The effect of starvation on liver regeneration in rats after partial hepatectomy

Decreased expression of peroxisome proliferator-activated receptor alpha and liver fatty acid binding protein after partial hepatectomy of rats and mice

BACKGROUND AIMS

Marked changes in metabolism, including liver steatosis and hypoglycemia, occur after partial hepatectomy. Peroxisome proliferator-activated receptor alpha (PPAR alpha) is a nuclear hormone receptor that is activated by fatty acids and involved in hepatic fatty acid metabolism and regeneration. Liver fatty acid binding protein (LFABP) is an abundant protein in liver cytosol whose expression is regulated by PPAR alpha. It is involved in fatty acid uptake and diffusion and in PPAR alpha signaling. The aim of this study was to investigate the expression of PPAR alpha and LFABP during liver regeneration.

METHODS

Male Sprague-Dawley rats and male C57 Bl/6 mice were subjected to 2/3 hepatectomy and LFABP and PPAR alpha mRNA and protein levels were measured at different time points after surgery. The effect of partial hepatectomy was followed during 48 h in rats and 72 h in mice.

RESULTS

PPAR alpha mRNA and protein levels were decreased 26 h after hepatectomy of rats. The LFABP mRNA and protein levels paralleled those of PPAR alpha and were also decreased 26 h after hepatectomy. In mice, the mRNA level was decreased after 36 and 72 h after hepatectomy. In this case, LFABP mRNA levels decreased more slowly after partial hepatectomy than in rats.

CONCLUSIONS

A marked decrease in PPAR alpha expression may be important for changed gene expression, e.g. LFABP, and metabolic changes, such as hypoglycemia, during liver regeneration.

Nutritional modulation of liver regeneration by carbohydrates, lipids, and amino acids: a review

The survival of patients after a life-threatening hepatic injury of varying etiology depends on the ability of the remaining hepatocytes to regenerate. Thus, the stimulation of hepatic regeneration can have tremendous therapeutic relevance. Experimental studies--performed mostly on a model of regenerating rat liver after partial hepatectomy--indicate that glucose administration inhibits, whereas infusion of a lipid emulsion can enhance, the rate of liver regeneration. However, the inhibitory effect of glucose on liver regeneration is not observed when glucose is administered together with other nutrients. The results further indicate that administration of a standard amino acid mixture without energy substrate has an inhibitory effect and that development of liver regeneration can be favorably influenced by branched-chain amino acids (valine, leucine, and isoleucine) and glutamine.

Contrasting effects of identical nutrients given parenterally or enterally after 70% hepatectomy: bacterial translocation

High mortality occurs in rats with 70% hepatectomy fed intravenous (IV) total parenteral nutrition (TPN; 13.9% glucose, 4.17% amino acids, 1.46% fat, electrolytes, trace minerals, and vitamins providing 216 kcal.kg-1.d-1) but not when the identical nutrients are given at the same rate enterally (gastrostomy). We hypothesized that a difference in bacterial translocation (BT) was a contributing factor to this phenomenon. Forty-five male Sprague-Dawley rats (300-360 g) were divided into five groups and underwent the following: control (no operation), sham (intraperitoneal [IP] pentobarbital anesthesia, central venous and gastrostomy catheters, laparotomy, sham hepatectomy), standard oral feeding (SOF), TPN (IV nutrients), and total enteral nutrition (TEN; gastrostomy). The SOF, TPN, and TEN groups had IP pentobarbital anesthesia, central venous and gastrostomy catheters, and 70% hepatectomy. Postoperatively, control and SOF (both catheters plugged) rats ate a commercial rat chow and drank tap water ad libitum pre- and postoperatively. The sham, TPN, and TEN groups were given the identical infusate composition as above, but the nutrient concentrations were cut in half (110 kcal/kg) and three-quarters (165 kcal/kg) on postoperative days 1 and 2, respectively. At the end of postoperative day 2, all rats were euthanized. BT to mesenteric lymph nodes (MLNs), liver, spleen, and lungs was significantly higher in the TPN rats compared with all other groups, except that BT to the MLNs was similar in the TPN and TEN groups. Bacteremia was found only in the TPN rats. BT in TPN rats with 70% hepatectomy was significantly greater 48 h after operation than in those fed the identical nutrients enterally at the same rate; this correlates with the previously reported significantly greater mortality in rats with 70% hepatectomy receiving TPN.

