BACKGROUND Prostaglandin E1(PGE1),or alprostadil,is a potent vasodilator that improves hepatic blood flow and reduces ischemia-reperfusion injury post-liver transplantation(LT).However,the benefits of PGE1 on renal fu...BACKGROUND Prostaglandin E1(PGE1),or alprostadil,is a potent vasodilator that improves hepatic blood flow and reduces ischemia-reperfusion injury post-liver transplantation(LT).However,the benefits of PGE1 on renal function after LT have not yet been well described.AIM To assess the impact of PGE1 administration on renal function in patients who underwent liver or liver-kidney transplant.METHODS This retrospective study included all patients who underwent liver or liverkidney transplant at our institution from January,2011 to December,2021.Patients were classified based on whether they received PGE1.PGE1 was administered post-LT to those with transaminases>1000 U/L in the immediate postoperative period.Demographics,post-LT treatments and/or complications,renal function,and survival were analyzed.Multivariable logistic regression analysis was performed,and a two-tailed P value<0.05 was considered statistically significant.RESULTS A total of 145 patients underwent LT,with 44(30%)receiving PGE1.Baseline patient characteristics were comparable,except the PGE1 group had significantly higher aspartate aminotransferase(AST)(1961.9 U/L±1862.3 U/L vs 878 U/L±741.4 U/L,P=0.000),alanine aminotransferase(1070.6 U/L±895 U/L vs 547.7 U/L±410 U/L,P=0.000),international normalized ratio on post-LT day 1(2±0.74 vs 1.8±0.4,P=0.03),a longer intensive care unit stay(8.1 days±11.8 days vs 3.8 days±4.6 days,P=0.003),more vasopressor use(55.53 hours±111 hours vs 16.33 hours±26.3 hours,P=0.002),and higher immediate postoperative complications(18.6%vs 4.9%,P=0.04).The PGE1 group also had a significantly higher 90-day readmission rate(29.6%vs 13.1%,P=0.02)and lower 1-year liver graft survival(87.5%vs 98.9%,P=0.005).However,30-day readmission(31.6%vs 27.4%,P=0.64),LT complications(hepatic artery thrombosis,biliary complications,rejection of liver graft,cardiomyopathy),1-year patient survival(96.9%vs 97.8%,P=0.77),overall liver graft survival,and overall patient survival were similar between the two groups(95.4%vs 93.9%,P=0.74 and 88.4%vs 86.9%,P=0.81 respectively).Although the PGE1 group had a significantly lower glomerular filtration rate(eGFR)on post-LT day 7(46.3 mL/minute±26.7 mL/minute vs 62.5 mL/minute±34 mL/minute,P=0.009),the eventual need for renal replacement therapy(13.6%vs 5.9%,P=0.09),the number of dialysis sessions(0.91 vs 0.27,P=0.13),and eGFR at 1-month(37.2 mL/minute±35.9 mL/minute vs 42 mL/minute±36.9 mL/minute,P=0.49),6-months(54.8 mL/minute±21.6 mL/minute vs 62 mL/minute±21.4 mL/minute,P=0.09),and 12-months(63.7 mL/minute±20.7 mL/minute vs 62.8 mL/minute±20.3 mL/minute,P=0.85)post-LT were similar to those in the non-PGE1 group.CONCLUSION In patients who received PGE1 for ischemia-reperfusion injury,despite immediate acute renal injury post-LT,the renal function at 1-month,6-months,and 12-months post-LT was similar compared to those without ischemiareperfusion injury.Prospective clinical trials are needed to further elucidate the benefits of PGE1 use in renal function.展开更多
Summary： The antinephritic effect of lipo-prostaglandin E1. prostaglandin E1 incorporated in lipid mierospheres was investigated using an experimental model of mesangial proliferative glomerulonephritis （MsPGN）. Tw...Summary： The antinephritic effect of lipo-prostaglandin E1. prostaglandin E1 incorporated in lipid mierospheres was investigated using an experimental model of mesangial proliferative glomerulonephritis （MsPGN）. Twenty-two female rats were randomly divided into nephritic group （N, n=6）, lipo-prostaglandin E1 treated group （NL, n=8） and control group （C, n=6）. Lipo-prostaglandin E1 was given intravenously at 40 μg·kg^-1·d^-1 from the 6th week to the 8th week. Twenty-four h urinary protein contents and blood ereatinine （Cr） were determined and the pathological changes were observed in the experiment. The expression of proliferating cell nuclear antigen （PCNA）, extraeellular matrix （fibroneetin, FN; collagen type Ⅳ , Col Ⅳ ） and transforming growth factor β1 （TGFβ1） was detected by using immunohistoehemistry. The results showed that lipo-prostaglandin E1 significantly inhibited the glomerular histopathologieal changes as well as the elevation of plasma Cr （P〈0.05）. The overexpression of PCNA, FN, Col Ⅳ and TGFβ1 were also obviously inhibited in group NL as compared with the group N （P〈0.01）. It was suggested that lipo-prostaglandin E1 could improve renal function, inhibit the proliferation of glomerular cells and reduce the deposition of extraeellular matrix, which may be related to the down-regulation of the TGFβ1 expression.展开更多
