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A Src family kinase inhibitor improves survival in experimental acute liver failure associated with elevated cerebral and circulating vascular endothelial growth factor levels
Author(s) -
Aspinall Richard J.,
Weis Sara M.,
Barnes Leo,
LutuFuga Kimberly,
Bylund David J.,
Pockros Paul J.,
Cheresh David A.
Publication year - 2011
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02554.x
Subject(s) - vascular endothelial growth factor , hepatic encephalopathy , medicine , vascular endothelial growth factor a , encephalopathy , endocrinology , proto oncogene tyrosine protein kinase src , cerebral edema , pathology , cancer research , vegf receptors , cirrhosis , receptor
Background and aims: Acute liver failure (ALF) is frequently complicated by cerebral oedema, systemic inflammation and multiorgan dysfunction. Vascular endothelial growth factor (VEGF) may stimulate liver regeneration but it can also be pro‐inflammatory, activating endothelial cells and increasing permeability, actions mediated through Src kinase signalling. We therefore examined whether a Src inhibitor could have therapeutic potential in ALF. Methods: Murine ALF was induced with azoxymethane. Liver pathology was graded by a blinded examiner and apoptosis quantified by immunohistochemistry. Cerebral VEGF expression was imaged using VEGF‐green fluorescent protein transgenic mice. Circulating and macrophage‐secreted VEGF levels were measured. Experimental animals received a Src inhibitor or vehicle controls. Results: VEGF was undetectable in normal plasma but reached a mean of 835 pg/ml at grade III encephalopathy ( P <0.001). Ammonia, lipopolysaccharide and interferon‐gamma acted synergistically to enhance VEGF secretion by macrophages. Production of VEGF by cerebral cortical astrocytes increased with disease progression. Late treatment with inhibitors of Src or VEGF did not improve liver histology, encephalopathy or survival. However, early use of a Src kinase inhibitor significantly reduced hepatic injury, delayed encephalopathy and allowed 25% of mice to survive an otherwise lethal insult. Conclusion: Systemic and cerebral VEGF levels are significantly elevated during experimental ALF and may be exacerbated by hyperammonemia and macrophage activation. Early use of a Src inhibitor reduced hepatocellular injury and enabled survival, indicating such agents may have some promise in the treatment of ALF.