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Erschienen in: International Journal of Colorectal Disease 1/2008

01.01.2008 | Original Article

The effect of estrogen on hepatic microcirculation after ischemia/reperfusion

verfasst von: M. Burkhardt, J. E. Slotta, P. Garcia, A. Seekamp, M. D. Menger, T. Pohlemann

Erschienen in: International Journal of Colorectal Disease | Ausgabe 1/2008

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Abstract

Background and aims

Gender dimorphism in clinical manifestation of sepsis, hemorrhage, and trauma is still under investigation. Several experimental studies have indicated a protective effect of estrogen. Nonetheless, the effect of gender on hepatic ischemia/reperfusion remains controversially discussed, and the influence of estrogen is still unclear. In the present study, we investigated whether hepatic ischemia/reperfusion (I/R) injury is gender-dependent and if hepatic microvascular reperfusion injury can be prevented by estrogen.

Materials and methods

Eight female and eight male Sprague-Dawley rats were subjected to 90 min left lobar ischemia followed by 60 min reperfusion. Additional six males were pretreated with 17β-estradiol 24 h before I/R. Six female and six male rats served as nonischemic sham animals. By means of intravital microscopy, sinusoidal perfusion, leukocyte–endothelial cell interaction, and Kupffer cell activity were analyzed. Finally, arterial blood and liver tissue samples were taken for histomorphological analysis and liver enzyme determination.

Results

After hepatic ischemia/reperfusion, animals revealed a significant gender-specific impairment of hepatic microcirculation, whereas Kupffer cell depression, sinusoidal perfusion failure, leukocyte–endothelial cell interaction within post sinusoidal venules, and parenchymal liver cell damage were more pronounced in male animals. Pretreatment with estrogen caused a normalization of Kupffer cell dysfunction and an amelioration of sinusoidal perfusion failure and venular leukocyte–endothelial cell interaction. However, estrogen did not protect from manifestation of post ischemic parenchymal cell damage.