BACKGROUND Hepatic artery obstruction is a critical consideration in graft outcomes after living donor liver transplantation.We report a case of diffuse arterial vasospasm that developed immediately after anastomosis ...BACKGROUND Hepatic artery obstruction is a critical consideration in graft outcomes after living donor liver transplantation.We report a case of diffuse arterial vasospasm that developed immediately after anastomosis and was managed with an intra-arterial infusion of lipo-prostaglandin E1(PGE1).CASE SUMMARY A 57-year-old male with hepatitis B virus-related liver cirrhosis and hepatocellular carcinoma underwent ABO-incompatible living donor liver transplant.The grafted hepatic artery was first anastomosed to the recipient’s right hepatic artery stump.However,the arterial pulse immediately weakened.Although a new anastomosis was performed using the right gastroepiploic artery,the patient’s arterial pulse rate remained poor.We attempted angiographic intervention immediately after the operation;it showed diffuse arterial vasospasms like‘beads on a string’.We attempted continuous infusion of lipo-PGE1 overnight via an intra-arterial catheter.The next day,arterial flow improved without any spasms or strictures.The patient had no additional arterial complications or related sequelae at the time of writing,1-year post-liver transplantation.CONCLUSION Angiographic evaluation is helpful in cases of repetitive arterial obstruction,and intra-arterial infusion of lipo-PGE1 may be effective in treating diffuse arterial spasms.展开更多
The selection of proper treatment is based on identification of the causes of massive hemorrhage of gastrointestinal tract after pericardial devascularization.The combined use of prostaglandin E1 indirect portal vein ...The selection of proper treatment is based on identification of the causes of massive hemorrhage of gastrointestinal tract after pericardial devascularization.The combined use of prostaglandin E1 indirect portal vein angiography, DSA of celiac artery and color Doppler can provide detailed information about portal vein system,including the presence of embolism, spongioid changes and devasculization of left gastric vein and left gastric artery and the direction of blood flow. If these techniques failed to reveal the causes of digestive tract bleeding, the endoscopy may show lesions of gastric mucosa, which could be accountable for the bleeding.展开更多
Chronic enteropathy associated with the SLCO2A1 gene(CEAS)is a complex gastroenterological condition characterized by multiple ulcers in the small intestine with chronic bleeding and protein loss.This review explores ...Chronic enteropathy associated with the SLCO2A1 gene(CEAS)is a complex gastroenterological condition characterized by multiple ulcers in the small intestine with chronic bleeding and protein loss.This review explores the potential mechanisms underlying the pathogenesis of CEAS,focusing on the role of SLCO2A1-encoded prostaglandin transporter OATP2A1 and its impact on prostaglandin E2(PGE2)levels.Studies have suggested that elevated PGE2 levels contribute to mucosal damage,inflammation,and disruption of the intestinal barrier.The effects of PGE2 on macrophage activation and Maxi-Cl channel functionality,as well as its interaction with nonsteroidal anti-inflammatory drugs play crucial roles in the progression of CEAS.Understanding the balance between its protective and pro-inflammatory effects and the complex interactions within the gastrointestinal tract can shed light on potential therapeutic targets for CEAS and guide the development of novel,targeted therapies.展开更多
