Abstract

BackgroundPost-liver transplantation acute lung injury (ALI) severely affects patients’ survival, whereas the mechanism is unclear and effective therapy is lacking. The authors postulated that reperfusion-induced increased oxidative stress plays a critical role in mediating post-liver transplantation ALI and that induction of heme oxgenase-1 (HO-1), an enzyme with anti-oxidative stress properties, can confer effective protection of lung against ALI.MethodsMale Sprague–Dawley rats underwent autologous orthotopic liver transplantation (OALT) in the absence or presence of treatments with the selective HO-1 inducer (Hemin) or HO-1 inhibitor (ZnPP). Lung tissues were collected at 8 h after OALT, pathological scores and lung water content were evaluated; survival rate of rats was analyzed; protein expression of HO-1 was determined by western blotting, and nuclear translocation of Nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear factor(NF)-κB p65 were detected by Immunofluorescence staining. The inflammatory cytokines and oxidative indexes of lung tissue were determined.ResultsIn lungs harvested at the early stage i.e. 8 h after OALT, Hemin treatment significantly increased superoxide dismutase activities, and reduced malondialdehyde, hydrogen peroxide, interleukin-6, myeloperoxidase, and tumor necrosis factor-α production,which were associated with increased HO-1 protein expression and lower pathological scores and increased survival rate of rats. The underline mechanisms might associate with activation of Nrf2 and inhibition of NF-κB p65 nuclear translocation. However, these changes were aggravated by ZnPP.ConclusionsHemin pretreatment, by enhancing HO-1 induction, increased lung antioxidant capacity and reduced inflammatory stress,protected the lung from OALT-induced ALI at early stage of reperfusion.

Highlights

  • Post-liver transplantation acute lung injury (ALI) severely affects patients’ survival, whereas the mechanism is unclear and effective therapy is lacking

  • While lung in rats from model groups displayed severe damage manifested as increased infiltration of polymorphonuclear and mononuclear inflammatory cells into the intraalveolar and interstitial spaces that were associated with increased interstitial edema and pulmonary architecture damage as well as highest histopathologic scores (P < 0.01 vs. sham) (Fig. 1b)

  • In the current study, we have demonstrated that up-regulation of heme oxgenase-1 (HO-1) by its activator hemin, through reducing NF-κB p65 activation and enhancing Nuclear factor erythroid 2-related factor 2 (Nrf2), reduced lung oxidative stress and inflammation, and subsequently attenuated orthotopic liver transplantation (OALT)-induced ALI and increased the survival rate of rats

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Summary

Introduction

Post-liver transplantation acute lung injury (ALI) severely affects patients’ survival, whereas the mechanism is unclear and effective therapy is lacking. The authors postulated that reperfusion-induced increased oxidative stress plays a critical role in mediating post-liver transplantation ALI and that induction of heme oxgenase-1 (HO-1), an enzyme with anti-oxidative stress properties, can confer effective protection of lung against ALI. Upregulation of HO-1 represents one of the most critical cytoprotective mechanisms that are activated during times of cellular stress, such as inflammation, ischemia, hypoxia, hyperoxia, hyperthermia, or radiation, and it is thought to play a key role in maintaining antioxidant/oxidant homeostasis during multiple cellular injury [9,10,11,12]. Overexpression of HO-1 confers protective effects in numerous transplantation models (i.e. heart transplantation, liver transplantation, and kidney transplantation) by enhancing tissue antioxidant capacity, maintaining microcirculation and reducing inflammatory stress [13]. Whether or not induction of HO-1 could protect the lung against OLT-induced ALI has not been study

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