Beneficial Effects of Ischemic Preconditioning in Patients Undergoing Hepatectomy: The Role of Neutrophils
HYPOTHESES Temporary vascular clampage (Pringle maneuver) during liver surgery can cause ischemia-reperfusion injury. In this process, activation of polymorphonuclear leukocytes (PMNLs) might play a major role. Thus, we investigated the effects of hepatic ischemic preconditioning on PMNL functions....
Gespeichert in:
| Veröffentlicht in: | Archives of surgery (Chicago. 1960) 2005-02, Vol.140 (2), p.129-136 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 136 |
|---|---|
| container_issue | 2 |
| container_start_page | 129 |
| container_title | Archives of surgery (Chicago. 1960) |
| container_volume | 140 |
| creator | Choukèr, Alexander Martignoni, André Schauer, Rolf Dugas, Martin Rau, Horst-Günther Jauch, Karl-Walter Peter, Klaus Thiel, Manfred |
| description | HYPOTHESES Temporary vascular clampage (Pringle maneuver) during liver surgery can cause ischemia-reperfusion injury. In this process, activation of polymorphonuclear leukocytes (PMNLs) might play a major role. Thus, we investigated the effects of hepatic ischemic preconditioning on PMNL functions. DESIGN Prospective randomized study. Patients who underwent partial liver resection were randomly assigned to 3 groups: group 1 without Pringle maneuver; group 2 with Pringle maneuver, and group 3 with ischemic preconditioning using 10 minutes of ischemia and 10 minutes of reperfusion prior to Pringle maneuver for resection. SETTING University hospital, Munich, Germany. PATIENTS Seventy-five patients underwent hepatic surgery mostly owing to metastasis. MAIN OUTCOME MEASURES Perioperative factors for PMNL activation, inflammation, and postoperative hepatocellular integrity. RESULTS Ischemia-reperfusion of the human liver (mean ± SD time to perform the Pringle maneuver, 35.5 ± 2.6 minutes) caused (1) a decrease in the number of circulating PMNLs, (2) their intrahepatic sequestration, (3) their systemic activation, and (4) a significant correlation between the degree of their postischemic activation and the postoperative rise in liver enzyme serum levels. In parallel, cytokines with proinflammatory and chemotactic properties were released reaching the highest values when stimulation of PMNLs was most pronounced. When ischemic preconditioning preceded the Pringle maneuver, activation of PMNLs and cytokine plasma levels was reduced as evidenced by the attenuation of superoxide anion production, β2-integrin up-regulation, and interleukin 8 serum concentrations, followed by a significant reduction in serum alanine aminotransferase levels on the first and second postoperative days. CONCLUSIONS These results demonstrate in humans that ischemic preconditioning reduces activation of PMNLs elicited by the Pringle maneuver. The down-regulation of potentially cytotoxic functions of PMNLs might be one of yet unknown important pathways that altogether mediate protection by ischemic preconditioning.Arch Surg. 2005;140:129-136--> |
| doi_str_mv | 10.1001/archsurg.140.2.129 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67448749</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>508325</ama_id><sourcerecordid>793564791</sourcerecordid><originalsourceid>FETCH-LOGICAL-a327t-2b020cd8a34cc040dfe003afe097a8c27830a68e8b31bf24150069e5e97d84f83</originalsourceid><addsrcrecordid>eNpd0c9rFDEUB_AgFrtW_wA9yCDobbYvP2Ym8aal2kJpi7TnkM287GaZSbbJzKH_vVl2teAlCcnnPR75EvKRwpIC0HOT7CbPab2kApZsSZl6RRa04bLmrRCvyQIARF0knJK3OW_LiUnF3pBT2nSMK8UXZPsDAzpvvRmqS-fQTrmKrrrOdoOjt9V9QhtD7ycfgw_ryofq3kweQ3GPoce0jvvrK9yZqRTH8flb9bDB6ncccN_oFucpxd3GD_kdOXFmyPj-uJ-Rx5-XDxdX9c3dr-uL7ze14aybarYCBraXhgtrQUDvEICbsqrOSMs6ycG0EuWK05VjgjYArcIGVddL4SQ_I18PfXcpPs2YJz36bHEYTMA4Z912QshOqAI__we3cU6hzKYZZ03TUMULYgdkU8w5odO75EeTnjUFvY9B_41Blxg00yWGUvTp2Hlejdi_lBz_vYAvR2CyNYNLJlifX1zbtAwoLe7DwZnR_HttQJbx-B_ryJqh</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>232555193</pqid></control><display><type>article</type><title>Beneficial