The protective role of steroids in ischemia-reperfusion injury of the liver.
Liver ischemia-reperfusion injury occurs in a number of clinical settings, including liver surgery, transplantation, and circulatory shock, leading to significant morbidity and mortality. There is a substantial evidence that hepatic ischemia-reperfusion injury results from an intense inflammatory response initiated by oxidative stress in the liver parenchyma during reperfusion. The anti-inflammatory effects of glucocorticosteroids (GCs) have been known for decades and have found extensive therapeutic use in a wide range of clinical situations associated with organ ischemia. Based on their biological effects, routine perioperative GCs administration has been advocated to reduce hepatic ischemic injury. However, the use of GCs in hepatic surgery remains controversial and clinical benefits are still uncertain. The aim of this review is to present the experimental and clinical evidence about the role of GCs in modulating hepatic ischemia-reperfusion injury.
Pulitanò
Carlo
C
Department of Surgery-Liver Unit, Scientific Institute San Raffaele, Vita-Salute San Raffaele University, Italy. pulitano.carlo@hsr.it
Aldrighetti
Luca
L
D000818:Animals; D000975:Antioxidants / Q000502:physiology / Q000627:therapeutic use; D017209:Apoptosis / Q000187:drug effects; D005938:Glucocorticoids / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007511:Ischemia / Q000378:metabolism / Q000517:prevention & control; D008099:Liver / Q000098:blood supply* / Q000378:metabolism; D018384:Oxidative Stress / Q000187:drug effects; D015427:Reperfusion Injury / Q000378:metabolism / Q000517:prevention & control*
D000975:Antioxidants; D005938:Glucocorticoids