The effect of liver cytosol on hepatic regeneration and tumor growth
L MakowkaRudolf E. FalkJudith A. FalkJulita A. Teodorczyk-InjeyanDavid VenturiLorne RotsteinWilliam FalkBernard LangerLaurence M. BlendisM. James Phillips
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This report further evaluates the concept that the interaction of factors that originate within the liver can contribute, regulate or even initiate the actual development of hepatic regeneration after liver cell necrosis or partial hepatectomy. The effect of liver cytosol (100,000 g supernatant), both from intact adult rat liver (NLC) and from adult rat liver remnants that had been regenerating for 24 hours after 70% partial hepatectomy (PH) in posthepatectomy liver regeneration in the rat was studied. The specificity of the growth-controlling properties in liver cytosol was determined using tumor cells. The intraperitoneal administration of NLC after PH resulted in approximately 70-80% inhibition of the peak 3H-DNA specific activity seen in controls at 18 and 24 hours post-PH, with a significant increase in DNA synthesis at 31-40 hours post-PH. The intraperitoneal administration of RLC after PH, augmented the hepatic regenerative response normally produced. Autoradiographic determination of hepatic nuclear labeling confirmed the inhibitory and stimulatory properties of NLC and RLC respectively. Syngeneic NLC or RLC at six and 24 days after subcutaneous tumor inoculation resulted in significant inhibition of tumor growth for both a methylcholanthrene-induced bladder carcinoma (FBCa) and an HTC-hepatoma. The retardation of FBCa growth could be enhanced by administering NLC or RLC every three or seven days. Syngeneic and xenogeneic liver cytosol resulted in dose-dependent inhibition of P815 mastocytoma cell proliferation in vitro. It is apparent from these studies that both stimulatory and inhibitory factors can be extracted from liver tissue that not only influence liver cell regeneration, but also affect tumor growth. Further isolation and characterization of these factors may lead to an understanding of more fundamental problems such as the control of normal and malignant cell growth.Keywords:
Liver Regeneration
Liver cell
Intraperitoneal injection
Liver cancer is one of the most lethal malignant tumors in the world, and surgical resection is the main treatment for liver cancer. Liver failure due to insufficient residual liver volume is a fatal complication after hepatectomy. How to effectively increase the residual liver volume after hepatectomy and improve the safety of hepatectomy has always been a problem to be solved in liver surgery. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) effectively reduces the occurrence of liver failure due to insufficient residual liver volume after hepatectomy, thereby increasing the probability of radical resection by inducing rapid proliferation of residual liver tissue. However, the molecular mechanism of residual liver tissue regeneration after primary ALPPS (combined liver partition and portal vein ligation) remains unclear. Here, we found that lots of circular RNAs (circRNAs) are upregulated after ALPPS in pig liver cells; then, we identified the orthologous circRNA in humans and pigs to detect their function in liver regeneration. The results showed that loss of circ-0067724 and circ-0016213 could suppress liver cell proliferation. Together, these findings suggest that circ-0067724 and circ-0016213 play an important role in liver cell proliferation, and this may help us to find new strategies to promote liver regeneration.
Liver Regeneration
Liver Cancer
Liver function
Liver cell
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OBJECTIVE: To describes the responsible molecular pathways and the clinical importance of post-hepatectomy liver regeneration and investigates how the regenerative process promote metastatic tumour recurrence.METHODS: A total of 365 English papers were searched with liver regeneration,liver metastases,hepatectomy and tumor recurrence as search terms in Medline and PubMed databases from Jan,2007 to Mar,2012.Fifty papers were selected according to the standards as follows: 1)post-hepatectomy liver regeneration;2) the recurrence of liver metastasis;3) the relationship between post-hepatectomy live regeneration and the recurrence of liver metastasis.RESULTS: The regenerative process that occurs postoperatively is a complex phenomenon.Some molecules such as hepatocyte growth factor,tumour growth factor beta and matrix metalloproteinases promote tumour growth and may contribute to the recurrence of liver metastasis.The reactivation of dormant micrometastases or the intrahepatic accumulation of circulating malignant cells have been suggested as the responsible mechanism,although not clearly described.CONCLUSIONS: Post-hepatectomy liver regeneration can promote the recurrence of liver metastasis.Despite the considerable progress of the last decade,multiple queries remain to be clarified concerning liver regeneration.