Effects of Ischemic Preconditioning in Patients Undergoing Hepatectomy: The Role of Neutrophils</title><source>MEDLINE</source><source>American Medical Association Journals</source><source>Alma/SFX Local Collection</source><creator>Choukèr, Alexander ; Martignoni, André ; Schauer, Rolf ; Dugas, Martin ; Rau, Horst-Günther ; Jauch, Karl-Walter ; Peter, Klaus ; Thiel, Manfred</creator><creatorcontrib>Choukèr, Alexander ; Martignoni, André ; Schauer, Rolf ; Dugas, Martin ; Rau, Horst-Günther ; Jauch, Karl-Walter ; Peter, Klaus ; Thiel, Manfred</creatorcontrib><description>HYPOTHESES Temporary vascular clampage (Pringle maneuver) during liver surgery can cause ischemia-reperfusion injury. In this process, activation of polymorphonuclear leukocytes (PMNLs) might play a major role. Thus, we investigated the effects of hepatic ischemic preconditioning on PMNL functions. DESIGN Prospective randomized study. Patients who underwent partial liver resection were randomly assigned to 3 groups: group 1 without Pringle maneuver; group 2 with Pringle maneuver, and group 3 with ischemic preconditioning using 10 minutes of ischemia and 10 minutes of reperfusion prior to Pringle maneuver for resection. SETTING University hospital, Munich, Germany. PATIENTS Seventy-five patients underwent hepatic surgery mostly owing to metastasis. MAIN OUTCOME MEASURES Perioperative factors for PMNL activation, inflammation, and postoperative hepatocellular integrity. RESULTS Ischemia-reperfusion of the human liver (mean ± SD time to perform the Pringle maneuver, 35.5 ± 2.6 minutes) caused (1) a decrease in the number of circulating PMNLs, (2) their intrahepatic sequestration, (3) their systemic activation, and (4) a significant correlation between the degree of their postischemic activation and the postoperative rise in liver enzyme serum levels. In parallel, cytokines with proinflammatory and chemotactic properties were released reaching the highest values when stimulation of PMNLs was most pronounced. When ischemic preconditioning preceded the Pringle maneuver, activation of PMNLs and cytokine plasma levels was reduced as evidenced by the attenuation of superoxide anion production, β2-integrin up-regulation, and interleukin 8 serum concentrations, followed by a significant reduction in serum alanine aminotransferase levels on the first and second postoperative days. CONCLUSIONS These results demonstrate in humans that ischemic preconditioning reduces activation of PMNLs elicited by the Pringle maneuver. The down-regulation of potentially cytotoxic functions of PMNLs might be one of yet unknown important pathways that altogether mediate protection by ischemic preconditioning.Arch Surg. 2005;140:129-136--></description><identifier>ISSN: 0004-0010</identifier><identifier>ISSN: 2168-6254</identifier><identifier>EISSN: 1538-3644</identifier><identifier>EISSN: 2168-6262</identifier><identifier>DOI: 10.1001/archsurg.140.2.129</identifier><identifier>PMID: 15723993</identifier><identifier>CODEN: ARSUAX</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Biological and medical sciences ; CD18 Antigens - blood ; Female ; General aspects ; Hepatectomy ; Humans ; Injuries ; Interleukin-8 - blood ; Ischemic Preconditioning ; Leukocytes ; Liver ; Liver Neoplasms - secondary ; Liver Neoplasms - surgery ; Liver, biliary tract, pancreas, portal circulation, spleen ; Male ; Medical sciences ; Middle Aged ; Neutrophil Activation - physiology ; Neutrophils - physiology ; Peroxidase - blood ; Prospective Studies ; Reperfusion Injury - physiopathology ; Risk factors ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system</subject><ispartof>Archives of surgery (Chicago. 