L’hydroxyéthylamidon 130/0,4 atténue les dommages hépatiques précoces causés par les lésions d’ischémie/reperfusion

Abstract

Purpose Ischemia/reperfusion injury (IRI) remains a clinical challenge. We tested the hypothesis that fluid therapy using hydroxyethyl starch (HES) 130/0.4 during the early phase of IRI in rat liver decreases markers of hepatic injury. Methods We induced liver IRI in three groups of rats anesthetized with ketamine and chlorpromazine by means of 60 min of segmental hepatic ischemia followed by 120 min of reperfusion. At the onset of reperfusion, Group 1 (IRI ? HES; n = 12) was given 13 mLÁkg -1 of HES; Group 2 (IRI ? HS; n = 12) received the same volume of 7.5% saline (HS), and Group 3 (IRI-only; n = 12) received no fluid. Three other groups of 12 animals each were shamoperated and received the same fluid as the test groups. We euthanized the animals after three hours, drew blood for alanine aminotransferase (ALT) quantification, and took ischemic liver samples for histomorphological study.Results Serum ALT activity was greater in all of the IRI groups than in the sham-operated animals. The ALT activity was 1,081 ± 575 IUÁL -1 in IRI ? HES Group 1; 2,363 ± 1,839 IUÁL -1 in IRI ? HS Group 2; and 2,866 ± 2,491 IUÁL -1 in IRI-only Group 3. There was a statistically significant difference between the IRI ? HES and the IRIonly groups (P = 0.001), but not between the IRI ? HS and the IRI-only groups (P [ 0.05). Likewise, histological scores were greater in all IRI groups compared with the sham-operated animals. Scores were higher in the IRI-only group (median 3.5) than in the groups receiving fluid (IRI ? HES median 2; IRI ? HS median 3). The difference between IRI ? HES and IRI-only was statistically significant (P = 0.008) but not so between IRI ? HS and IRI-only (P [ 0.05). Conclusions Giving HES 130/0.4 attenuates rat liver IRI compared with no fluid, while giving HS does not. This suggests a role for HES in hepatoprotection associated with liver IRI. RésuméObjectif La le´sion d'ische´mie/reperfusion (IR) reste un de´fi clinique. Nous avons e´mis l'hypothe`se qu'une the´rapie liquidienne a`base d'hydroxye´thylamidon (HES) 130/0,4 administre´e pendant la phase pre´coce d'IR dans un mode`le he´patique de rat, diminuerait les marqueurs de la le´sion he´patique. Méthode Nous avons provoque´une le´sion d'IR au niveau du foie dans trois groupes de rats anesthe´sie´s à la ke´tamine et a`la chlorpromazine en cre´ant une ische´mie he´patique segmentaire de 60 min suivie de 120 min de reperfusion. Au de´but de la reperfusion, le groupe 1 (IR ? HES; n = 12) a reçu 13 mLÁkg -1 de HES; le groupe 2 (IR ? HS; n = 12) a reçu le meˆme volume de se´rum physiologique 7,5 % (HS), et le groupe 3 (IR seule;This investigation was supported, in part, by research funds of the School of Medicine of the University of Coimbra (GAPI 08/08).

Effects of crystalloids and colloids on liver and intestine microcirculation and function in cecal ligation and puncture induced septic rodents

“…In addition repeated administration of hydroxyethylstarch can aggravate portal hypertension, liver failure and sepsis in patients with chronic liver disease [7]. On the other side, Catre and colleagues have demonstrated protective effects of HES 130/0.4 on hepatic reperfusion damage [8]. However volume resuscitation is a cornerstone in the treatment of sepsis and shock.…”

Shen-Qi-Di-Huang Decoction Prevents Cisplatin-Induced Kidney and Liver Injury by Inhibiting Apoptosis

“…It scores damage intensity in the samples from 1 to 4, and we assign 0 to normal tissue (0, no damage; 1, 0-25% damaged tubules; 2, 25-50% damaged tubules; 3, 50-75% damaged tubules; and 4 >75% damaged tubules). I give liver sections histological scores based on the extent of hepatocellular injury [8]: 0) Normal liver architecture; 1) Minimal injury (swelling, congestion, single cell necrosis); 2) Mild injury, with one or more minute foci of necrosis, the largest involving <1% of the examined sectional area of the lobule; 3) Moderate injury, as in 2, but the necrotic foci occupying 1-5% of the lobule; and 4) Severe injury, as above, but with necrotic foci covering >5% of the lobule.…”