The effect of electroacupuncture (EA) on fever induced by either lipopolysaccharide (LPS), Interleukin-1β(IL-1β) or Prostaglandin E2(PGE2 ) was examined in SD rats in this study. EA stimulation (successive stimulati...The effect of electroacupuncture (EA) on fever induced by either lipopolysaccharide (LPS), Interleukin-1β(IL-1β) or Prostaglandin E2(PGE2 ) was examined in SD rats in this study. EA stimulation (successive stimulation output; voltage intensity, 1 to 4 V; frequency, 1 Hz) was applied to bilateral equvalent Quchi (LI 11 ) acupoints for 30 min. Intraperitoneal injection of LPS (0111: B 4) at a single dose of 100 μg/kg caused high rectal temperature in rats, which was remarably sup pressed by EA either given simultaneously or 2 h after LPS injection. No difference in reduction of fever was found between two groups of rats treated by EA at different times. The rats that received adIninistration of hrIL-1β(2ng) or PGE2(3μg) into the prooptic area (POA) developed the acute and high fevers. The temperature in both cases was significantly decreased after EA stimulation. EA also partially inhibited the fever caused by intravenous injection of 0. 5μg/kg IL-1β. The they temperature increased within 1℃ in the rats that got intravenous injection of PGE2 (1. 5mg/kg), and EA did not present strong inhibitory effect on it. The present results demonstrate that EA possesses an antipyretic effect in rats and suggest that which may attribute to the suppression of the actions of IL-1β and/or PGE2 in the development of fever.展开更多
Objective To investigate the effect of prostaglandin E1 (PGE1) on recovery of early renal graft functions after transplantation. Methods One hundred and seven patients after renal transplantation were allocated in the...Objective To investigate the effect of prostaglandin E1 (PGE1) on recovery of early renal graft functions after transplantation. Methods One hundred and seven patients after renal transplantation were allocated in the treated group, and treated by conventional treatment with injection of 10 μg prostaglandin E1 additionally twice a day for 14 days. And eighty-eight patients who received conventional treatment alone after renal transplantation at the corresponding period were allocated in the control group. Indexes of the two groups, including incidence of delayed graft function and acute rejection reaction, volume of urine, serum certaintie (SCr), endogenous certainties clearance rate (CCr), the blood flow resistance in graft as well as blood viscosity (BV), and platelet aggregation rate (PAR), were determined. Results The urinary volume and endogenous certainties clearance rate of the treated group were significantly higher, but the level of SCr, incidence of renal function recovery retardation, BV, PAR and blood flow resistance in graft were significantly lower than those of the control group (P<0.05). The difference of incidence of acute rejection reaction between the two groups was insignificant (P>0.05). Conclusion Prostaglandin E1 can improve blood microcirculation and decrease the incidence of renal function recovery retardation. These effects are helpful for recovery of renal function after renal transplantation.展开更多
文摘BACKGROUND Prostaglandin E1(PGE1),or alprostadil,is a potent vasodilator that improves hepatic blood flow and reduces ischemia-reperfusion injury post-liver transplantation(LT).However,the benefits of PGE1 on renal function after LT have not yet been well described.AIM To assess the impact of PGE1 administration on renal function in patients who underwent liver or liver-kidney transplant.METHODS This retrospective study included all patients who underwent liver or liverkidney transplant at our institution from January,2011 to December,2021.Patients were classified based on whether they received PGE1.PGE1 was administered post-LT to those with transaminases>1000 U/L in the immediate postoperative period.Demographics,post-LT treatments and/or complications,renal function,and survival were analyzed.Multivariable logistic regression analysis was performed,and a two-tailed P value<0.05 was considered statistically significant.RESULTS A total of 145 patients underwent LT,with 44(30%)receiving PGE1.Baseline patient characteristics were comparable,except the PGE1 group had significantly higher aspartate aminotransferase(AST)(1961.9 U/L±1862.3 U/L vs 878 U/L±741.4 U/L,P=0.000),alanine aminotransferase(1070.6 U/L±895 U/L vs 547.7 U/L±410 U/L,P=0.000),international normalized ratio on post-LT day 1(2±0.74 vs 1.8±0.4,P=0.03),a longer intensive care