1960), 2005-02, Vol.140 (2), p.129-136</ispartof><rights>2005 INIST-CNRS</rights><rights>Copyright American Medical Association Feb 2005</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamasurgery/articlepdf/10.1001/archsurg.140.2.129$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/archsurg.140.2.129$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,776,780,3327,27901,27902,76231,76234</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16562011$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15723993$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Choukèr, Alexander</creatorcontrib><creatorcontrib>Martignoni, André</creatorcontrib><creatorcontrib>Schauer, Rolf</creatorcontrib><creatorcontrib>Dugas, Martin</creatorcontrib><creatorcontrib>Rau, Horst-Günther</creatorcontrib><creatorcontrib>Jauch, Karl-Walter</creatorcontrib><creatorcontrib>Peter, Klaus</creatorcontrib><creatorcontrib>Thiel, Manfred</creatorcontrib><title>Beneficial Effects of Ischemic Preconditioning in Patients Undergoing Hepatectomy: The Role of Neutrophils</title><title>Archives of surgery (Chicago. 1960)</title><addtitle>Arch Surg</addtitle><description>HYPOTHESES Temporary vascular clampage (Pringle maneuver) during liver surgery can cause ischemia-reperfusion injury. In this process, activation of polymorphonuclear leukocytes (PMNLs) might play a major role. Thus, we investigated the effects of hepatic ischemic preconditioning on PMNL functions. DESIGN Prospective randomized study. Patients who underwent partial liver resection were randomly assigned to 3 groups: group 1 without Pringle maneuver; group 2 with Pringle maneuver, and group 3 with ischemic preconditioning using 10 minutes of ischemia and 10 minutes of reperfusion prior to Pringle maneuver for resection. SETTING University hospital, Munich, Germany. PATIENTS Seventy-five patients underwent hepatic surgery mostly owing to metastasis. MAIN OUTCOME MEASURES Perioperative factors for PMNL activation, inflammation, and postoperative hepatocellular integrity. RESULTS Ischemia-reperfusion of the human liver (mean ± SD time to perform the Pringle maneuver, 35.5 ± 2.6 minutes) caused (1) a decrease in the number of circulating PMNLs, (2) their intrahepatic sequestration, (3) their systemic activation, and (4) a significant correlation between the degree of their postischemic activation and the postoperative rise in liver enzyme serum levels. In parallel, cytokines with proinflammatory and chemotactic properties were released reaching the highest values when stimulation of PMNLs was most pronounced. When ischemic preconditioning preceded the Pringle maneuver, activation of PMNLs and cytokine plasma levels was reduced as evidenced by the attenuation of superoxide anion production, β2-integrin up-regulation, and interleukin 8 serum concentrations, followed by a significant reduction in serum alanine aminotransferase levels on the first and second postoperative days. CONCLUSIONS These results demonstrate in humans that ischemic preconditioning reduces activation of PMNLs elicited by the Pringle maneuver. The down-regulation of potentially cytotoxic functions of PMNLs might be one of yet unknown important pathways that altogether mediate protection by ischemic preconditioning.Arch Surg. 2005;140:129-136--></description><subject>Biological and medical sciences</subject><subject>CD18 Antigens - blood</subject><subject>Female</subject><subject>General aspects</subject><subject>Hepatectomy</subject><subject>Humans</subject><subject>Injuries</subject><subject>Interleukin-8 - blood</subject><subject>Ischemic Preconditioning</subject><subject>Leukocytes</subject><subject>Liver</subject><subject>Liver Neoplasms - secondary</subject><subject>Liver Neoplasms - surgery</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neutrophil