Effect of sevoflurane pretreatment in relieving liver ischemia/reperfusion-induced pulmonary and hepatic injury

Abstract Purpose To investigate the effect of sevoflurane preconditioning on ischemia/reperfusion (I/R)-induced pulmonary/hepatic injury Methods Fifty-one Wistar rats were randomly grouped into sham, I/R, and sevoflurane groups. After reperfusion, the structural change of the lung was measured by Smith score, the wet and dry weights (W/D) were determined, malondialdehyde (MDA) myeloperoxidase (MPO) content was determined colorimetrically and by fluorescence, respectively, and matrix metalloprotein-9 (MMP-9) mRNA was quantified by RT-PCR. Biopsy and morphological analyses were performed on liver tissue, activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were determined, and tumor necrosis factor-alpha (TNF-α) level was determined. Results The sham group showed no changes in tissue structure. Structural lesions in the sevoflurane and I/R groups were mild and severe, respectively. Smith score, W/D, MDA, MPO, and MMP mRNA showed the same trend, and were increased in the I/R group and recovered in the sevoflurane group, compared with the sham group (both P<0.05). AST and ALT were significantly increased compared to the sham group (AST: 655±52.06 vs . 29±9.30 U/L; ALT: 693±75.56 vs . 37±6.71 U/L; P<0.05). In the sevoflurane group, AST and ALT levels were significantly decreased (464±47.71 and 516±78.84 U/L; P<0.001). TNF-α presented similar results. Conclusion The protection of lung and liver by sevoflurane may be mediated by inhibited leukocyte recruitment and MMP-9 secretion.

摘要
## 目的
探讨七氟烷（sevoflurane）预处理对缺血再灌注（I/R，ischemia/reperfusion）诱导的肺/肝损伤的影响。
## 方法
将51只Wistar大鼠随机分为假手术组、I/R组及七氟烷组。再灌注后，采用Smith评分评估肺组织结构改变，测定肺组织干湿重（W/D）比值；采用比色法检测丙二醛（malondialdehyde, MDA）含量，采用荧光法检测髓过氧化物酶（myeloperoxidase, MPO）含量；采用逆转录聚合酶链反应（reverse transcription-polymerase chain reaction, RT-PCR）定量检测基质金属蛋白酶-9（matrix metalloprotein-9, MMP-9）mRNA的表达水平。对肝组织进行活检及形态学分析，测定天冬氨酸转氨酶（aspartate aminotransferase, AST）与丙氨酸转氨酶（alanine aminotransferase, ALT）活性，并检测肿瘤坏死因子-α（tumor necrosis factor-alpha, TNF-α）水平。
## 结果
假手术组大鼠组织结构无异常改变。七氟烷组与I/R组的组织结构损伤程度分别为轻度与重度。与假手术组相比，I/R组的Smith评分、W/D比值、MDA、MPO及MMP-9 mRNA水平均显著升高，七氟烷组上述指标较I/R组有所恢复（两组比较均P<0.05）。I/R组AST与ALT水平较假手术组显著升高（AST：655±52.06 vs 29±9.30 U/L；ALT：693±75.56 vs 37±6.71 U/L；P<0.05）；七氟烷组AST与ALT水平显著降低（分别为464±47.71 U/L与516±78.84 U/L；P<0.001）。TNF-α水平呈现相似的变化趋势。
## 结论
七氟烷对肺与肝组织的保护作用可能通过抑制白细胞募集及MMP-9分泌介导。