2019 Vol. 33, No. 4
Hepatic ischemia-reperfusion injury is a major cause of liver transplant failure, and is of increasing significance due to increased use of expanded criteria livers for transplantation. This review summarizes the mechanisms and protective strategies for hepatic ischemia-reperfusion injury in the context of liver transplantation. Pharmacological therapies, the use of pre-and post-conditioning and machine perfusion are discussed as protective strategies. The use of machine perfusion offers significant potential in the reconditioning of liver grafts and the prevention of hepatic ischemia-reperfusion injury, and is an exciting and active area of research, which needs more study clinically.
Clinical xenotransplantations have been hampered by human preformed antibody-mediated damage of the xenografts. To overcome biological incompatibility between pigs and humans, one strategy is to remove the major antigens [Gal, Neu5Gc, and Sd(a)] present on pig cells and tissues. Triple gene (GGTA1, CMAH, and β4GalNT2) knockout (TKO) pigs were produced in our laboratory by CRISPR-Cas9 targeting. To investigate the antigenicity reduction in the TKO pigs, the expression levels of these three xenoantigens in the cornea, heart, liver, spleen, lung, kidney, and pancreas tissues were examined. The level of human IgG/IgM binding to those tissues was also investigated, with wildtype pig tissues as control. The results showed that αGal, Neu5Gc, and Sd(a) were markedly positive in all the examined tissues in wildtype pigs but barely detected in TKO pigs. Compared to wildtype pigs, the liver, spleen, and pancreas of TKO pigs showed comparable levels of human IgG and IgM binding, whereas corneas, heart, lung, and kidney of TKO pigs exhibited significantly reduced human IgG and IgM binding. These results indicate that the antigenicity of TKO pig is significantly reduced and the remaining xenoantigens on porcine tissues can be eliminated via a gene targeting approach.
To evaluate the effect of methotrexate on collagen-induced arthritis, micro-computed tomography (micro-CT) and histopathological analyses were used in male Wistar rats. Rats were divided randomly into three groups. Group 1 was treated with 0.9% saline, and groups 2 and 3 were boosted with type Ⅱ collagen. From day 21 to 42, groups 1 and 2 were orally treated with 0.9% saline and group 3 was orally treated with 1.5 mg/kg methotrexate. All rats were sacrificed at day 42 after the first collagen treatment. Micro-CT analyses showed bony parameters, such as bone volume and trabecular number, were decreased in group 2 compared to group 1, and these parameters were recovered in group 3. Histopathological examination and pathological parameter scoring showed that the knee joints of rats in group 2 had severe joint destruction, showing cartilage and bone erosion, enlarged cavities with inflammatory cell infiltration and activation of synovial fibroblasts. By contrast, these changes were reduced in group 3. Taken together, methotrexate treatment showed therapeutic potential in male rat collagen-induced arthritis model, and micro-CT analysis and histopathological tools could be integrated to assess the quantification/qualification of arthritic lesions.
The prevalence of cardiovascular diseases (CVDs) is increasing at a rapid pace in developed countries, and CVDs are the leading cause of morbidity and mortality. Natural products and ethnomedicine have been shown to reduce the risk of CVDs. Schizonepeta (S.) tenuifolia is a medicinal plant widely used in China, Korea, and Japan and is known to exhibit anti-inflammatory, antioxidant, and immunomodulatory activities. We hypothesized that given herbal plant exhibit pharmacological activities against CVDs, we specifically explored its effects on platelet function. Platelet aggregation was evaluated using standard light transmission aggregometry. Intracellular calcium mobilization was assessed using Fura-2/AM, and granule secretion (ATP release) was measured in a luminometer. Fibrinogen binding to integrin αⅡbβ3, was assessed using flow cytometry. Phosphorylation of mitogen-activated protein kinase (MAPK) signaling molecules and activation of the protein kinase B (Akt) was assessed using Western blot assays. S. tenuifolia, extract potently and significantly inhibited platelet aggregation, calcium mobilization, granule secretion, and fibrinogen binding to integrin αⅡbβ3. Moreover, all extracts significantly inhibited MAPK and Akt phosphorylation. S. tenuifolia extract inhibited platelet aggregation and granule secretion, and attenuated collagen mediated GPVI downstream signaling, indicating the potential therapeutic effects of these plant extracts on the cardiovascular system and platelet function. We suggest that S. tenuifolia extract may be a potent candidate to treat platelet-related CVDs and to be used as an antiplatelet and antithrombotic agent.