Conclusion

Hepatic ischemia and reperfusion generate a gender-specific occurrence of microvascular injury, which seems to be partially mediated by estrogen. However, additional factors may contribute to the initial post ischemic parenchymal cell damage.
Literatur
1.
Zurück zum Zitat Kahn D, Gavaler JS, Makowka L, van Thiel DH (1993) Gender of donor influences outcome after orthotopic liver transplantation in adults. Dig Dis Sci 38(8):1485–1488PubMedCrossRef Kahn D, Gavaler JS, Makowka L, van Thiel DH (1993) Gender of donor influences outcome after orthotopic liver transplantation in adults. Dig Dis Sci 38(8):1485–1488PubMedCrossRef
2.
Zurück zum Zitat Zeier M, Döhler B, Opelz G, Ritz E (2002) The effect of donor gender on graft survival. J Am Soc Nephrol 13:2570–2576PubMedCrossRef Zeier M, Döhler B, Opelz G, Ritz E (2002) The effect of donor gender on graft survival. J Am Soc Nephrol 13:2570–2576PubMedCrossRef
3.
Zurück zum Zitat Ng IO, Ng M, Fan ST (1997) Better survival in women with resected hepatocellular carcinoma is not related to tumor proliferation or expression of hormone receptors. Am J Gastroenterol 92:1355–1358PubMed Ng IO, Ng M, Fan ST (1997) Better survival in women with resected hepatocellular carcinoma is not related to tumor proliferation or expression of hormone receptors. Am J Gastroenterol 92:1355–1358PubMed
4.
Zurück zum Zitat Lee CC, Chau GY, Lui WY, Tsay SH, King KL, Loong CC, Hshia CY, Wu CW (2000) Better post-resectional survival in female cirrhotic patients with hepatocellular carcinoma. Hepatogastroenterology 47:446–449PubMed Lee CC, Chau GY, Lui WY, Tsay SH, King KL, Loong CC, Hshia CY, Wu CW (2000) Better post-resectional survival in female cirrhotic patients with hepatocellular carcinoma. Hepatogastroenterology 47:446–449PubMed
5.
Zurück zum Zitat Jain A, Reyes J, Kashyap R, Dodson SF, Demetris AJ, Ruppert K, Abu-Elmagd K, Marsh W, Madariaga J, Mazariegos G, Geller D, Bonham CA, Gayowski T, Cacciarelli T, Fontes P, Starzl TE, Fung JJ (2000) Long-term survival after liver transplantation in 4,000 consecutive patients at a single center. Ann Surg 232:490–500PubMedCrossRef Jain A, Reyes J, Kashyap R, Dodson SF, Demetris AJ, Ruppert K, Abu-Elmagd K, Marsh W, Madariaga J, Mazariegos G, Geller D, Bonham CA, Gayowski T, Cacciarelli T, Fontes P, Starzl TE, Fung JJ (2000) Long-term survival after liver transplantation in 4,000 consecutive patients at a single center. Ann Surg 232:490–500PubMedCrossRef
6.
Zurück zum Zitat Colantoni A, De Maria N, Caraceni P, Bernardi M, Van Thiel DH (1999) Gender influences cold preservation-reoxygenation injury in the liver. Transplant Proc 31(1–2):1052–1053PubMedCrossRef Colantoni A, De Maria N, Caraceni P, Bernardi M, Van Thiel DH (1999) Gender influences cold preservation-reoxygenation injury in the liver. Transplant Proc 31(1–2):1052–1053PubMedCrossRef
7.
Zurück zum Zitat Gasbarrini A, Addolorato G, Di Campli C, Simoncini M, Montemagno S, Castagneto M, Padalino C, Pola P, Gasbarrini G (2001) Gender affects reperfusion injury in rat liver. Dig Dis Sci 46(6):1305–1312PubMedCrossRef Gasbarrini A, Addolorato G, Di Campli C, Simoncini M, Montemagno S, Castagneto M, Padalino C, Pola P, Gasbarrini G (2001) Gender affects reperfusion injury in rat liver. Dig Dis Sci 46(6):1305–1312PubMedCrossRef
8.
Zurück zum Zitat Harada H, Pavlick KP, Hines IN, Hoffman JM, Bharwani S, Gray L, Wolf RE, Grisham MB (2001) Selected contribution: effects of gender on reduced-size liver ischemia and reperfusion injury. J Appl Physiol 91(6):2816–22PubMed Harada H, Pavlick KP, Hines IN, Hoffman JM, Bharwani S, Gray L, Wolf RE, Grisham MB (2001) Selected contribution: effects of gender on reduced-size liver ischemia and reperfusion injury. J Appl Physiol 91(6):2816–22PubMed
