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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Hepatol
2017 ; 67
(6
): 1232-1242
Nephropedia Template TP
Nakamura K
; Zhang M
; Kageyama S
; Ke B
; Fujii T
; Sosa RA
; Reed EF
; Datta N
; Zarrinpar A
; Busuttil RW
; Araujo JA
; Kupiec-Weglinski JW
J Hepatol
2017[Dec]; 67
(6
): 1232-1242
PMID28842295
show ga
BACKGROUND & AIMS: Hepatic ischemia-reperfusion injury (IRI), characterized by
exogenous antigen-independent local inflammation and hepatocellular death,
represents a risk factor for acute and chronic rejection in liver
transplantation. We aimed to investigate the molecular communication involved in
the mechanism of liver IRI. METHODS: We analyzed human liver transplants, primary
murine macrophage cell cultures and IR-stressed livers in myeloid-specific heme
oxygenase-1 (HO-1) gene mutant mice, for anti-inflammatory and cytoprotective
functions of macrophage-specific HO-1/SIRT1 (sirtuin 1)/p53 (tumor suppressor
protein) signaling. RESULTS: Decreased HO-1 expression in human post-reperfusion
liver transplant biopsies correlated with a deterioration in hepatocellular
function (serum ALT; p<0.05) and inferior patient survival (p<0.05). In the low
HO-1 liver transplant biopsy group, SIRT1/Arf (alternative reading
frame)/p53/MDM2 (murine double minute 2) expression levels decreased (p<0.05)
while cleaved caspase 3 and frequency of TUNEL+cells simultaneously increased
(p<0.05). Immunofluorescence showed macrophages were the principal source of HO-1
in human and mouse IR-stressed livers. In vitro macrophage cultures revealed that
HO-1 induction positively regulated SIRT1 signaling, whereas SIRT1-induced Arf
inhibited ubiquitinating activity of MDM2 against p53, which in turn attenuated
macrophage activation. In a murine model of hepatic warm IRI, myeloid-specific
HO-1 deletion lacked SIRT1/p53, exacerbated liver inflammation and
IR-hepatocellular death, whereas adjunctive SIRT1 activation restored p53
signaling and rescued livers from IR-damage. CONCLUSION: This bench-to-bedside
study identifies a new class of macrophages activated via the HO-1-SIRT1-p53
signaling axis in the mechanism of hepatic sterile inflammation. This mechanism
could be a target for novel therapeutic strategies in liver transplant
recipients. LAY SUMMARY: Post-transplant low macrophage HO-1 expression in human
liver transplants correlates with reduced hepatocellular function and survival.
HO-1 regulates macrophage activation via the SIRT1-p53 signaling network and
regulates hepatocellular death in liver ischemia-reperfusion injury. Thus
targeting this pathway in liver transplant recipients could be of therapeutic
benefit.