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Protective effects elicited by levosimendan against liver ischemia/reperfusion injury in anesthetized rats
Author(s) -
Grossini Elena,
Pollesello Piero,
Bellofatto Kevin,
Sigaudo Lorenzo,
Farruggio Serena,
Origlia Veronica,
Mombello Cristina,
Mary David A. S. G.,
Valente Guido,
Vacca Giovanni
Publication year - 2014
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.23799
Subject(s) - levosimendan , medicine , reperfusion injury , tbars , oxidative stress , protein kinase b , pharmacology , enos , nitric oxide , glutathione , endocrinology , apoptosis , ischemia , nitric oxide synthase , lipid peroxidation , chemistry , biochemistry , heart failure , enzyme
As in other organs, oxidative stress–induced injury and cell death may result from free oxygen radical–dependent mechanisms and alterations in signal transduction pathways leading to apoptosis. Among the new suggested therapies for injuries caused by oxidative stress, the use of levosimendan has been reported to be quite promising. In the present study, we aimed to examine the protective effects of levosimendan against liver oxidative stress in anesthetized rats and to analyze the involvement of mitochondrial adenosine triphosphate–dependent potassium (mitoK ATP ) channels and nitric oxide (NO). In 50 anesthetized rats, liver ischemia/reperfusion (I/R) was performed via nontraumatic portal occlusion. In some animals, levosimendan was infused into the portal vein at the onset of reperfusion, whereas other rats received the vehicle only. Moreover, in some rats, levosimendan was given after the intraportal administration of l ‐ N ω‐nitro‐arginine methyl ester ( l ‐NAME) or 5‐hydroxydecanoate (5HD). The portal vein blood flow was measured, and blood samples were taken for the determination of transaminases, thiobarbituric acid reactive substances (TBARS), and reduced glutathione (GSH); liver biopsy samples were used for B cell lymphoma 2–associated X protein, caspase‐9, Akt, and endothelial nitric oxide synthase (eNOS) activation through western blotting. Also, caspase‐3 activity was measured. In rats, I/R caused an increase in apoptotic markers, transaminases, and TBARS and a decrease in GSH and Akt activation. Levosimendan administration was able to counteract oxidative damage and apoptosis in a dose‐dependent way and to increase GSH, Akt, and eNOS activation. All effects of levosimendan were abolished by pretreatment with l ‐NAME and 5HD. In conclusion, the results of the present study show that levosimendan can exert protection against ischemic liver damage through mechanisms related to NO production and mitoK ATP channel function. These data provide interesting perspectives into the use of levosimendan in hepatic surgery and transplantation. Liver Transpl 20:361‐375, 2014 . © 2013 AASLD.