title: Angiogenesis and proliferation of bile duct enhances ischemic tolerance in rats with cirrhosis.
abstract: OBJECTIVE
  Primary biliary cirrhosis (PBC), an autoimmune disease of the liver, is marked by slow progressive destruction of bile ducts. These patients with PBC often undergo orthotopic liver transplantation (OLT). Ischemic bile duct lesion (IBDL) is a major source of morbidity and even mortality after OLT. Cirrhosis of the liver has a higher tolerance to ischemia than a normal liver, but the mechanism remains unknown. Angiogenesis and proliferation of bile duct often responses in bile duct ischemia, which may enhance ischemic tolerance in patients with cirrhosis.
  
  
  METHODS
  To test the hypothesis, a rat model with cirrhosis was established. Biochemical indexes of ischemic severity were measured including total bilirubin (TBIL) and direct bilirubin (DBIL). Immunohistochemical assay was performed for Ki67 (a biomarker for the proliferation of bile duct) and CD34 (a biomarker of angiogenesis).
  
  
  RESULTS
  The levels were lower for TBIL and DBIL in the bile duct from rat model with cirrhosis than that from a normal rat after ischemic surgery (P < 0.05). The levels were higher for Ki67 and CD34 from a rat model with cirrhosis than that from a normal rat after ischemic surgery (P < 0.05).
  
  
  CONCLUSIONS
  The results suggest that a liver with cirrhosis has a better ischemic tolerance than a normal liver. Angiogenesis and proliferation of bile duct enhances ischemic tolerance in rats with cirrhosis. More research on the pathogenesis of IBDLs is needed for developing more specific preventive or therapeutic strategies.
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Nanjing Medical University Nanjing 210029, China.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Nanjing Medical University Nanjing 210029, China.
authors.forename: Zhennan
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Nanjing Medical University Nanjing 210029, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Zou
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Nanjing Medical University Nanjing 210029, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Nanjing Medical University Nanjing 210029, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Nanjing Medical University Nanjing 210029, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Miao
keywords: Angiogenesis; bile duct; cirrhosis; ischemia; proliferation