Reperfusion Injury

再灌注损伤
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    文章类型: Journal Article
    分泌性白细胞蛋白酶抑制剂(SLPI)主要由免疫细胞和各种上皮细胞产生,受多种细胞因子的调节,如转化生长因子β1、白细胞介素1β和肿瘤坏死因子α。除了通常已知的抗蛋白酶活性,近年来发现SLPI在抗细胞凋亡中起着重要作用,调节细胞周期,细胞分化和增殖,抑制炎症反应。SLPI还可以通过增强吞噬细胞的吞噬功能来帮助免疫系统清除病原体/受损细胞,从而改善组织损伤,促进修复。此外,近年来研究表明,心血管手术患者血清SLPI水平的变化对预测急性肾损伤的发生具有较高的诊断价值,提示SLPI参与缺血再灌注(IR)诱导的急性肾损伤。在这次审查中,我们总结了表达式,regulation,SLPI在不同器官损伤模型中的信号通路和相关生物学事件,并讨论和评估了SLPI在肾脏保护抵抗IR诱导的急性肾损伤中的潜在作用及其作为新生物标志物的潜力。
    The secretory leukocyte protease inhibitor (SLPI) is mainly produced by immune cells and various epithelial cells, and is regulated by a variety of cytokines, such as transforming growth factor β1, interleukin 1β and tumor necrosis factor α. In addition to commonly known anti-protease activity, it has been found in recent years that SLPI plays essential roles in anti-apoptosis, regulating cell cycle, cell differentiation and proliferation, and inhibiting inflammatory response. SLPI can also assist the immune system to clear pathogens/damaged cells by enhancing the phagocytic function of phagocytes, so as to ameliorate tissue damage and promote repair. Moreover, recent studies have shown that the change of SLPI level in the serum of patients post cardiovascular surgery has a high diagnostic value in predicting the occurrence of acute kidney injury, suggesting that SLPI is involved in ischemia-reperfusion (IR) induced acute kidney injury. In this review, we summarized the expression, regulation, signaling pathways and associated biological events of SLPI in different organ injury models, and also discussed and evaluated the potential role of SLPI in renoprotection against IR induced acute kidney injury and its potential as a new biomarker.
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  • 文章类型: Journal Article
    背景与目的:硒缺乏是严重疾病发生的危险因素,如急性肾损伤(AKI)。最近,硒蛋白-p1(SEPP1),硒转运蛋白,主要由肝脏释放,作为心脏手术的结果,已成为AKI的有希望的血浆生物标志物。本研究的目的是调查,在肾小管细胞缺氧诱导的体外模型上,HK-2、亚硒酸钠(Na2SeO3)的影响并评价SEPP1的表达作为损伤标记物。材料和方法:将HK-2细胞与100nMNa2SeO3预孵育24小时,然后,用CoCl2(500µM)处理24小时,化学缺氧诱导剂。结果来自ROS测定,MTT,和蛋白质印迹分析。结果:预处理确定了细胞活力的增加和活性氧(ROS)的减少,如MTT和ROS测定所示。此外,通过Westernblot,在低氧损伤后与添加亚硒酸钠后一样,观察到SEPP1表达增加。结论:我们的初步结果揭示了补充硒作为预防急性肾损伤后氧化损伤和增加SEPP1的手段的可能作用。在我们的体外模型中,SEPP1作为肾损伤的一个有希望的生物标志物,尽管需要进一步的体内研究来验证我们的发现。
    Background and Objectives: Selenium deficiency represents a risk factor for the occurrence of severe diseases, such as acute kidney injury (AKI). Recently, selenoprotein-p1 (SEPP1), a selenium transporter, mainly released by the liver, has emerged as a promising plasmatic biomarker of AKI as a consequence of cardio-surgery operations. The aim of the present study was to investigate, on an in vitro model of hypoxia induced in renal tubular cells, HK-2, the effects of sodium selenite (Na2SeO3) and to evaluate the expression of SEPP1 as a marker of injury. Materials and Methods: HK-2 cells were pre-incubated with 100 nM Na2SeO3 for 24 h, and then, treated for 24 h with CoCl2 (500 µM), a chemical hypoxia inducer. The results were derived from an ROS assay, MTT, and Western blot analysis. Results: The pre-treatment determined an increase in cells\' viability and a reduction in reactive oxygen species (ROS), as shown by MTT and the ROS assay. Moreover, by Western blot an increase in SEPP1 expression was observed after hypoxic injury as after adding sodium selenite. Conclusions: Our preliminary results shed light on the possible role of selenium supplementation as a means to prevent oxidative damage and to increase SEPP1 after acute kidney injury. In our in vitro model, SEPP1 emerges as a promising biomarker of kidney injury, although further studies in vivo are necessary to validate our findings.