unit stay(8.1 days±11.8 days vs 3.8 days±4.6 days,P=0.003),more vasopressor use(55.53 hours±111 hours vs 16.33 hours±26.3 hours,P=0.002),and higher immediate postoperative complications(18.6%vs 4.9%,P=0.04).The PGE1 group also had a significantly higher 90-day readmission rate(29.6%vs 13.1%,P=0.02)and lower 1-year liver graft survival(87.5%vs 98.9%,P=0.005).However,30-day readmission(31.6%vs 27.4%,P=0.64),LT complications(hepatic artery thrombosis,biliary complications,rejection of liver graft,cardiomyopathy),1-year patient survival(96.9%vs 97.8%,P=0.77),overall liver graft survival,and overall patient survival were similar between the two groups(95.4%vs 93.9%,P=0.74 and 88.4%vs 86.9%,P=0.81 respectively).Although the PGE1 group had a significantly lower glomerular filtration rate(eGFR)on post-LT day 7(46.3 mL/minute±26.7 mL/minute vs 62.5 mL/minute±34 mL/minute,P=0.009),the eventual need for renal replacement therapy(13.6%vs 5.9%,P=0.09),the number of dialysis sessions(0.91 vs 0.27,P=0.13),and eGFR at 1-month(37.2 mL/minute±35.9 mL/minute vs 42 mL/minute±36.9 mL/minute,P=0.49),6-months(54.8 mL/minute±21.6 mL/minute vs 62 mL/minute±21.4 mL/minute,P=0.09),and 12-months(63.7 mL/minute±20.7 mL/minute vs 62.8 mL/minute±20.3 mL/minute,P=0.85)post-LT were similar to those in the non-PGE1 group.CONCLUSION In patients who received PGE1 for ischemia-reperfusion injury,despite immediate acute renal injury post-LT,the renal function at 1-month,6-months,and 12-months post-LT was similar compared to those without ischemiareperfusion injury.Prospective clinical trials are needed to further elucidate the benefits of PGE1 use in renal function.
文摘Summary： The antinephritic effect of lipo-prostaglandin E1. prostaglandin E1 incorporated in lipid mierospheres was investigated using an experimental model of mesangial proliferative glomerulonephritis （MsPGN）. Twenty-two female rats were randomly divided into nephritic group （N, n=6）, lipo-prostaglandin E1 treated group （NL, n=8） and control group （C, n=6）. Lipo-prostaglandin E1 was given intravenously at 40 μg·kg^-1·d^-1 from the 6th week to the 8th week. Twenty-four h urinary protein contents and blood ereatinine （Cr） were determined and the pathological changes were observed in the experiment. The expression of proliferating cell nuclear antigen （PCNA）, extraeellular matrix （fibroneetin, FN; collagen type Ⅳ , Col Ⅳ ） and transforming growth factor β1 （TGFβ1） was detected by using immunohistoehemistry. The results showed that lipo-prostaglandin E1 significantly inhibited the glomerular histopathologieal changes as well as the elevation of plasma Cr （P〈0.05）. The overexpression of PCNA, FN, Col Ⅳ and TGFβ1 were also obviously inhibited in group NL as compared with the group N （P〈0.01）. It was suggested that lipo-prostaglandin E1 could improve renal function, inhibit the proliferation of glomerular cells and reduce the deposition of extraeellular matrix, which may be related to the down-regulation of the TGFβ1 expression.
文摘BACKGROUND Hepatic artery obstruction is a critical consideration in graft outcomes after living donor liver transplantation.We report a case of diffuse arterial vasospasm that developed immediately after anastomosis and was managed with an intra-arterial infusion of lipo-prostaglandin E1(PGE1).CASE SUMMARY A 57-year-old male with hepatitis B virus-related liver cirrhosis and hepatocellular carcinoma underwent ABO-incompatible living donor liver transplant.The grafted hepatic artery was first anastomosed to the recipient’s right hepatic artery stump.However,the arterial pulse immediately weakened.Although a new anastomosis was performed using the right gastroepiploic artery,the patient’s arterial pulse rate remained poor.We attempted angiographic intervention immediately after the operation;it showed diffuse arterial vasospasms like‘beads on a string’.We attempted continuous infusion of lipo-PGE1 overnight via an intra-arterial catheter.The next day,arterial flow improved without any spasms or strictures.The patient had no additional arterial complications or related sequelae at the time of writing,1-year post-liver transplantation.CONCLUSION Angiographic evaluation is helpful in cases of repetitive arterial obstruction,and intra-arterial infusion of lipo-PGE1 may be effective in treating diffuse arterial spasms.
