TY - JOUR
TI - The Effects of Ursodeoxycholic Acid Pretreatment in an Experimental
Setting of Extended Hepatectomy: A Feasibility Study
AU - Paspala, Anna
AU - Papakonstantinou, Dimitrios
AU - Prodromidou, Anastasia
AU - and Danias, Nick
AU - Machairas, Anastasios
AU - Agrogiannis, Georgios and
AU - Machairas, Nikolaos
AU - Zavras, Nikolaos J.
AU - Patapis, Paulos and
AU - Pikoulis, Emmanouil
JO - CUREUS
PY - 2020
VL - 12
TODO - 12
SP - null
PB - CUREUS INC
SN - null
TODO - 10.7759/cureus.12120
TODO - ursodeoxycholic acid; extended hepatectomy; liver resection; liver
regeneration
TODO - Introduction
Liver regeneration is an exceptionally complex process, orchestrated by
a multitude of growth factors and cytoldnes. Tumor necrosis factor-alpha
(TNF-a) and interleuldn-6 (11-6) have a pivotal role in the initiation
of the regenerative response. Ursodeoxycholic acid (UDCA) exhibits a
liver protective effect that enhances liver growth after injury. The aim
of the present study is to evaluate the effect of UDCA in the
circulating levels of TNF-a and II-6 in rats undergoing extended 80%
hepatectomy.
Materials and methods
Twenty-two male Sprague Dawley rats were randomly assigned in an
experimental (UDCA group) and a control group. Mice in the UDC:A-group
received oral pretreatment of UDCA for two weeks preoperatively at a
dosage of 25 mg/kg/day. An 80% hepatic resection was performed in both
groups by resecting the middle, inferior right, and left lateral liver
lobes. The experiment ended 48 hours postoperatively.
Results
UDCA pretreatment significantly depressed circulating levels of both
TNF-a and Il-6 after the conclusion of the experiment as compared to the
control group (p=0.001 and p=0.01, respectively). Furthermore, TNF-a
levels were significantly reduced before the institution of liver injury
(p=0.02). Mice in the UDCA-group exhibited better liver growth as
demonstrated by significantly increased Ki-67 and mitotic rate (p=0.04
and p=0.02, respectively). Finally, the liver regeneration rate (LRR)
was significantly elevated in the experimental group (UDCA group, 54.5%
vs control group, 35.8%; p=0.002) signifying enhanced liver growth
kinetics.
Conclusion
UDCA reduces the expression of TNF-a and Il-6 during the priming phase
of liver regeneration. An 80% hepatectomy model of acute liver failure
exhibited enhanced liver regeneration in the experimental group,
plausibly due to the immunomodulatory effects of UDCA.
ER -