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Liver regeneration is a physiological mechanism that leads to restoration of the hepatic parenchyma following hepatectomy or toxic injury. As a two-third hepatectomy is the usual model to analyse this phenomenon, few studies have compared liver regeneration after minor vs major hepatectomy. We have used a quantitative RT-PCR technique to study the hepatic transcription of the TGF-alpha gene in rats submitted to 30% or 80% hepatectomy and we have correlated this transcription with the regenerative response assessed by flow cytometry and Ki-67 expression. The level of TGF-alpha expression and the regenerative response were different, according to the volume of liver removed, and were statistically correlated (r = 0.679, p = 0.002). TGF-alpha expression and phase S peaked at day 2 vs 6 in the 80% vs 30% hepatectomized rat groups, respectively. Ki-67 expression occurred at 2 h post-hepatectomy in the two groups of rats and was observed until day 14 mainly in the 80% hepatectomy group. Our results indicate that TGF-alpha expression in regenerating liver is strongly correlated with hepatocyte mitosis, that a delayed regenerative response occurs following 30% hepatectomy and that the course of regeneration differs between minor vs major hepatectomy.
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Enhanced effect on rat hepatocyte regeneration through activation of the reticuloendothelial system (RES) was investigated. RES was activated using by OK-432 and the phagocytic activity (K-value) increased 2-fold over control rats 24 hours after intraperitoneal injection of OK-432. In OK-432 treated rats, the amount of cyclic AMP in the regenerating liver also increased 1.5-fold higher than in control rats 14 hours after hepatectomy. After 70% partial hepatectomy, liver DNA synthesis in OK-432 treated rats increased 2 to 5-fold higher than in control rats. There was a good correlation between the K-value before hepatectomy and DNA synthesis 24 hours after hepatectomy (r = 0.96). Therefore the RES is one of the most important regulatory factors in liver regeneration. Augmentation of RES before hepatectomy may prevent hepatic failure after resection in liver diseases.
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AIMTo highlight the potential mechanisms of regeneration in the Associating Liver Partition and Portal vein ligation for Stage hepatectomy models (clinical and experimental) that could unlock the myth behind the extraordinary capability of the liver for regeneration, which would help in designing new therapeutic options for the regenerative drive in difficult setup, such as chronic liver diseases.Associating Liver Partition and Portal vein ligation for Stage hepatectomy has been recently advocated to induce rapid future liver remnant hypertrophy that significantly shortens the time for the second stage hepatectomy.The introduction of Associating Liver Partition and Portal vein ligation for Stage hepatectomy in the surgical armamentarium of therapeutic tools for liver surgeons represented a real breakthrough in the history of liver surgery. METHODSA comprehensive literature review of Associating Liver Partition and Portal vein ligation for Stage hepatectomy and its utility in liver regeneration is performed. RESULTS Liver regeneration after Associating Liver Partition and Portal vein ligation for Stage hepatectomy is a
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Abstract Background Surgical treatment for perihilar cholangiocarcinoma frequently involves hepatectomy and extrahepatic bile duct resection with a choledochojejunostomy (CJ). Cholangitis owing to bilioenteric anastomosis is a common complication. The impact of CJ or regurgitating cholangitis on the liver regeneration process after major hepatectomy is unknown. Methods Rats underwent 70 per cent hepatectomy (Hx group) or hepatectomy with CJ (Hx + CJ group). The intrahepatic inflammatory response, hepatic regeneration rate, and expression of regeneration-associated genes in the liver and blood were compared between these two groups. Results Levels of hepatobiliary markers in the blood were significantly higher 4 and 7 days after operation in the Hx + CJ group than the Hx group. Intrahepatic expression of inflammation-associated genes, such as interleukin 6 and tumour necrosis factor α, was also significantly higher in the Hx + CJ group on days 4 and 7. A progressive periportal inflammatory response was identified in the Hx + CJ group by histological examination. The hepatic regeneration rate was significantly lower in the Hx + CJ group than in the Hx group on day 2 (mean(s.d.) 14·2(6·3) versus 21·4(2·6) per cent; P = 0·013) and day 4 (32·4(5·3) versus 41·3(4·4) per cent; P = 0·004). Gene expression levels of hepatic regeneration-promoting factors such as hepatocyte growth factor were significantly lower in the Hx + CJ group than the Hx group on day 1. Conclusion CJ perturbs early liver regeneration after hepatectomy. An excessive inflammatory response in the liver and suppression of liver regeneration-associated factors may play a role. Surgical relevancePatients with perihilar cholangiocarcinoma may need major hepatectomy with extrahepatic bile duct resection and choledochojejunostomy. This carries a substantial risk of postoperative complications including liver failure.A rat model of partial hepatectomy with choledochojejunostomy was established. The molecular mechanisms underlying liver regeneration, and perturbation of this process by duodenobiliary reflux via the choledochojejunostomy, are described.The results give insight into the pathophysiological events following major hepatectomy with extrahepatic bile duct resection and choledochojejunostomy. This may help to develop a treatment strategy to reduce postoperative liver failure.
