3,4,85 (1) May not be feasible in all donor hospitals; (2) Nitric oxide is expensive Pharmacologic preconditioning (nitrites, adenosine, interleukin-10) 2,6,7 (1) More expensive; (2) Potential side effects of agents NOTE: In contradistinction to ischemic preconditioning, all listed modalities are applicable in both liver donors and recipients. They share avoidance of direct organ ischemia and, when used in deceased donors, have the potential to benefit recipients of many organs.…”

“…Preconditioning strategies effective in the laboratory include ischemic preconditioning (IPC), anesthetic preconditioning, hyperthermic or heat-shock preconditioning, and pharmacological preconditioning. [1][2][3][4][5][6][7] In the past decade, serious efforts have commenced to translate some of the robust benefits of preconditioning against ischemia reperfusion (RP) to the clinical arena. Although all of the preconditioning methods offer potential clinical benefits, much of the initial translational effort has focused on IPC, probably due to its extensive and consistently beneficial laboratory experience.…”

Brain death and its implications for management of the potential organ donor

“…133 Volatile anesthetics (sevoflurane, isoflurane, and desflurane) have, in several experimental and clinical settings, been shown to protect the heart from I/R injury. [134][135][136][137] Recently, isoflurane was demonstrated to have a similar effect on the rat liver, 138 and sevoflurane, in a prospective randomized study, protected the human liver from I/R injury during liver resection. 139 It is our practice to administer volatile anesthetics at least during the last 30 min before aortic cross clamping.…”

Volatile and Intravenous Anesthesia Alter Rat Liver Proteins: Proteomic Time Course Analysis of Rat Liver Proteins

“…Hepatocellular protective functions of anesthetics through activation of antioxidant enzymes in the liver in an ischemic re-perfusion model were also reported [6,7]. Many *Address correspondence to this author at the Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan; Tel: +81 3 5814 6243; Fax: +81 3 5685 3077; E-mail: s00-098@nms.ac.jp factors such as antioxidant enzymes, hepatic detox enzymes, heat shock proteins (HSPs), and direct effects of anesthetics may mediate hepatocellular protection from biological stresses [7,8].…”

“…Many *Address correspondence to this author at the Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan; Tel: +81 3 5814 6243; Fax: +81 3 5685 3077; E-mail: s00-098@nms.ac.jp factors such as antioxidant enzymes, hepatic detox enzymes, heat shock proteins (HSPs), and direct effects of anesthetics may mediate hepatocellular protection from biological stresses [7,8]. Other hepatocellular antioxidant enzymes such as catalase (CAT), glutathione S transferase (GST), superoxide dismutase (SOD), and aldehyde dehydrogenase-7A1 (ALDH7A1) also show liver protective functions by scavenging reactive oxygen species (ROS) or in other ways [9][10][11][12][13].…”