Acute reactant cytokines and neutrophil adhesion after warm ischemia in cirrhotic and noncirrhotic human livers

被引:17
作者
Clavien, PA
Camargo, CA
Gorczynski, R
Washington, MK
Levy, GA
Langer, B
Greig, PD
机构
[1] DUKE UNIV,MED CTR,DEPT PATHOL,DURHAM,NC 27710
[2] UNIV TORONTO,DEPT SURG,TORONTO,ON,CANADA
[3] UNIV TORONTO,DEPT IMMUNOL,TORONTO,ON,CANADA
[4] UNIV TORONTO,DEPT MED,TORONTO,ON,CANADA
关键词
D O I
10.1053/jhep.1996.v23.pm0008675164
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Animal studies suggest that acute phase reactant cytokines and polymorphonuclear leukocytes (PR;IN) may play a critical role in ischemia-reperfusion injury, To evaluate whether similar mechanisms are operative in human liver, six cirrhotic and nine noncirrhotic patients undergoing right hepatectomy were randomized for utilization of hepatic vascular exclusion (HVE) as a model of ischemia-reperfusion injury, Port-al and systemic levels of acute reactant cytokines (interleukin 6 [IL-6], interleukin 1 [IL-1], tumor necrosis factor alpha [TNF-alpha]) and neutrophil adhesion in serial liver biopsy specimens were studied, Correlations among mediators, leukocyte adhesion, and markers of liver injury were also evaluated. Hepatic vascular exclusion resulted in substantial and reproducible changes in portal and arterial IL-6 levels in both cirrhotic and noncirrhotic patients, Portal and systemic cytokine levels were comparable in most instances, whereas levels were usually higher in cirrhotic patients than in noncirrhotic patients, Negative correlations were found between IL-6 levels at the time of reperfusion and later TNF-alpha levels, IL-6 levels correlated negatively with numerous markers of hepatocellular injury and the number of postoperative complications, Hepatic vascular exclusion increased neutrophils adhesion after reperfusion in cirrhotic patients but not in noncirrhotic patients, In cirrhotic patients, the degree of leukocyte adhesion after reperfusion correlated with several postoperative markers of liver injury, This study in humans shows that acute reactant cytokines are released during liver ischemia and, interestingly, that IL-6 levels strongly correlate with clinical and laboratory measures of injury. Further studies to evaluate possible causal relationship with hepatic injury are warranted, with emphasis on the role of IL-6 and PMN adhesion.
引用
收藏
页码:1456 / 1463
页数:8
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