文摘The selection of proper treatment is based on identification of the causes of massive hemorrhage of gastrointestinal tract after pericardial devascularization.The combined use of prostaglandin E1 indirect portal vein angiography, DSA of celiac artery and color Doppler can provide detailed information about portal vein system,including the presence of embolism, spongioid changes and devasculization of left gastric vein and left gastric artery and the direction of blood flow. If these techniques failed to reveal the causes of digestive tract bleeding, the endoscopy may show lesions of gastric mucosa, which could be accountable for the bleeding.
基金Supported by the National High-Level Hospital Clinical Research Fund,No.2022-PUMCH-A-020the Undergraduate Teaching Reform and Innovation Project,No.2022zlgc0108.
文摘Chronic enteropathy associated with the SLCO2A1 gene(CEAS)is a complex gastroenterological condition characterized by multiple ulcers in the small intestine with chronic bleeding and protein loss.This review explores the potential mechanisms underlying the pathogenesis of CEAS,focusing on the role of SLCO2A1-encoded prostaglandin transporter OATP2A1 and its impact on prostaglandin E2(PGE2)levels.Studies have suggested that elevated PGE2 levels contribute to mucosal damage,inflammation,and disruption of the intestinal barrier.The effects of PGE2 on macrophage activation and Maxi-Cl channel functionality,as well as its interaction with nonsteroidal anti-inflammatory drugs play crucial roles in the progression of CEAS.Understanding the balance between its protective and pro-inflammatory effects and the complex interactions within the gastrointestinal tract can shed light on potential therapeutic targets for CEAS and guide the development of novel,targeted therapies.
文摘The effect of electroacupuncture (EA) on fever induced by either lipopolysaccharide (LPS), Interleukin-1β(IL-1β) or Prostaglandin E2(PGE2 ) was examined in SD rats in this study. EA stimulation (successive stimulation output; voltage intensity, 1 to 4 V; frequency, 1 Hz) was applied to bilateral equvalent Quchi (LI 11 ) acupoints for 30 min. Intraperitoneal injection of LPS (0111: B 4) at a single dose of 100 μg/kg caused high rectal temperature in rats, which was remarably sup pressed by EA either given simultaneously or 2 h after LPS injection. No difference in reduction of fever was found between two groups of rats treated by EA at different times. The rats that received adIninistration of hrIL-1β(2ng) or PGE2(3μg) into the prooptic area (POA) developed the acute and high fevers. The temperature in both cases was significantly decreased after EA stimulation. EA also partially inhibited the fever caused by intravenous injection of 0. 5μg/kg IL-1β. The they temperature increased within 1℃ in the rats that got intravenous injection of PGE2 (1. 5mg/kg), and EA did not present strong inhibitory effect on it. The present results demonstrate that EA possesses an antipyretic effect in rats and suggest that which may attribute to the suppression of the actions of IL-1β and/or PGE2 in the development of fever.
基金supported by the National Natural Science Foundation of China (No.30471640)
文摘Objective To investigate the effect of prostaglandin E1 (PGE1) on recovery of early renal graft functions after transplantation. Methods One hundred and seven patients after renal transplantation were allocated in the treated group, and treated by conventional treatment with injection of 10 μg prostaglandin E1 additionally twice a day for 14 days. And eighty-eight patients who received conventional treatment alone after renal transplantation at the corresponding period were allocated in the control group. Indexes of the two groups, including incidence of delayed graft function and acute rejection reaction, volume of urine, serum certaintie (SCr), endogenous certainties clearance rate (CCr), the blood flow resistance in graft as well as blood viscosity (BV), and platelet aggregation rate (PAR), were determined. Results The urinary volume and endogenous certainties clearance rate of the treated group were significantly higher, but the level of SCr, incidence of renal function recovery retardation, BV, PAR and blood flow resistance in graft were significantly lower than those of the control group (P<0.05). The difference of incidence of acute rejection reaction between the two groups was insignificant (P>0.05). Conclusion Prostaglandin E1 can improve blood microcirculation and decrease the incidence of renal function recovery retardation. These effects are helpful for recovery of renal function after renal transplantation.