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  • 文章类型: Journal Article
    肝脏缺血/再灌注损伤(IRI)是影响肝脏再生和术后功能恢复的重要因素。许多研究表明,间充质干细胞(MSCs)通过外泌体介导的旁分泌机制促进肝组织修复和功能恢复。与啮齿动物相比,小型猪的肝脏特征与人类相似得多。本研究旨在探讨脂肪间充质干细胞(ADSCs-exo)外泌体能否积极促进小型猪肝切除联合HIRI后肝再生及其在细胞增殖过程中的作用。本研究还比较了ADSCs和ADSCs-exo在炎症反应和肝再生中的作用和差异。结果表明,ADSCs-exo抑制肝脏组织病理学改变,减轻炎症浸润;ALT水平明显降低,TBIL,HA,和促炎细胞因子TNF-α,IL-6和CRP;抗炎细胞因子IL-10和促再生因子Ki67,PCNA,CyclinD1,HGF,STAT3,VEGF,ANG1,ANG2;以及抗再生因子SOCS3和TGF-β的水平降低。上述指标与ADSCs干预组的变化相似。表明ADSCs-exo在调节炎症反应和促进肝脏再生方面可以发挥与ADSCs相同的作用。我们的发现为ADSCs-exo可能被认为是促进受损肝脏再生的安全有效的无细胞疗法提供了实验证据。
    Hepatic ischemia/reperfusion injury (IRI) is an important factor affecting liver regeneration and functional recovery postoperatively. Many studies have suggested that mesenchymal stem cells (MSCs) contribute to hepatic tissue repair and functional recovery through paracrine mechanisms mediated by exosomes. Minipigs exhibit much more similar characteristics of the liver to those of humans than rodents. This study aimed to explore whether exosomes from adipose-derived MSCs (ADSCs-exo) could actively promote liver regeneration after hepatectomy combined with HIRI in minipigs and the role they play in the cell proliferation process. This study also compared the effects and differences in the role of ADSCs and ADSCs-exo in the inflammatory response and liver regeneration. The results showed that ADSCs-exo suppressed histopathological changes and reduced inflammatory infiltration in the liver; significantly decreased levels of ALT, TBIL, HA, and the pro-inflammatory cytokines TNF-α, IL-6, and CRP; increased levels of the anti-inflammatory cytokine IL-10 and the pro-regeneration factors Ki67, PCNA, CyclinD1, HGF, STAT3, VEGF, ANG1, ANG2; and decreased levels of the anti-regeneration factors SOCS3 and TGF-β. These indicators above showed similar changes with the ADSCs intervention group. Indicating that ADSCs-exo can exert the same role as ADSCs in regulating inflammatory responses and promoting liver regeneration. Our findings provide experimental evidence for the possibility that ADSCs-exo could be considered a safe and effective cell-free therapy to promote regeneration of injured livers.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    中风是一个普遍和衰弱的全球健康问题,需要创新的治疗策略,尤其是在恢复期间。虽然现有文献通常侧重于急性干预,我们的研究探讨了伤口愈合过程中脑组织的独特性,强调慢性期遵循常用的大脑中动脉(MCA)闭塞模型。在雄性和雌性小鼠中使用临床相关终点,例如磁共振成像(MRI)和等离子神经丝光(NFL)测量,随着免疫组织化学,我们描述了损伤的演变。我们的发现记录了水肿的显著改变,组织重塑,和钆通过核磁共振泄漏。血浆NFL浓度在中风后30天保持升高。小胶质细胞反应仅限于损伤附近的区域,而不是持续广泛的激活,和硼-二吡咯亚甲基(BODIPY)染色显示梗死灶内持续存在泡沫细胞。其他免疫组织化学强调了中风后脑中持续存在的B和T淋巴细胞。这些观察结果强调了由富含脂质的大脑环境引起的慢性炎症所发挥的潜在关键作用。和慢性血脑屏障功能障碍,在继发性神经变性的发展中。这项研究揭示了缺血性中风在最常用的啮齿动物中风模型中的持久后果,并为未来的研究提供了有价值的见解。临床策略,和治疗发展。
