Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Metalloproteinase expression after desflurane preconditioning in hepatectomies: A randomized clinical trial
Eleni Koraki, Ioannis Mantzoros, Christos Chatzakis, Anna Gkiouliava, Angeliki Cheva, Athina Lavrentieva, Freideriki Sifaki, Helena Argiriadou, Isaak Kesisoglou, Konstantinos Galanos-Demiris, Stefanos Bitsianis, Konstantinos Tsalis
Eleni Koraki, Anna Gkiouliava, Freideriki Sifaki, Department of Anaesthesiology, “G Papanikolaou” General Hospital, Thessaloniki 57010, Greece
Ioannis Mantzoros, Christos Chatzakis, Konstantinos Galanos-Demiris, Stefanos Bitsianis, Konstantinos Tsalis, Fourth Department of Surgery, Medical School, Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
Angeliki Cheva, Department of Pathology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
Athina Lavrentieva, First Department of Intensive Care Unit, "G Papanikolaou" General Hospital, Thessaloniki 57010, Greece
Helena Argiriadou, Department of Anaesthesiology and Intensive Care Unit, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki 54636, Greece
Isaak Kesisoglou, Third Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki 54636, Greece
Author contributions: Koraki E, Tsalis K, Kesisoglou I and Mantzoros I designed the research; Chatzakis C, Gkiouliava A, Cheva A, Lavrentieva A, Sifaki F and Argiriadou H analyzed and interpreted the data; Koraki E, Mantzoros I, Chatzakis C, Gkiouliava A, Galanos-Demiris K and Bitsianis S wrote the paper.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the General Hospital of Thessaloniki, Georgios Papanikolaou, No. 763/26.06.2016.
Clinical trial registration statement: The study is registered at clinicaltrials.gov. The registration identification number is NCT03848780.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Anna Gkiouliava, MD, Doctor, Research Fellow, Department of Anaesthesiology, “G Papanikolaou” General Hospital, Exochi, Thessaloniki, Greece, Thessaloniki 57010, Greece. annagkou@auth.gr
Received: July 21, 2020
Peer-review started: July 21, 2020
First decision: September 14, 2020
Revised: September 26, 2020
Accepted: October 12, 2020
Article in press: October 12, 2020
Published online: November 27, 2020
ARTICLE HIGHLIGHTS
Research background
The primary cause of morbidity and mortality in hepatectomies is ischemia-reperfusion injury (IRI).
Research motivation
Understanding the pathophysiology accompanying IRI can offer novel therapeutic targets. Metalloproteinases have been identified as regulators of IRI, and ischemic preconditioning has shown promising results in attenuating IRI.
Research objectives
Our aim was to investigate the effect of ischemic preconditioning with desflurane, primarily on metalloproteinases and their inhibitors, and on the indices of liver and coagulation function.
Research methods
Patients undergoing liver resection were randomized to receive pharmacologic preconditioning with desflurane or not. Blood samples and liver tissue specimens were collected for laboratory analysis.
Research results
Desflurane preconditioning resulted in an attenuated inflammatory response compared to the control group.
Research conclusions
Desflurane preconditioning may be effective in ameliorating IRI in hepatectomies, as indicated by the reduction in the expression of matrix metalloproteinases observed in the intervention group. Large scale studies are needed to verify our findings, with data on long-term clinical outcomes.
Research perspectives
Metalloproteinases may represent a useful target for managing IRI after hepatectomy.
