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Langenbeck's Archives of Surgery

01.05.2007 | Original Article

Intraabdominal bacterial infections significantly alter regeneration and function of the liver in a rat model of major hepatectomy

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 3/2007

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Abstract

Background

No systematic investigations of interactions of postoperative infections and liver regeneration after resection are available.

Materials and methods

Male Sprague–Dawley rats underwent sham operation, 70% partial hepatectomy (PH), cecal ligation and puncture (CLP), or synchronous PH + CLP and were killed at regular intervals. Liver regeneration and function were measured by the mitotic index, Bromo-deoxy-uridine labeling, and Ki-67 as well as bilirubin, albumin, and indocyanine green plasma disappearance rate. The inflammatory response was evaluated by determination of IL-1β and myeloperoxidase (MPO) activity. Bacterial concentrations in different organs were quantified.

Results

Simultaneous CLP + PH resulted in a significantly delayed regeneration kinetic, which was most pronounced at 24 h. This was preceded by hyperinflammation with increased liberation of pro-inflammatory cytokines in the PH + CLP group at 6 h. After 48 h, the pro-inflammatory response declined, and regeneration proceeded also in the PH + CLP group. Liver function was found impaired in both groups; however, it was significantly worse in the PH + CLP group. Especially after 48 h, when regeneration peaked in this group, liver function significantly declined. At 96 h, only minor differences were seen, but the persistently elevated proliferative activity indicated the delay of regeneration after PH + CLP.