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Although the risk of post-hepatectomy liver failure is severe and it affects the prognosis of patients, hepatectomy is the first choice for hepatocellular carcinoma patients. At present, the mechanism of liver regeneration and post-hepatectomy liver failure is unclear. In this paper, we reviewed the liver regeneration for three stages: initiation, proliferation and termination, and also reviewed the mechanism of post-hepatectomy liver failure.
Key words:
Carcinoma, hepatocyte; Hepatectomy; Liver failure; Liver regeneration
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Impaired liver function attenuates liver regeneration and hypertrophy after portal vein embolization
To clarify the clinical factors associated with liver regeneration after major hepatectomy and the hypertrophic rate after portal vein embolization (PVE).A total of 63 patients who underwent major hepatectomy and 13 patients who underwent PVE in a tertiary care hospital between January 2012 and August 2015 were included in the analysis. We calculated the remnant liver volume following hepatectomy using contrast-enhanced computed tomography (CT) performed before and approximately 3-6 mo after hepatectomy. Furthermore, we calculated the liver volume using CT performed 2-4 wk after PVE. Preoperative patient characteristics and laboratory data were analyzed to identify factors affecting postoperative liver regeneration or hypertrophy rate following PVE.The remnant liver volume/total liver volume ratio negatively correlated with the liver regeneration rate after hepatectomy (ρ = -0.850, P < 0.001). The regeneration rate was significantly lower in patients with an indocyanine green retention rate at 15 min (ICG-R15) of ≥ 20% in the right hepatectomy group but not in the left hepatectomy group. The hypertrophic rate after PVE positively correlated with the regeneration rate after hepatectomy (ρ = 0.648, P = 0.017). In addition, the hypertrophic rate after PVE was significantly lower in patients with an ICG-R15 ≥ 20% and a serum total bilirubin ≥ 1.5 mg/dL.The regeneration rate after major hepatectomy correlated with hypertrophic rate after PVE. Both of them were attenuated in the presence of impaired liver function.
Liver Regeneration
Liver function
Indocyanine Green
Portal vein embolization
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The Authors investigated the effect produced by endotoxin upon regenerating rat liver. The animals were divided into three groups after hepatectomy. The first group of animals received physiological solution, the second group received 0.5 mg of E. coli endotoxin soon after hepatectomy and the last group received the same quantity of endotoxin 22 hours after hepatectomy. To estimate hepatic regeneration we used: percentage of liver regeneration and mitotic activity. It was noted that the percentage of hepatic regeneration and mitotic activity were higher in the two groups of treated animals than in the control group. Mitotic activity and hepatic regeneration were higher in the animals treated 22 hours after hepatectomy than in the animls of second group. These results lead us to conclude that E. coli O 127 endotoxin is mitogenic also in vivo.
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Mitotic index
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Background The mechanisms and kinetics of hepatic growth have continuously been investigated. This study concerns liver regeneration in animal and patients who underwent partial hepatectomy evaluated by the hepatic extraction fraction (HEF) calculated through radioisotopic methods. Methods Thirty normal Wistar rats were submitted to an 85% hepatectomy, and 95 patients with primary and secondary liver tumours were included. In animal study, the liver regeneration kinetics was assessed by HEF using 99mTc-mebrofenin, the ratio liver/bodyweight and by using bromodeoxyuridine deoxyribonucleic acid incorporation. In patient study, the liver regeneration was evaluated by calculation of HEF before surgery, 5 and 30 days after hepatectomy. Results In animal, we verified a positive correlation between HEF kinetics and liver/bodyweight ratio or hepatocyte proliferation evaluated by bromodeoxyuridine deoxyribonucleic acid staining after 85% hepatectomy. In the clinical arm, no statistical differences of the HEF before hepatectomy, 5 and 30 days after hepatectomy, were observed. Conclusions Our results support the view that human liver regeneration commences early, is fast, non-anatomical and functionally complete 5 days after hepatectomy. The fast functional liver regeneration may have a high clinical impact particularly concerning the post-operative oncological therapeutic approaches.
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