重组人促红细胞生成素预处理抑制肝移植术后早期患者血NF-κB表达

Recombinant human erythropoietin preconditioning prevents expression of blood NF-κB early after liver transplantation

目的观察重组人促红细胞生成素(rhEPO)预处理对肝移植患者术后早期肝功能及核转录因子-κB(NF-κB)表达的影响,探讨rhEPO预处理对肝移植术后缺血再灌注损伤的可能作用及机制。方法26例晚期肝硬化患者随机均分为实验组和对照组(n=13),均接受肝移植治疗,实验组患者移植术前1、3、5d给予rhEPO100U/kg皮下注射,对照组相同时间点给予生理盐水(2ml)皮下注射,供肝恢复血供后1、2、4、6h取外周血检测肝功能,蛋白质印迹法检测外周血中NF-κBp65表达,双抗体夹心酶联免疫吸附法测定外周血TNF-α水平。结果与对照组相比,实验组移植术后各时间点外周血肝功能指标、NF-κBp65、TNF-α表达水平明显下降,差异均有统计学意义(P<0.05)。结论rhEPO预处理能抑制肝移植术后早期肝脏炎症反应,保护肝功能,可能会缓解移植后缺血再灌注损伤。

Objective To study the influence of recombinant human erythropoietin （ rhEPO） preconditioning on the liver function and expression of nuclear factor-κB （NF-κB） during early stage following liver transplantation,and to investigate the possible mechanism of rhEPO preconditioning on ischemia -reperfusion injury after liver transplantation. Methods Twenty-six patients with advanced hepatic cirrhosis were randomly divided into two groups（ n = 13） ：the rhEPo pre-treatment group received subcutaneous injection of rhEPO 100 U/kg at 1,3 and 5 d before liver transplantation,and the control group received 2 ml normal saline in the same manner. The peripheral blood samples were harvested at 1,2,4 and 6 h after blood supply recovery in the donator liver to examine the hepatic functions. The NF-κB p65 expression in the peripheral blood samples were examined by Western blotting analysis,the TNF-α level in the blood was detected by ABC enzyme linked immunosorbent assay. Serum ALT and AST were also determined. Results The liver function indices and the levels of serum NF-κB p65,TNF-α in the rhEPO pre-treatment group were significantly lower than those in the control group （ P 〈 0. 05 ）. Conclusion Pre-treatment with rhEPO can inhibit hepatic inflammation early after liver transplantation,protecting hepatic function and reducing ischemia-reperfusion injury after liver transplantation.