title: Hepatoprotective effect of ulinastatin in a rat model of major hepatectomy after obstructive jaundice.
abstract: BACKGROUND
  To date, major hepatectomy with obstructive jaundice is still a highly risky and difficult surgery because of the high rate of complications. An excessive inflammatory response may be the primary hindrance to postoperative recovery of liver function.
  
  
  OBJECTIVE
  Recent research has demonstrated that ulinastatin blocks the release of inflammatory factors and prevents the cytokine cascade reaction. This study was conducted to investigate the effect of ulinastatin on major hepatectomy after obstructive jaundice and to explore the potential mechanisms of this effect.
  
  
  METHODS
  Male Sprague-Dawley rats were divided into three groups: sham, control and treated groups. In the control and treated groups, obstructive jaundice was induced, and a 70 % major hepatectomy was performed with implementation of ulinastatin treatment in the treated group but not the control group. The rats were sacrificed after hepatectomy on day 1, day 3, day 5 and day 7. The survival time, liver function, inflammatory cytokine expression and the indices of proliferation activities were examined. Kupffer cells were isolated, and the mRNA and protein levels of CD14 and NF-κB P65 in the Kupffer cells were determined.
  
  
  RESULTS
  Compared to the control group, the survival rates, postoperative liver function, and the indices of proliferation activities were better in the treated group; in the treated group serum TNF-α and IL-6 levels were lower whereas serum IL-10 levels were higher. The expression of CD14 and NF-κB P65 in Kupffer cells at both the mRNA and protein levels was significantly higher in the control group than in the treated group.
  
  
  CONCLUSIONS
  Ulinastatin has a protective effect in major hepatectomy with obstructive jaundice by inhibiting Kupffer cell activation and modulating the hepatic cytokine response.
authors: Department of Biliary-Pancreatic Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China, lx-guilin@163.com.
authors: Xun
authors: X
authors: Li
authors: Jing
authors: J
authors: Li
authors: Yang-Jie
authors: YJ
authors: Ou
authors: Xiao-Xu
authors: XX
authors: Zhu
authors: Xiao-Yu
authors: XY
authors: Yin
authors: Yun-Xiao
authors: YX
authors: Zhu
authors: Di
authors: D
authors: Tang
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood; D004195:Disease Models, Animal; D006023:Glycoproteins / Q000494:pharmacology*; D006498:Hepatectomy; D007150:Immunohistochemistry; D041781:Jaundice, Obstructive / Q000188:drug therapy* / Q000601:surgery*; D008111:Liver Function Tests; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D060888:Real-Time Polymerase Chain Reaction; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D016207:Cytokines; D006023:Glycoproteins; C028665:urinastatin
references: J Surg Oncol. 2014 Sep;110(4):445-50
references: 24962104
references: Hepatology. 1999 Nov;30(5):1206-14
references: 10534342
references: World J Gastroenterol. 2006 Mar 21;12(11):1681-5
references: 16586534
references: Acta Anaesthesiol Scand. 2010 Aug;54(7):871-7
references: 20236100
references: Hepatology. 2003 May;37(5):1043-55
references: 12717385
references: J Ethnopharmacol. 2011 Apr 26;135(1):116-25
references: 21382463
references: Cytokine. 2001 Feb 7;13(3):188-91
references: 11161464
references: Immunol Rev. 2000 Apr;174:21-34
references: 10807504
references: Surgery. 1990 Aug;108(2):370-4; discussion 374-5
references: 2200158
references: Am J Surg. 1990 Jan;159(1):79-84
references: 2136788
references: J Hepatobiliary Pancreat Surg. 2008;15(1):41-54
references: 18274843
references: Toxicol Sci. 2007 Mar;96(1):2-15
references: 17122412
references: Nat Rev Gastroenterol Hepatol. 2013 Sep;10 (9):503
references: 23877532
references: Hepatogastroenterology. 2007 Jan-Feb;54(73):186-9
references: 17419257
references: Hepatology. 1999 Jul;30(1):203-8
references: 10385657
references: Cell. 2004 Feb 20;116(4):491-7
references: 14980217
references: Eur J Gastroenterol Hepatol. 2012 Jan;24(1):25-32
references: 22027701
references: J Invest Surg. 2003 May-Jun;16(3):141-7
references: 12775430
references: Compr Physiol. 2013 Apr;3(2):785-97
references: 23720329
references: Ann Ital Chir. 2014 Mar-Apr;85(2):159-65
references: 24901383
references: Dig Dis Sci. 2011 Mar;56(3):663-72
references: 20635143
references: HPB (Oxford). 2002;4(1):11-9
references: 18333147
references: World J Gastroenterol. 2004 Nov 1;10 (21):3161-4
references: 15457564
references: J Gastroenterol Hepatol. 2013 Apr;28(4):593-607
references: 23350673
references: Eur J Gastroenterol Hepatol. 2012 Sep;24(9):1039-50
references: 22647740
references: Ann Surg. 2000 Aug;232(2):166-74
references: 10903592
references: World J Gastroenterol. 2006 Dec 14;12(46):7413-20
references: 17167827
references: Dig Dis Sci. 2012 Feb;57(2):399-404
references: 22001939
references: Dig Dis Sci. 2006 Dec;51(12):2220-4
references: 17103039
references: World J Gastroenterol. 2013 Nov 28;19(44):7983-91
references: 24307791
references: Physiol Rev. 2009 Oct;89(4):1269-339
references: 19789382
references: Hepatogastroenterology. 2007 Jan-Feb;54(73):229-33
references: 17419266
references: Mediators Inflamm. 2014;2014:808695
references: 24623963
references: Clin Exp Immunol. 2014 Jun;176(3):301-9
references: 24528300
references: J Autoimmun. 2013 Oct;46:74-80
references: 23871639
references: World J Gastroenterol. 2006 Apr 7;12(13):2053-9
references: 16610056
references: World J Gastroenterol. 2002 Oct;8(5):923-7
references: 12378643