Congestive heart failure (CHF) is defined as a cardiac dysfunction leading to low cardiac output and inadequate tissue perfusion. Intravenous positive inotropes are used to increase myocardial contractility in hospitalized patients with advanced heart failure. Milrinone is a phosphodiesterase Ⅲ inhibitor and used most commonly for inotropic effect. The well-known PROMISE study investigated the effects of milrinone on mortality in patients with severe CHF, and concluded that long-term therapy with milrinone increased morbidity and mortality among patients with advanced CHF. Previous studies have suggested that phosphodiesterase inhibitors can have potential effects on inflammatory pathways. Hence, we hypothesized that milrinone may alter inflammatory gene expressions in cardiomyocytes, thus leading to adverse clinical outcomes. We used rat cardiomyocyte cell line H9C2 and studied the impact of exposing cardiomyocytes to milrinone (10 μmol/L) for 24 hours on inflammatory gene expressions. RNA extracted from cultured cardiomyocytes was used for whole rat genome gene expression assay (41 000 genes). The following changes in inflammatory response-related gene expressions were discovered. Genes with increased expressions included: THBS2 (+ 9.98), MMP2 (+3.47), DDIT3 (+2.39), and ADORA3 (+3.5). Genes with decreased expressions were: SPP1 (−5.28) and CD14 (−2.05). We found that the above mentioned gene expression changes seem to indicate that milrinone may hinder the inflammatory process which may potentially lead to adverse clinical outcomes. However, further in vivo and clinical investigations will be needed to illustrate the clinical relevance of these gene expression changes induced by milrinone.
Volatile anesthetic preconditioning has been shown to be a potent way to provide myocardium protection against ischemia/reperfusion (I/R) injury; however, this cardioprotection is lost in senescent animal models and elderly patients. NFκB-regulated genes have been linked to myocardial I/R injury and anesthetic preconditioning. Here, we investigated NFκB activation related to anesthetic preconditioning in aging rat myocardium. Isolated, Langendorff perfused rat hearts from Fischer 344 male rats, 24 months old, were randomly assigned to one of the three groups. The hearts of the control group were perfused with physiologic solution without any intervention. The hearts in the I/R group were subjected to 25 minutes ischemia and followed by 60 minutes reperfusion. The hearts in the treatment group were subjected to 10 minutes 2.5% sevoflurane, followed by 20 minutes washout and by 25 minutes ischemia and 60 minutes of reperfusion, respectively. Left ventricular developed pressure (LVDP) and left ventricular enddiastolic pressure (LVEDP) were measured. Western blot analysis was used to measure inhibitor of κB (IκB) and antiapoptotic genes: A1, ILP, c-IAP-2, Bcl-2, caspase 8 and caspase 9. Ischemia and reperfusion significantly decreased LVDP and increased LVEDP in aged rat hearts. Anesthetic preconditioning with sevoflurane did not change the effects I/R on LVDP and LVEDP, despite the fact that after treatment with anesthetic preconditioning, the levels of IκB, A1, ILP, caspase 8 and caspase 9 were significantly different compared to those of the control hearts. In conclusion, anesthetic preconditioning with sevoflurane does not improve myocardial systolic and diastolic functions. Our results suggest that the activation of NFκB regulated genes is different in the senescent myocardium and could account for loss of cardioprotection with aging.
Increased expression of matrix metalloproteinase-1 (MMP-1) has been observed in the lesions of atherosclerosis and aneurysms; however, it is not fully understood whether macrophage-derived MMP-1 affects these diseases. To investigate whether macrophage-derived MMP-1 participates in the development of vascular diseases, we generated transgenic (Tg) rabbits expressing human MMP-1 in the monocyte/macrophage lineage under the control of the human scavenger receptor enhancer/promoter. Tg rabbits exhibited no visible abnormalities throughout their bodies. Western blotting analysis revealed that the amount of MMP-1 proteins in the conditioned media secreted from peritoneal macrophages of Tg rabbits was up to 3-fold higher than that in non-Tg rabbits. For the first experiment, Tg and non-Tg rabbits were fed a cholesterol diet for 16 weeks, and aortic and coronary atherosclerosis were evaluated. The gross lesion area of aortic atherosclerosis in Tg rabbits was not significantly different from that in non-Tg rabbits, but Tg rabbits had marked destruction of the medial elastic lamina of the aortic lesions on microscopic examination. For the second experiment, we generated aortic aneurysms by incubating with elastase. Compared with non-Tg rabbits, Tg rabbits exhibited a significantly greater aortic dilation. Increased macrophage-derived MMP-1 led to increased medial destruction in both aortic atherosclerosis and aneurysms. These results demonstrate that MMP-1 plays a different role in the pathogenesis of atherosclerosis and aneurysms.
Contrary to freezing preservation and formalin embalming, Thiel embalmed cadaver presents soft texture and color very close to that of living organism, and many applications based on Thiel embalmed cadavers have been reported. However, Thiel embalmed cadavers cannot be used as reliable evaluation model for radiofrequency ablation (RFA) due to dramatic changes of electrical conductivity in the embalmed tissue. To address this issue, we investigated various modifications of the original Thiel embalming solution. By altering the chemicals' species and concentration we figured out a formula that can greatly reduce the embalming fluid's electrical conductivity without significantly compromising the 18-day embalmed kidney samples' suppleness and color. We also investigated a two-stage embalming technique by first submerging the kidney sample into original Thiel's tank fluid for 28 days, then the sample was withdrawn from the tank fluid and placed into modified dilution fluids for additional two weeks. Stiffening and discoloration occurred in these diluted samples implying the reversibility of Thiel-embalmed tissues' suppleness and color with the removal of the strong electrolytes. This study presents a modified embalming method which could be used for RFA evaluation and also helps our understanding of the mechanism of embalmment process.