    Stroke is a pervasive and debilitating global health concern, necessitating innovative therapeutic strategies, especially during recovery. While existing literature often focuses on acute interventions, our study addresses the uniqueness of brain tissue during wound healing, emphasizing the chronic phase following the commonly used middle cerebral artery (MCA) occlusion model. Using clinically relevant endpoints in male and female mice such as magnetic resonance imaging (MRI) and plasma neurofilament light (NFL) measurement, along with immunohistochemistry, we describe injury evolution. Our findings document significant alterations in edema, tissue remodeling, and gadolinium leakage through MRI. Plasma NFL concentration remained elevated at 30 days poststroke. Microglia responses are confined to the region adjacent to the injury, rather than continued widespread activation, and boron-dipyrromethene (BODIPY) staining demonstrated the persistent presence of foam cells within the infarct. Additional immunohistochemistry highlighted sustained B and T lymphocyte presence in the poststroke brain. These observations underscore potentially pivotal roles played by chronic inflammation brought on by the lipid-rich brain environment, and chronic blood-brain barrier dysfunction, in the development of secondary neurodegeneration. This study sheds light on the enduring consequences of ischemic stroke in the most used rodent stroke model and provides valuable insights for future research, clinical strategies, and therapeutic development.
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  • 文章类型: Systematic Review
    肝移植过程中的缺血再灌注损伤(IRI)与肝细胞癌(HCC)的复发有关。本系统评价旨在评估肝癌肝移植期间降低IRI的干预措施及其对肿瘤学结果的影响。一项全面的文献检索检索到四项回顾性研究,涉及938例HCC患者,利用干预措施,如术后前列腺素给药,低温机器灌注,和常温机灌注。总的来说,接受治疗的患者术后肝细胞损伤和炎症减少,无复发生存率显著提高.尽管这些有希望的结果,这些干预措施对总生存期的影响尚不清楚.这强调了进一步前瞻性研究的必要性,以全面了解这些干预措施在接受移植的HCC患者中的疗效。调查结果强调了这些策略的潜在好处,同时强调需要继续调查其整体影响。
    Ischemia-reperfusion injury (IRI) during liver transplantation has been implicated in the recurrence of hepatocellular carcinoma (HCC). This systematic review aimed to evaluate interventions to reduce IRI during liver transplantation for HCC and their impact on oncologic outcomes. A comprehensive literature search retrieved four retrospective studies involving 938 HCC patients, utilising interventions such as post-operative prostaglandin administration, hypothermic machine perfusion, and normothermic machine perfusion. Overall, treated patients exhibited reduced post-operative hepatocellular injury and inflammation and significantly enhanced recurrence-free survival. Despite these promising results, the impact of these interventions on overall survival remains unclear. This underscores the imperative for further prospective research to comprehensively understand the efficacy of these interventions in HCC patients undergoing transplantation. The findings highlight the potential benefits of these strategies while emphasising the need for continued investigation into their overall impact.