Activation - physiology</subject><subject>Neutrophils - physiology</subject><subject>Peroxidase - blood</subject><subject>Prospective Studies</subject><subject>Reperfusion Injury - physiopathology</subject><subject>Risk factors</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><issn>0004-0010</issn><issn>2168-6254</issn><issn>1538-3644</issn><issn>2168-6262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0c9rFDEUB_AgFrtW_wA9yCDobbYvP2Ym8aal2kJpi7TnkM287GaZSbbJzKH_vVl2teAlCcnnPR75EvKRwpIC0HOT7CbPab2kApZsSZl6RRa04bLmrRCvyQIARF0knJK3OW_LiUnF3pBT2nSMK8UXZPsDAzpvvRmqS-fQTrmKrrrOdoOjt9V9QhtD7ycfgw_ryofq3kweQ3GPoce0jvvrK9yZqRTH8flb9bDB6ncccN_oFucpxd3GD_kdOXFmyPj-uJ-Rx5-XDxdX9c3dr-uL7ze14aybarYCBraXhgtrQUDvEICbsqrOSMs6ycG0EuWK05VjgjYArcIGVddL4SQ_I18PfXcpPs2YJz36bHEYTMA4Z912QshOqAI__we3cU6hzKYZZ03TUMULYgdkU8w5odO75EeTnjUFvY9B_41Blxg00yWGUvTp2Hlejdi_lBz_vYAvR2CyNYNLJlifX1zbtAwoLe7DwZnR_HttQJbx-B_ryJqh</recordid><startdate>20050201</startdate><enddate>20050201</enddate><creator>Choukèr, Alexander</creator><creator>Martignoni, André</creator><creator>Schauer, Rolf</creator><creator>Dugas, Martin</creator><creator>Rau, Horst-Günther</creator><creator>Jauch, Karl-Walter</creator><creator>Peter, Klaus</creator><creator>Thiel, Manfred</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20050201</creationdate><title>Beneficial Effects of Ischemic Preconditioning in Patients Undergoing Hepatectomy: The Role of Neutrophils</title><author>Choukèr, Alexander ; Martignoni, André ; Schauer, Rolf ; Dugas, Martin ; Rau, Horst-Günther ; Jauch, Karl-Walter ; Peter, Klaus ; Thiel, Manfred</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a327t-2b020cd8a34cc040dfe003afe097a8c27830a68e8b31bf24150069e5e97d84f83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Biological and medical sciences</topic><topic>CD18 Antigens - blood</topic><topic>Female</topic><topic>General aspects</topic><topic>Hepatectomy</topic><topic>Humans</topic><topic>Injuries</topic><topic>Interleukin-8 - blood</topic><topic>Ischemic Preconditioning</topic><topic>Leukocytes</topic><topic>Liver</topic><topic>Liver Neoplasms - secondary</topic><topic>Liver Neoplasms - surgery</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neutrophil Activation - physiology</topic><topic>Neutrophils - physiology</topic><topic>Peroxidase - blood</topic><topic>Prospective Studies</topic><topic>Reperfusion Injury - physiopathology</topic><topic>Risk factors</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><toplevel>online_resources</toplevel><creatorcontrib>Choukèr, Alexander</creatorcontrib><creatorcontrib>Martignoni, André</creatorcontrib><creatorcontrib>Schauer, Rolf</creatorcontrib><creatorcontrib>Dugas, Martin</creatorcontrib><creatorcontrib>Rau, Horst-Günther</creatorcontrib><creatorcontrib>Jauch, Karl-Walter</creatorcontrib><creatorcontrib>Peter, Klaus</creatorcontrib><creatorcontrib>Thiel, Manfred</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of surgery (Chicago. 1960)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Choukèr, Alexander</au><au>Martignoni, André</au><au>Schauer, Rolf</au><au>Dugas, Martin</au><au>Rau, Horst-Günther</au><au>Jauch, Karl-Walter</au><au>Peter, Klaus</au><au>Thiel, Manfred</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Beneficial Effects of Ischemic Preconditioning in Patients Undergoing Hepatectomy: The Role of Neutrophils</atitle><jtitle>Archives of surgery (Chicago. 