セボフルランはポストコンディショニング作用を有し、プレコンディショニングと同様に肝虚血再灌流傷害を軽減する

• Main Author: 白石, 早紀
• Format: Other/Unknown Material
• Language: English
• Published: 日本麻酔科学会 2019
• Subjects: Sevoflurane; Preconditioning; Postconditioning; Ischemia?reperfusion injury; Hepatic; Heme oxygenase-1; taiga
• Online Access: https://nagasaki-u.repo.nii.ac.jp/record/2017/files/ISYK1164_Shiraishi.pdf

Nagasaki University (長崎大学) 博士(医学) Purpose: Ischemia?reperfusion (IR) injury is inevitable after liver transplantation and liver resection with inflow occlusion. Sevoflurane has been widely used during hepatobiliary surgery and was reported to exhibit preconditioning (PreC) properties against hepatic IR injury; however, its postconditioning (PostC) properties remain unknown. This study examined whether a clinically applicable dose of sevoflurane has PostC and PreC properties against hepatic IR injury and roles of heme oxygenase-1 (HO-1). Methods: Warm ischemia was induced in male Wistar rats, excluding the sham group, for 1 h, followed by 3 h of reperfusion. Group C received propofol from 60 min before ischemia until the end of the experimental procedure. In the SPreC and SPostC groups, propofol was replaced by 2.5% sevoflurane for 30 min from 35 min before ischemia in the SPreC group and for 30 min from 5 min before reperfusion in the SPostC group. The SPreC+Z and SPostC+Z groups received a HO-1 inhibitor, zinc protoporphyrin (Znpp), 60 min before ischemia, and sevoflurane PreC and PostC were induced. Results: Serum aspartate aminotransferase, alanine aminotransferase, and lactic dehydrogenase levels, and histological damage scores in the SPreC and SPostC groups were significantly lower than those in group C. Inhibiting HO-1 with Znpp partially blocked these protective effects of sevoflurane. Sevoflurane PreC and PostC significantly increased the number of HO-1-positive Kupffer cells in comparison with group C, and Znpp prevented sevoflurane-induced HO-1 expression. Conclusion: PostC and PreC by sevoflurane at a clinically applicable dose have equally protective effects against hepatic IR injury by increasing HO-1 expression. 長崎大学学位論文 学位記番号:博(医歯薬)甲第1164号 学位授与年月日:令和元年6月5日 Author: Saki Shiraishi, Sungsam Cho, Daiji Akiyama, Taiga Ichinomiya, Itsuko Shibata, Osamu Yoshitomi, Takuji Maekawa, Eisuke Ozawa, Hisamitsu Miyaaki,Tetsuya Hara Citation: Journal of Anesthesia, 33(3), pp.390-398; 2019 Nagasaki ...