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  • 文章类型: Journal Article
    在青光眼的背景下,眼内压(IOP)和年龄是导致其发病和进展的主要因素.然而,IOP的显著降低未能完全阻止其进步。新兴的文献强调了神经炎症在青光眼中的作用。本研究旨在利用缺血再灌注(IR)青光眼模型探讨溴芬酸在缓解与青光眼相关的神经炎症中的抗炎特性。通过蛋白质印迹和酶联免疫吸附测定评估了在压力下溴芬酸对小胶质细胞和星形胶质细胞的影响。免疫组织化学染色用于评估IR模型中神经胶质活化和炎症标志物表达的变化。溴芬酸导致炎症标志物的下调,在高压条件下升高,星形胶质细胞中的坏死标记物下调。在IR模型中,GFAP和Iba-1水平升高表明神经胶质激活。溴芬酸给药后,iNOS的水平,COX-2和PGE2-R降低,表明神经炎症的减少。此外,在IR模型中给予溴芬酸导致视网膜神经节细胞(RGCs)的存活改善和视网膜功能的保存,如免疫组织化学染色和视网膜电图所示。总之,溴芬酸被证明可有效减少神经炎症,并提高RGC的存活率。
    In the context of glaucoma, intraocular pressure (IOP) and age are recognized as the primary factors contributing to its onset and progression. However, significant reductions in IOP fail to completely halt its advancement. An emerging body of literature highlights the role of neuroinflammation in glaucoma. This study aimed to explore Bromfenac\'s anti-inflammatory properties in mitigating neuroinflammation associated with glaucoma using an ischemia-reperfusion (IR) glaucoma model. Bromfenac\'s impact on microglia and astrocytes under pressure was assessed via Western blotting and an enzyme-linked immunosorbent assay. Immunohistochemical staining was used to evaluate glial activation and changes in inflammatory marker expression in the IR model. Bromfenac led to the downregulation of inflammatory markers, which were elevated in the conditions of elevated pressure, and necroptosis markers were downregulated in astrocytes. In the IR model, elevated levels of GFAP and Iba-1 indicated glial activation. Following Bromfenac administration, levels of iNOS, COX-2, and PGE2-R were reduced, suggesting a decrease in neuroinflammation. Furthermore, Bromfenac administration in the IR model resulted in the improved survival of retinal ganglion cells (RGCs) and preservation of retinal function, as demonstrated by immunohistochemical staining and electroretinography. In summary, Bromfenac proved effective in diminishing neuroinflammation and resulted in enhanced RGC survival.
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  • 文章类型: Journal Article
    胰岛素附着胰岛素受体以激活PI3-激酶/Akt信号传导以维持葡萄糖稳态并抑制细胞凋亡。这项研究确定了胰岛素和葡萄糖预处理是否可以保护肾脏免受缺血再灌注损伤(IRI)。
    在C57BL/6小鼠中通过夹住肾血管30分钟进行肾IRI,然后再灌注24小时。在肾脏IRI之前,对小鼠进行皮下总0.1单位的胰岛素以及饮用水中的10%葡萄糖处理24小时。通过测定血浆中的BUN和Cr,研究肾功能和损伤。以及细胞凋亡和P-AKT的表达,巴克斯,和caspase-3在肾脏。使用AKT抑制剂测试了P-AKT在胰岛素治疗的IRI肾脏中的作用。通过将治疗持续时间扩展至1、3和6天来研究胰岛素和葡萄糖的先决条件持续时间对IRI肾脏的影响。
    用胰岛素和葡萄糖预处理可保护肾脏免受IRI,表现为肌酐和BUN减少以及肾小管损伤减少。保护作用由P-AKT-BAX-caspase-3信号通路介导,导致凋亡细胞死亡的抑制。AKT抑制剂部分逆转了先决条件胰岛素的保护作用。1、3和6天的先决条件持续时间在改善肾功能和病理方面没有差异。
    胰岛素和葡萄糖的短期预处理通过激活p-AKT和随后减少BAX-caspase-3诱导的细胞凋亡来保护肾脏免受IRI。短期先决条件为保护肾脏免受可预测的IRI提供了可行的策略,如肾移植和低血压高风险的大型外科手术。
    UNASSIGNED: Insulin attaches insulin receptor to activate the PI3-kinase/Akt signaling to maintain glucose homeostasis and inhibit apoptosis. This study determined whether preconditioning with insulin and glucose protects the kidney against ischemia-reperfusion injury (IRI).