1960)</jtitle><addtitle>Arch Surg</addtitle><date>2005-02-01</date><risdate>2005</risdate><volume>140</volume><issue>2</issue><spage>129</spage><epage>136</epage><pages>129-136</pages><issn>0004-0010</issn><issn>2168-6254</issn><eissn>1538-3644</eissn><eissn>2168-6262</eissn><coden>ARSUAX</coden><abstract>HYPOTHESES Temporary vascular clampage (Pringle maneuver) during liver surgery can cause ischemia-reperfusion injury. In this process, activation of polymorphonuclear leukocytes (PMNLs) might play a major role. Thus, we investigated the effects of hepatic ischemic preconditioning on PMNL functions. DESIGN Prospective randomized study. Patients who underwent partial liver resection were randomly assigned to 3 groups: group 1 without Pringle maneuver; group 2 with Pringle maneuver, and group 3 with ischemic preconditioning using 10 minutes of ischemia and 10 minutes of reperfusion prior to Pringle maneuver for resection. SETTING University hospital, Munich, Germany. PATIENTS Seventy-five patients underwent hepatic surgery mostly owing to metastasis. MAIN OUTCOME MEASURES Perioperative factors for PMNL activation, inflammation, and postoperative hepatocellular integrity. RESULTS Ischemia-reperfusion of the human liver (mean ± SD time to perform the Pringle maneuver, 35.5 ± 2.6 minutes) caused (1) a decrease in the number of circulating PMNLs, (2) their intrahepatic sequestration, (3) their systemic activation, and (4) a significant correlation between the degree of their postischemic activation and the postoperative rise in liver enzyme serum levels. In parallel, cytokines with proinflammatory and chemotactic properties were released reaching the highest values when stimulation of PMNLs was most pronounced. When ischemic preconditioning preceded the Pringle maneuver, activation of PMNLs and cytokine plasma levels was reduced as evidenced by the attenuation of superoxide anion production, β2-integrin up-regulation, and interleukin 8 serum concentrations, followed by a significant reduction in serum alanine aminotransferase levels on the first and second postoperative days. CONCLUSIONS These results demonstrate in humans that ischemic preconditioning reduces activation of PMNLs elicited by the Pringle maneuver. The down-regulation of potentially cytotoxic functions of PMNLs might be one of yet unknown important pathways that altogether mediate protection by ischemic preconditioning.Arch Surg. 2005;140:129-136--></abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>15723993</pmid><doi>10.1001/archsurg.140.2.129</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0004-0010 |
| ispartof | Archives of surgery (Chicago. 1960), 2005-02, Vol.140 (2), p.129-136 |
| issn | 0004-0010 2168-6254 1538-3644 2168-6262 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_67448749 |
| source | MEDLINE; American Medical Association Journals; Alma/SFX Local Collection |
| subjects | Biological and medical sciences CD18 Antigens - blood Female General aspects Hepatectomy Humans Injuries Interleukin-8 - blood Ischemic Preconditioning Leukocytes Liver Liver Neoplasms - secondary Liver Neoplasms - surgery Liver, biliary tract, pancreas, portal circulation, spleen Male Medical sciences Middle Aged Neutrophil Activation - physiology Neutrophils - physiology Peroxidase - blood Prospective Studies Reperfusion Injury - physiopathology Risk factors Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system |
| title | Beneficial Effects of Ischemic Preconditioning in Patients Undergoing Hepatectomy: The Role of Neutrophils |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T10%3A10%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Beneficial%20Effects%20of%20Ischemic%20Preconditioning%20in%20Patients%20Undergoing%20Hepatectomy:%20The%20Role%20of%20Neutrophils&rft.jtitle=Archives%20of%20surgery%20(Chicago.%201960)&rft.au=Chouk%C3%A8r,%20Alexander&rft.date=2005-02-01&rft.volume=140&rft.issue=2&rft.spage=129&rft.epage=136&rft.pages=129-136&rft.issn=0004-0010&rft.eissn=1538-3644&rft.coden=ARSUAX&rft_id=info:doi/10.1001/archsurg.140.2.129&rft_dat=%3Cproquest_cross%3E793564791%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=232555193&rft_id=info:pmid/15723993&rft_ama_id=508325&rfr_iscdi=true |