Effects of amino acid infusions on liver regeneration after partial hepatectomy in the rat

Administration of solutions high in branched-chain amino acids (BCAA) has been advocated in patients with severe liver failure; however, the effect of this treatment on the process of liver regeneration is still unclear. In the present study using rats we investigated the influence on liver regeneration of infusing solutions differing in amino acid content. After 75% hepatectomy, rats were infused via jugular vein with one of the following solutions: Sol A) 10% dextrose, Sol B) 10% dextrose + 3% amino acids (22% BCAA), Sol C) 10% dextrose + 3% amino acids (35% BCAA). Liver regeneration was estimated by measuring the incorporation of 3H-thymidine into DNA at five different time points after the operation. Peak regeneration occurred earlier in rats infused with the BCAA-enriched solution compared to animals infused with the standard amino acid solution or with dextrose alone. The increased incorporation of 3H-thymidine into DNA at 24 hr in rats infused with the BCAA-enriched solution was associated with elevated plasma levels of BCAA and decreased concentrations of tyrosine, phenylalanine, and methionine in comparison with the other two treatment groups. These results suggest that liver regeneration in rats can be accelerated by administering a parenteral nutrition solution tailored to normalize the deranged pattern of plasma amino acids associated with compromised liver function.

Somatomedin C/insulinlike growth factor I during liver regeneration in the rat

We measured immunoreactive somatomedin C/insulinlike growth factor I (Sm C/IGF I) in blood and tissues of rats following partial hepatectomy (PH) to determine a possible regulatory role for this growth factor in liver regeneration. From a mean value of 0.66 U/ml +/- 0.19 before PH, the serum Sm C/IGF I rose to 1.09 +/- 0.08 1 h after PH [P less than 0.001 vs. sham-hepatectomized (SH) values]. Concurrently there was a twofold rise in serum aspartate aminotransferase, suggesting that the rise in Sm C/IGF I may be the result of hepatocellular injury rather than a specific secretory event. In the subsequent 22 h, serum Sm C/IGF I of PH rats fell to 0.31 +/- 0.06 U/ml, compared with 0.73 +/- 0.03 in SH rats. During this time, liver concentrations of the peptide declined to 30% of basal, whereas lung and kidney fell to only approximately 60% of basal. As the Sm C/IGF I declined, hepatic DNA synthesis increased 10-fold in PH animals. Our results, therefore, do not support a mitogenic role for Sm C/IGF I in the regulation of liver regulation. Food consumption was markedly depressed in the 22 h after PH (20.8 +/- 2.6 vs. 4.33 +/- 2.9 g/day; P less than 0.001). PH and pair-fed SH rats had serum Sm C/IGF I concentrations that were indistinguishable (0.31 +/- 0.06 vs. 0.35 +/- 0.11 U/ml), although liver tissue concentrations were lower in PH rats (0.04 +/- 0.01 U/g vs. 0.07 +/- 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Hepatocyte and Kupffer cell functions during liver regeneration in streptozotocin-diabetic rats

The insulinoprivic influence of acute severe streptozotocin diabetes on liver regeneration in rats was evaluated by determining liver weights as well as hepatocyte and Kupffer cell functional capacities. Functional capacities were assessed by bromosulfophthalein uptake for hepatocytes and carbon phagocytosis for Kupffer cells. Evaluation immediately after partial hepatectomy revealed a 66% reduction of liver mass, a 63% decrease in hepatocyte bromosulfophthalein removal, and a 65% decline in Kupffer cell carbon phagocytosis. Per cent recovery at 48-hr posthepatectomy was considerably greater for carbon phagocytosis than for bromosulfophthalein removal by regenerating livers. This apparent difference in functional recovery was likely due in part to enhanced non-Kupffer cell carbon phagocytosis. No significant differences of the three regeneration indices were noted for untreated streptozotocin-diabetic rats compared to nondiabetic animals. However, insulin administration to fasted streptozotocin diabetics significantly stimulated liver regeneration above that of untreated fasted rats and almost equivalent to that of pair-fed animals. Fasted rats had in general slower liver regeneration than pair-fed animals as expected. Furthermore, insulin administration to fasted nondiabetic rats after partial hepatectomy caused severe hypoglycemia and resulted in a further depression of liver regeneration.

Hyperinsulinemia and hyperglucagonemia in fasted rats during liver regeneration

The two pancreatic hormones, insulin and glucagon, have been implicated as hepatotrophic factors for the regenerating liver after partial hepatectomy. Similar to previous studies, hyperglucagonemia and hypoinsulinemia were noted following major liver resection of initially well-fed rats. In contrast to well-fed animals, rats fasted for 24 h prior to surgery to deplete hepatic glycogen and establish low basal insulin levels developed both portal venous hyperglucagonemia and hyperinsulinemia after 67% hepatectomy. Elevation of basal portal venous levels of the two hormones suggested enhanced pancreatic secretion of insulin and glucagon in response to acute liver injury in fasted animals. Because polypeptide hormones must bind to specific hepatic cell membrane receptors to exert their hepatotrophic influences, basal portal-systemic venous differences of insulin and glucagon and glucose-elicited portal-hepatic venous insulin differences were evaluated. The evidence implies that hepatic extraction and, therefore, cell membrane receptor binding of both insulin and glucagon by regenerating livers were enhanced even though portal venous levels of the two hormones were elevated.