9.
Zurück zum Zitat Eckhoff DE, Bilbao G, Frenette L, Thompson JA, Contreras JL (2002) 17-Beta-estradiol protects the liver against warm ischemia/reperfusion injury and is associated with increased serum nitric oxide and decreased tumor necrosis factor-alpha. Surgery 132(2):302–309PubMedCrossRef Eckhoff DE, Bilbao G, Frenette L, Thompson JA, Contreras JL (2002) 17-Beta-estradiol protects the liver against warm ischemia/reperfusion injury and is associated with increased serum nitric oxide and decreased tumor necrosis factor-alpha. Surgery 132(2):302–309PubMedCrossRef
10.
Zurück zum Zitat Jarrar D, Wang P, Knoferl MW, Kuebler JF, Cioffi WG, Bland KI, Chaudry IH (2000) Insight into the mechanism by which estradiol improves organ functions after trauma-hemorrhage. Surgery 128(2):246–252PubMedCrossRef Jarrar D, Wang P, Knoferl MW, Kuebler JF, Cioffi WG, Bland KI, Chaudry IH (2000) Insight into the mechanism by which estradiol improves organ functions after trauma-hemorrhage. Surgery 128(2):246–252PubMedCrossRef
11.
Zurück zum Zitat Kuebler JF, Jarrar D, Toth B, Bland KI, Rue LW 3rd, Wang P, Chaudry IH (2002) Estradiol administration improves splanchnic perfusion following trauma-hemorrhage and sepsis. Arch Surg 137(1):74–79PubMedCrossRef Kuebler JF, Jarrar D, Toth B, Bland KI, Rue LW 3rd, Wang P, Chaudry IH (2002) Estradiol administration improves splanchnic perfusion following trauma-hemorrhage and sepsis. Arch Surg 137(1):74–79PubMedCrossRef
12.
Zurück zum Zitat Yokoyama Y, Toth B, Kitchens WC, Schwacha MG, Rue LW 3rd, Bland KI, Chaudry IH (2004) Estradiol’s effect on portal response to endothelin-1 after trauma-hemorrhage. J Surg Res 121(1):25–30PubMedCrossRef Yokoyama Y, Toth B, Kitchens WC, Schwacha MG, Rue LW 3rd, Bland KI, Chaudry IH (2004) Estradiol’s effect on portal response to endothelin-1 after trauma-hemorrhage. J Surg Res 121(1):25–30PubMedCrossRef
13.
Zurück zum Zitat Vollmar B, Glasz J, Leiderer R, Post S, Menger MD (1994) Hepatic microcirculatory perfusion failure is a determinant of liver dysfunction in warm ischemia–reperfusion. Am J Pathol 145(6):1421–1431PubMed Vollmar B, Glasz J, Leiderer R, Post S, Menger MD (1994) Hepatic microcirculatory perfusion failure is a determinant of liver dysfunction in warm ischemia–reperfusion. Am J Pathol 145(6):1421–1431PubMed
14.
Zurück zum Zitat Vollmar B, Menger MD, Glasz J, Leiderer R, Messmer K (1994) Impact of leukocyte–endothelial cell interaction in hepatic ischemia–reperfusion injury. Am J Physiol 267:G786–G793PubMed Vollmar B, Menger MD, Glasz J, Leiderer R, Messmer K (1994) Impact of leukocyte–endothelial cell interaction in hepatic ischemia–reperfusion injury. Am J Physiol 267:G786–G793PubMed
15.
Zurück zum Zitat Vollmar B, Glasz J, Post S, Menger MD (1994) Depressed phagocytic activity of Kupffer cells after warm ischemia–reperfusion of the liver. J Hepatol 20:301–304PubMedCrossRef Vollmar B, Glasz J, Post S, Menger MD (1994) Depressed phagocytic activity of Kupffer cells after warm ischemia–reperfusion of the liver. J Hepatol 20:301–304PubMedCrossRef
16.
Zurück zum Zitat Majno G, Joris I (1995) Apoptosis, oncosis, and necrosis. An overview of cell death. Am J Pathol 146(1):3–15PubMed Majno G, Joris I (1995) Apoptosis, oncosis, and necrosis. An overview of cell death. Am J Pathol 146(1):3–15PubMed
17.
Zurück zum Zitat Levin S, Bucci TJ, Cohen SM, Fix AS, Hardisty JF, LeGrand EK, Maronpot RR, Trump BF (1999) The nomenclature of cell death: recommendations of an ad hoc Committee of the Society of Toxicologic Pathologists. Toxicol Pathol 27(4):484–490PubMed Levin S, Bucci TJ, Cohen SM, Fix AS, Hardisty JF, LeGrand EK, Maronpot RR, Trump BF (1999) The nomenclature of cell death: recommendations of an ad hoc Committee of the Society of Toxicologic Pathologists. Toxicol Pathol 27(4):484–490PubMed