Conclusion

The present analysis shows that infectious conditions delay liver regeneration. Our data suggest a cross-linkage of both conditions via the functional liver capacity. A direct role of microorganisms seems unlikely; however, the inhibitory effect of the pro-inflammatory cytokines may be involved.
Literatur
1.
Wacha H, Hau T, Dittmer R, Ohmann C (1999) Risk factors associated with intraabdominal infections: a prospective multicenter study. Langenbecks Arch Surg 384:24–32PubMedCrossRef
2.
Kooby DA, Fong Y, Suriawinata A, Gonen M, Allen PJ, Klimstra DS, DeMatteo RP, D’Angelica M, Blumgart LH, Jarnagin WR (2003) Impact of steatosis on perioperative outcome following hepatic resection. J Gastrointest Surg 7:1034–1044PubMedCrossRef
3.
Wang X, Andersson R, Soltesz V, Bengmark S (1992) Bacterial translocation after major hepatectomy in patients and rats. Arch Surg 127:1101–1106PubMed
4.
Takeda K, Togo S, Kunihiro O, Fujii Y, Kurosawa H, Tanaka K, Endo I, Takimoto A, Sekido H, Hara M, Shimada H (2002) Clinicohistological features of liver failure after excessive hepatectomy. Hepatogastroenterology 49:354–358PubMed
5.
Shigeta H, Nagino M, Kamiya J, Uesaka K, Sano T, Yamamoto H, Hayakawa N, Kanai M, Nimura Y (2002) Bacteremia after hepatectomy: an analysis of a single-center, 10-year experience with 407 patients. Langenbecks Arch Surg 387:117–124PubMedCrossRef
6.
Elias D, Detroz B, Lasser P, Plaud B, Jerbi G (1995) Is simultaneous hepatectomy and intestinal anastomosis safe? Am J Surg 169:254–260PubMedCrossRef
7.
Shinagawa N, Hisada M, Ishihara H (1992) Postoperative infection control in patients with hepatic, biliary tract and pancreatic cancers. Gan To Kagaku Ryoho 19:173–177PubMed
8.
Nelson LA, O’Brien DP, Kemp CJ, Williams JL, Dunke-Jacobs E, Erwin CR, Warner BW (2002) Intestinal and hepatic response to combined partial hepatectomy and small bowel resection in mice. Am J Surg 183:435–440PubMedCrossRef
9.
Yang S, Koo DJ, Zhou M, Chaudry IH, Wang P (2000) Gut-derived norepinephrine plays a critical role in producing hepatocellular dysfunction during early sepsis. Am J Physiol Gastrointest Liver Physiol 279:1274–1281
10.
Weiss YG, Bellin L, Kim PK, Andrejko KM, Haaxma CA, Raj N, Furth EE, Deutschmann CS (2001) Compensatory hepatic regeneration after mild, but not fulminant intraperitoneal sepsis in rats. Am J Physiol Gastrointest Liver Physiol 280:G968–G973PubMed
11.
Furutani M, Arii S, Monden K (1994) Immunologic activation of hepatic macrophages in septic rats: a possible mechanism of sepsis-associated liver injury. J Lab Clin Med 123:430–436PubMed
12.
Minato M, Houssin D, Morin J, Szekely AM, Bismuth H (1982) Surgically induced acute hepatic failure in the rat. Eur Surg Res 14:185–191PubMed
13.
Singleton KD, Wischmeyer PE (2003) Distance of coecum ligated influences mortality, tumor necrosis factor-alpha and interleukin-6 expression following cecal ligation and puncture in the rat. Eur Surg Res 35:486–491PubMedCrossRef
14.
Scholzen T, Gerdes J (2000) The Ki-67 protein: from the known to the unknown. J Cell Physiol 182:311–322PubMedCrossRef
15.
Colletti LM, Kunkel SL, Green M, Burdick M, Strieter RM.Shock (1996) Hepatic inflammation following 70% hepatectomy may be related to up-regulation of epithelial neutrophil activating protein-78. Shock 6:403–404CrossRef
16.
Seehofer D, Rayes N, Schiller R, Stockmann M, Müller AR, Schäper F, Tullius SG, Bengmark S, Neuhaus P (2004) Probiotics partly reverse increased bacterial translocation after simultaneous liver resection and colonic anastomosis in rats. J Surg Res 117:262–271PubMedCrossRef
17.
Paumgartner G, Probst P, Kraines R, Leevy CM (1970) Kinetics of indocyanine green removal from the blood. Ann N Y Acad Sci 170:134–147CrossRef
18.
Lowry OH, Rosenbrough NJ, Farr AL, Randall RJ (1951) Protein measurement with the folin phenol reagent. J Biol Chem 193:265–275PubMed
19.
Cornell RP, Liljequist BL, Bartizal KF (1990) Depressed liver regeneration after partial hepatectomy of germ-free, athymic and lipopolysaccharide resistant mice. Hepatology 11:916–922PubMedCrossRef
20.
Yoshimoto N, Togo S, Kubota T, Kamimukai N, Saito S, Nagano Y, Endo I, Sekido H, Nagashima Y, Shimada H (2004) Role of transforming growth factor-β1 (TGF-β1) in endotoxin-induced hepatic failure after extensive hepatectomy in rats. J Endotoxin Res 11:33–39CrossRef
21.
22.