    UNASSIGNED: Kidney IRI was performed in C57BL/6 mice by clamping the renal vessels for 30 min, followed by reperfusion for 24 h. A total subcutaneous 0.1 unit of insulin along with 10% glucose in drinking water was treated on the mice for 24 h before kidney IRI. The kidney function and injuries were investigated through the determination of BUN and Cr in blood plasma, as well as the apoptosis and the expression of P-AKT, BAX, and caspase-3 in the kidneys. The role of P-AKT in insulin-treated IRI kidneys was tested using an AKT inhibitor. The effects of the preconditional duration of insulin and glucose on IRI kidneys were investigated by expanding the treatment duration to 1, 3, and 6 days.
    UNASSIGNED: Preconditioning with insulin and glucose protected the kidney against IRI as manifested by a decrease in creatinine and BUN and a reduction of kidney tubular injury. The protection effect was mediated by P-AKT-BAX-caspase-3 signaling pathway resulting in suppression of apoptotic cell death. An AKT inhibitor partially reversed the protective effects of preconditional insulin. The preconditional duration for 1, 3, and 6 days had no differences in improving kidney functions and pathology.
    UNASSIGNED: A short-term preconditioning with insulin and glucose protected the kidney from IRI through the activation of p-AKT and subsequent reduction of BAX-caspase-3-induced apoptosis. The short-term precondition provides a practicable strategy for protecting the kidney against predictable IRI, such as kidney transplant and major surgical operations with high risk of hypotension.
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  • 文章类型: Journal Article
    缺血再灌注损伤(IRI)的不良反应仍然是挽救生命的原位肝移植(OLT)后成功结局的主要障碍。在IRI的不同阶段的基因表达是动态的,并通过个体暴露而改变,这对于确定潜在的治疗目标以改善移植合适器官的数量和患者的预后具有吸引力。然而,肝移植IRI期间基因表达的功能景观数据仍然有限,从采购到再灌注和恢复。因此,我们试图表征人OLT中多个阶段IRI的转录组学特征。
    我们进行了临床数据分析,组织学评估,和17个连续人原代OLT的RNA测序。我们在4个时间点进行了肝脏移植活检:基线(B,在供体交叉夹之前),在冷缺血(CI)结束时,在早期再灌注期间(ER,血运重建后),和晚期再灌注(LR)。生成数据,然后按OLT后结局类别对接受者进行分组:立即同种异体移植功能(IAF;n=11)与早期同种异体移植功能障碍(EAD;n=6)组。
    我们观察到CI(vsB)改变了代谢和免疫过程的转录组景观。标志性炎症反应基因的表达水平从CI过渡到ER较高,从ER过渡到LR降低。与EAD组相比,IAF组主要表现出较高的胆汁和脂肪酸代谢活性。而EAD组保持较多的免疫调节活性。在所有时间点,EAD标本在胆汁和脂肪酸途径中均表现出降低的代谢活性。
    我们报告了从供体的预保存到受体的移植后的人肝脏同种异体移植IRI的转录组学特征。在IAF和EAD同种异体移植物之间,ER和LR阶段的免疫调节和代谢景观不同。我们的研究还强调了这些生物过程的标记基因,我们计划探索作为临床OLT中严重同种异体移植损伤的新型治疗靶标或替代标记。
    UNASSIGNED: The adverse effects of ischemia-reperfusion injury (IRI) remain a principal barrier to a successful outcome after lifesaving orthotopic liver transplantation (OLT). Gene expression during different phases of IRI is dynamic and modified by individual exposures, making it attractive for identifying potential therapeutic targets for improving the number of suitable organs for transplantation and patient outcomes. However, data remain limited on the functional landscape of gene expression during liver graft IRI, spanning procurement to reperfusion and recovery. Therefore, we sought to characterize transcriptomic profiles of IRI during multiple phases in human OLT.