18.
Zurück zum Zitat Yokoyama Y, Nimura Y, Nagino M, Bland KI, Chaudry IH (2005) Current understanding of gender dimorphism in hepatic pathophysiology. J Surg Res 128:147–156PubMed Yokoyama Y, Nimura Y, Nagino M, Bland KI, Chaudry IH (2005) Current understanding of gender dimorphism in hepatic pathophysiology. J Surg Res 128:147–156PubMed
19.
Zurück zum Zitat Lentsch AB, Kato A, Yoshidome H, McMasters KM, Edwards MJ (2000) Inflammatory mechanisms and therapeutic strategies for warm hepatic ischemia/reperfusion injury. Hepatology 32(2):169–173PubMedCrossRef Lentsch AB, Kato A, Yoshidome H, McMasters KM, Edwards MJ (2000) Inflammatory mechanisms and therapeutic strategies for warm hepatic ischemia/reperfusion injury. Hepatology 32(2):169–173PubMedCrossRef
20.
Zurück zum Zitat Harada H, Bharwani S, Pavlick KP, Korach KS, Grisham MB (2004) Estrogen receptor-alpha, sexual dimorphism and reduced-size liver ischemia and reperfusion injury in mice. Pediatr Res 55(3):450–456PubMedCrossRef Harada H, Bharwani S, Pavlick KP, Korach KS, Grisham MB (2004) Estrogen receptor-alpha, sexual dimorphism and reduced-size liver ischemia and reperfusion injury in mice. Pediatr Res 55(3):450–456PubMedCrossRef
21.
Zurück zum Zitat Lü P, Liu F, Wang CY, Chen DD, Yao Z, Tian Y, Zhang JH, Wu YH (2005) Gender differences in hepatic ischemic reperfusion injury in rats are associated with endothelial cell nitric oxide synthase-derived nitric oxide. World J Gastroenterol 11(22):3441–3445PubMed Lü P, Liu F, Wang CY, Chen DD, Yao Z, Tian Y, Zhang JH, Wu YH (2005) Gender differences in hepatic ischemic reperfusion injury in rats are associated with endothelial cell nitric oxide synthase-derived nitric oxide. World J Gastroenterol 11(22):3441–3445PubMed
22.
Zurück zum Zitat Jaeschke H, Farhood A (1991) Neutrophil and Kupffer cell-induced oxidant stress and ischemia–reperfusion injury in rat liver. Am J Physiol 260:G355–G362PubMed Jaeschke H, Farhood A (1991) Neutrophil and Kupffer cell-induced oxidant stress and ischemia–reperfusion injury in rat liver. Am J Physiol 260:G355–G362PubMed
23.
Zurück zum Zitat Menger MD, Richter S, Yamauchi J, Vollmar B (1999) Role of microcirculation in hepatic ischemia/reperfusion injury. Hepatogastroenterology 46(Suppl 2):1452–1457PubMed Menger MD, Richter S, Yamauchi J, Vollmar B (1999) Role of microcirculation in hepatic ischemia/reperfusion injury. Hepatogastroenterology 46(Suppl 2):1452–1457PubMed
24.
Zurück zum Zitat Yokoyama Y, Kuebler JF, Matsutani T, Schwacha MG, Bland KI, Chaudry IH (2003) Mechanism of the salutary effects of 17beta-estradiol following trauma-hemorrhage: direct downregulation of Kupffer cell proinflammatory cytokine production. Cytokine 21:91–97PubMedCrossRef Yokoyama Y, Kuebler JF, Matsutani T, Schwacha MG, Bland KI, Chaudry IH (2003) Mechanism of the salutary effects of 17beta-estradiol following trauma-hemorrhage: direct downregulation of Kupffer cell proinflammatory cytokine production. Cytokine 21:91–97PubMedCrossRef
Metadaten
Titel
The effect of estrogen on hepatic microcirculation after ischemia/reperfusion
verfasst von
M. Burkhardt
J. E. Slotta
P. Garcia
A. Seekamp
M. D. Menger
T. Pohlemann
Publikationsdatum
01.01.2008
Verlag
Springer-Verlag
Erschienen in
International Journal of Colorectal Disease / Ausgabe 1/2008
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-007-0360-5

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