title: The strategy of combined ischemia preconditioning and salvianolic acid-B pretreatment to prevent hepatic ischemia-reperfusion injury in rats.
abstract: BACKGROUND
  Ischemia-reperfusion injury (IRI) is a serious complication of liver surgery, especially for extended hepatectomy and liver transplantation. The aim of this study was to evaluate the protective effect of combined ischemic preconditioning (IPC) and salvianolic acid-B (Sal-B) pretreatment against IRI-induced hepatocellular injury.
  
  
  METHODS
  Sixty male Wistar rats weighing around 200 g were randomized into five groups (n=12): sham group: only anesthesia and laparotomy; IR group: 90 min sustained ischemia by blocking the left ortal vessels; IPC group: 10 min ischemia and 10 min reperfusion prior to the sustained ischemia; Sal-B group: 10 mg/kg injection of Sal-B intravenously 10 min prior to the sustained ischemia; IPC+Sal-B group: same IPC procedure as in IPC group, but proceeded by intravenous administration of Sal-B 10 min prior to sustained ischemia. After 5 h of reperfusion, serum levels of ALT and AST were measured; the amount of malondialdehyde (MDA) and adenine nucleotides in liver tissue was determined; the expression of Bcl-2 and caspase-3 was detected by immunofluorescent and western blotting techniques; the severity of apoptosis and pathological alterations was evaluated by TUNEL and H&E staining, respectively.
  
  
  RESULTS
  The serum aminotransferases, hepatic MDA concentration, and apoptotic index in groups IPC, Sal-B, and IPC+Sal-B were significantly lower than those in the IR group (P<0.001), while the IPC+Sal-B group had the lowest values among these groups (P<0.05). Compared with the IR group, groups IPC and Sal-B not only had statistically higher ATP levels and energy charge (EC) values (P<0.01), but also had upregulated Bcl-2 expression and downregulated cleaved caspase-3 expression in liver tissue. All these effects were further augmented in the IPC+Sal-B group. Liver histopathological findings were consistent with these results.
  
  
  CONCLUSIONS
  Based on these results, the combined IPC and Sal-B pretreatment had a synergistically protective effect on liver tissue against IRI, which might be due to decreased post-ischemic oxidative stress, improved energy metabolism, and reduced hepatocellular apoptosis.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, the First Clinical College of Harbin Medical University, You Zheng Street 23, Harbin, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Kong
authors.forename: Yue
authors.initials: Y
authors.lastname: Gao
authors.forename: Bei
authors.initials: B
authors.lastname: Sun
authors.forename: Hua
authors.initials: H
authors.lastname: Chen
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.forename: Xiuyun
authors.initials: X
authors.lastname: Wang
authors.forename: Hong
authors.initials: H
authors.lastname: Zhu
authors.forename: Shangha
authors.initials: S
authors.lastname: Pan
authors.forename: Dongbo
authors.initials: D
authors.lastname: Xue
authors.forename: Hongchi
authors.initials: H
authors.lastname: Jiang
mesh_terms: D000227:Adenine Nucleotides / Q000378:metabolism; D000410:Alanine Transaminase / Q000097:blood; D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D001219:Aspartate Aminotransferases / Q000097:blood; D001572:Benzofurans / Q000008:administration & dosage*; D015153:Blotting, Western; D053148:Caspase 3 / Q000378:metabolism; D003131:Combined Modality Therapy; D019610:Cytoprotection; D004195:Disease Models, Animal; D004734:Energy Metabolism / Q000187:drug effects; D005455:Fluorescent Antibody Technique; D020287:In Situ Nick-End Labeling; D019194:Ischemic Preconditioning; D008099:Liver / Q000098:blood supply* / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D013997:Time Factors; D053630:Depsides
chemical_list: D000227:Adenine Nucleotides; D000410:Alanine Transaminase; D001219:Aspartate Aminotransferases; D001572:Benzofurans; D053148:Caspase 3; D008315:Malondialdehyde; D019253:Proto-Oncogene Proteins c-bcl-2; C076944:salvianolic acid B; D053630:Depsides; C505410:Casp3 protein, rat