    UNASSIGNED: We conducted clinical data analyses, histologic evaluation, and RNA sequencing of 17 consecutive human primary OLT. We performed liver allograft biopsies at 4 time points: baseline (B, before donor cross-clamp), at the end of cold ischemia (CI), during early reperfusion (ER, after revascularization), and during late reperfusion (LR). Data were generated and then recipients grouped by post-OLT outcomes categories: immediate allograft function (IAF; n = 11) versus early allograft dysfunction (EAD; n = 6) groups.
    UNASSIGNED: We observed that CI (vs B) modified a transcriptomic landscape enriched for a metabolic and immune process. Expression levels of hallmark inflammatory response genes were higher transitioning from CI to ER and decreased from ER to LR. IAF group predominantly showed higher bile and fatty acid metabolism activity during LR compared with EAD group, while EAD group maintained more immunomodulatory activities. Throughout all time points, EAD specimens exhibited decreased metabolic activity in both bile and fatty acid pathways.
    UNASSIGNED: We report transcriptomic profiles of human liver allograft IRI from prepreservation in the donor to posttransplantation in the recipient. Immunomodulatory and metabolic landscapes across ER and LR phases were different between IAF and EAD allografts. Our study also highlights marker genes for these biological processes that we plan to explore as novel therapeutic targets or surrogate markers for severe allograft injury in clinical OLT.
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  • 文章类型: Journal Article
    优化移植物保存是小儿肝移植(PSLT)中异位分裂移植物的关键。低温氧合灌注(HOPE)可改善成年LT的缺血再灌注损伤(IRI)和术后结局。这项研究比较了HOPE在非原位部分移植物中的使用,静态冷藏非原位部分移植物(SCS-Split)和金标准活体肝移植(LDLT)。所有连续的希望分裂,纳入了2018-2023年间为儿科接受者进行的SCS-Split和LDLT。再灌注后综合征(PRS,收缩压下降≥30%)和再灌注活检可作为IRI的早期指标。我们纳入了47名儿科受者(15名希望-分裂,17SCS-Split,和15LDLT)。与SCS-Split相比,HOPE-Split的冷缺血时间(CIT)明显较短(470minvs.538分钟;p=0.02),较低的PRS率(13.3%与47.1%;p=0.04)和较低的IRI评分(3与4;p=0.03)。整体IRI得分(3vs.3;p=0.28)和PRS(13.3%与13.3%;p=1)在HOPE-Split后与LDLT相当,尽管CIT更长(470分钟vs.117分钟;p<0.001)。手术并发症,一年的移植,受者生存率在各组间无差异.总之,与SCS-Split相比,HOPE-Split减轻了儿科接受者的早期IRI,接近LDLT的黄金标准。
    Optimizing graft preservation is key for ex-situ split grafts in pediatric liver transplantation (PSLT). Hypothermic Oxygenated Perfusion (HOPE) improves ischemia-reperfusion injury (IRI) and post-operative outcomes in adult LT. This study compares the use of HOPE in ex-situ partial grafts to static cold storage ex-situ partial grafts (SCS-Split) and to the gold standard living donor liver transplantation (LDLT). All consecutive HOPE-Split, SCS-Split and LDLT performed between 2018-2023 for pediatric recipients were included. Post-reperfusion syndrome (PRS, drop ≥30% in systolic arterial pressure) and reperfusion biopsies served as early indicators of IRI. We included 47 pediatric recipients (15 HOPE-Split, 17 SCS-Split, and 15 LDLT). In comparison to SCS-Split, HOPE-Split had a significantly shorter cold ischemia time (CIT) (470min vs. 538 min; p =0.02), lower PRS rates (13.3% vs. 47.1%; p = 0.04) and a lower IRI score (3 vs. 4; p = 0.03). The overall IRI score (3 vs. 3; p = 0.28) and PRS (13.3% vs. 13.3%; p = 1) after HOPE-Split were comparable to LDLT, despite a longer CIT (470 min vs. 117 min; p < 0.001). Surgical complications, one-year graft, and recipient survival did not differ among the groups. In conclusion, HOPE-Split mitigates early IRI in pediatric recipients in comparison to SCS-Split, approaching the gold standard of LDLT.
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