Belosjorow S, Schulz R, Dorge H, Schade FU, Heusch G (1999) Endotoxin and ischemic preconditioning: TNF-alpha concentration and myocardial infarct development in rabbits. Am J Physiol 277:H2470–H2475PubMed
23.
Shalaby MR, Waage A, Espevik T (1989) Endotoxin, tumor necrosis factor-alpha and interleukin 1 induce interleukin 6 production in vivo. Clin Immunol Immunopathol 53:488–498PubMedCrossRef
24.
Clowes GH, Zuschneid W, Turner M, Blackburn G, Rubin J, Toala P, Green G (1968) Observations on the pathogenesis of the pneumonitis associated with severe infections in other parts of the body. Ann Surg 167:630–650PubMedCrossRef
25.
Wichtermann KA, Baue AE, Chaudry IH (1980) Sepsis and septic shock—a review of laboratory models and a proposal. J Surg Res 29:189–201CrossRef
26.
Buras JA, Holzmann B, Sitkovsky M (2005) Animal models of sepsis: setting the stage. Nat Rev Drug Discov 4:854–865PubMedCrossRef
27.
Maier S, Traeger T, Entleutner M, Westerholt A, Kleist B, Huser N, Holzmann B, Stier A, Pfeffer K, Heidecke CD (2004) Cecal ligation and puncture versus colon ascendens stent peritonitis: two distinct animal models for polymicrobial sepsis. Shock 21:505–511PubMedCrossRef
28.
MacDonald RA, Rogers AE, Pechet G (1962) Regeneration of the liver. Relation of the regenerative response to size of partial hepatectomy. Lab Invest 11:544–548
29.
Corbin IR, Buist R, Volotovskyy V, Peeling J, Zhang M, Minuk GY (2002) Regenerative activity and liver function following partial hepatectomy in the rat using (31)P-MR spectroscopy. Hepatology 36:345–353PubMedCrossRef
30.
Yang SQ, Linz HZ, Mandal AK, Huang J, Diehl AM (2001) Disrupted signaling and inhibited regeneration in obese mice with fatty livers: implications for nonalcoholic fatty liver disease pathophysiology. Hepatology 34:694–706PubMedCrossRef
31.
Fukuhara K, Suzuki M, Unno M, Rahman MM, Endo K, Matsuno S (1999) The degree of hepatic regeneration after partial hepatectomy in rats with peritonitis and the role of lipid peroxidation. Free Radic Biol Med 26:881–886PubMedCrossRef
32.
Wang P, Ba ZF, Chaudry IH (1991) Hepatic extraction of indocyanine green is depressed early in sepsis despite increased hepatic blood flow and cardiac output. Arch Surg 126:219–224PubMed
33.
Roelofsen H, Ven Der Veere CN, Ottenhoff R, Schoemaker B, Jansen PLM, Elferink RPJO (1994) Decreased bilirubin transport in the perfused liver of endotoxemic rats. Gastroenterology 107:1075–1084PubMed
34.
Ayala A, Perrin MM, Wang P, Chaudry IH (1992) Sepsis induces an early increased spontaneous release of the hepatocellular stimulatory factor (IL-6) by Kupffer cells in both endotoxin tolerant or intolerant mice. J Surg Res 52:635–641PubMedCrossRef
35.
Bautista AP, Schuler A, Spolarcis Z, Spitzer JJ (1991) Tumor necrosis factor-α stimulates superoxide anion generation by perfused rat liver and Kupffer cells. Am J Physiol Gastrointest Liver Physiol 261:G891–G895
36.
Wang P, Chaudry IH (1996) Mechanism of hepatocellular dysfunction during hyperdynamic sepsis. Am J Physiol 39:R927–R938
37.
Lund M, Kang L, Tygstrup N, Wolkoff AW, Ott P (1999) Effects of LPS on transport of indocyanine green and alanine uptake in perfused rat liver. Am J Physiol 277:G91–G100PubMed
38.
Mann DV, Lam WW, Hjelm NM, So NM, Yeung DK, Metreweli C, Lau WY (2001) Human liver regeneration: hepatic energy economy is less efficient when the organ is diseased. Hepatology 34:557–565PubMedCrossRef
39.
Balzan S, Belghiti J, Farges O, Ogata S, Sauvent A, Delefosse D, Durand F (2005) The 50–50 criteria on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Ann Surg 242:824–828PubMedCrossRef
40.
Makino H, Togo S, Kubota T, Morioka D, Morita T, Kobayashi T, Tanaka K, Shimizu T, Matsuo K, Nagashima Y, Shimada H (2005) A good model of hepatic failure after excessive hepatectomy. J Surg Res 127:171–176PubMedCrossRef
41.
Nagy P, Teramoto T, Factor VM, Sanchez A, Schnur J, Paku S, Thorgeirsson SS (2001) Reconstitution of liver mass via cellular hypertrophy in the rat. Hepatology 33:339–345PubMedCrossRef
Metadaten
Titel
Intraabdominal bacterial infections significantly alter regeneration and function of the liver in a rat model of major hepatectomy
Publikationsdatum
01.05.2007
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 3/2007
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-007-0169-2

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