Abstract
We agree with Bhogal et al. that autophagy may play a role in the protection against hepatic ischemia/reperfusion injury observed after preoperative fasting. Whether this works via the sequestration of damaged or dysfunctional mitochondria or via other beneficial effects of autophagy is a challenging research question. We have studied the effects of fasting on mitochondria in the kidneys, and among other things, we have found that fasting does not affect the number of mitochondria and significantly inhibits Ca2+-dependent mitochondrial permeability transition pore openings (M. Verweij, unpublished data, 2011). This may contribute to the protection of the liver against ischemia/reperfusion injury as well. These data suggest that the beneficial response induced by fasting is multifactorial and may involve autophagy as one of its mechanisms. Because the functional role of increased autophagy in this model is not clear, this is a relevant research question for the future. Mariëlle Verweij M.Sc.*, Tessa M. van Ginhoven M.D., Ph.D.*, James R. Mitchell Ph.D.*, Wim Sluiter M.D., Ph.D.*, Sandra van den Engel B.Sc.*, Henk P. Roest Ph.D.*, Elham Torabi B.Sc.*, Jan N. M. IJzermans M.D., Ph.D.*, Jan H. J. Hoeijmakers Ph.D.*, Ron W. F. de Bruin Ph.D.*, * Department of Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
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