Therapeutic mechanisms of adjunct peritoneal resuscitation for the early hepatic injury in rats after hemorrhagic shock

Abstract

Objective To investigate the therapeutic effect of adjunct peritoneal resuscitation (APR) on the early hepatic injury in rats with hemorrhagic shock in order to explore its possible mechanisms. Methods Ninety-six male Wistar rats were assigned randomly (random number) into control group, shock group, APR1 group and APR2 group. Each group was further divided into 3 subgroups (n=8 in each) as per the animals sacrificed separately at 1 h, 2 h, and 6 h after resuscitation. The rat model of hemorrhagic shock was made by exsanguination under amytal anesthesia and heparinization. The rats in shock group received shed blood plus twice amount of normal saline as conventional intravenous resuscitation (CIR). Besides CIR, at the beginning of resuscitation, those rats in APR1 and APR2 groups were administered intra-peritoneally with 100 mL/kg of Ringer's solution or 2.5% glucose-based peritoneal dialysis solution, respectively. The shock rats in the four groups were sacrificed separately at above mentioned intervals after resuscitation. Liver enzymes and wet/dry weight ratio (W/D) of liver tissue were measured, and pathological changes of liver tissue were observed under optic microscope. The expressions of NF-κB and hot shock protein-70 (HSP70) mRNA in the liver tissue of rats were detected with RT-PCR. All data were statistically analyzed using SPSS 16.0 software. Results Compared with the shock group and APR1 group, the expressions of HSP70 mRNA in the liver tissue of rats at all given intervals after resuscitation in APR2 group increased significantly (P <0.05) , but the W/D ratios of liver tissue at 2 h, 6 h, the degree of pathological changes of liver tissue in 6 h, serum levels of ALT and AST at all given intervals and the expressions of NF-κB mRNA at all given intervals decreased significantly (P <0.05). Conclusions APR with 2.5% glucose-based peritoneal dialysis solution can significantly mitigate the early hepatic injury secondary to hemorrhagic shock, and the mechanisms may be associated with enhancement the expressions of HSP70 mRNA and inhibition the expressions of NF-κB mRNA. Key words: Adjunct peritoneal resuscitation; Hemorrhagic shock; Nulear factor kappa B; Heat- shock protein 70; Hepatic lesion; Peritoneal dialysis fluid; Liver function; Wet/dry weight ratio (W/D) of liver tissue