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©The Author(s) 2023.
World J Gastrointest Surg. Sep 27, 2023; 15(9): 1858-1870
Published online Sep 27, 2023. doi: 10.4240/wjgs.v15.i9.1858
Published online Sep 27, 2023. doi: 10.4240/wjgs.v15.i9.1858
Table 1 Hepatic ischemia-reperfusion injury mechanisms
Primary mechanisms | Subsequent reactions | Final outcomes |
Metabolism disorders | Systemic inflammatory response syndrome, multiple organ dysfunction syndrome | |
Anaerobic glycolysis | Mitochondria dysfunction | |
ATP production | Cellular immunity | |
Lactic acid and toxic acidic metabolites | Cell injury | |
Reactive oxygen species | Programmed cell death and apoptosis | |
Intracellular calcium overload | Microcirculatory dysfunction | |
Microcirculatory system disorders | ||
Vasoconstriction | ||
Obstruction | Microcirculatory dysfunction | |
Apoptosis of sinusoidal endothelial cells | Vascular permeability | |
Expression of adhesion molecules | Endothelial cells oedema | |
Ischemic injury | ||
Neutrophil accumulation | ||
Immune system disorders | ||
Kupffer cells activation | ||
Neutrophils activation | ||
Production of pro- and anti-inflammatory cytokines | Excessive inflammatory process | |
Accumulation of circulating lymphocytes, platelets and monocytes | Anti-inflammatory response | |
Recruitment of CD4+ T lymphocytes | ||
Gene expression | ||
Imbalance in mRNAs expression | Cell damage | |
Programmed cell death | Necrosis, apoptosis, necroptosis, pyroptosis, ferroptosis |
Table 2 Treprostinil mechanisms of action
Effect | Mechanism of action | Cellular response |
Vessel tone | cAMP increased. Endothelin 1 decreased. Potassium decreased | Vasodilation. Improvement of microcirculation dysfunction |
Antiproliferative | PPARs increased. cAMP increased. VEGF-A increased | Angiogenesis. Regulation of vascular homeostasis |
Antithrombotic | Thromboxane A2 decreased. PDGF decreased | Inhibition of platelets aggregation. Platelets adherence decreased |
Anti-inflammatory | P38 and JNK cascades decreased. IL-1, IL-6, TNF-α decreased. IL-10 increased. Reactive oxygen species decreased. TLR 9 decreased | Attenuation of inflammatory cascade. Apoptosis rate increased |
Energy balance | Pgc-1α mRNA expression decreased. Cytochrome c decreased. Caspase 3 activation decreased | ATP production increased. Mitochondrial biogenesis increased |
- Citation: Mouratidou C, Pavlidis ET, Katsanos G, Kotoulas SC, Mouloudi E, Tsoulfas G, Galanis IN, Pavlidis TE. Hepatic ischemia-reperfusion syndrome and its effect on the cardiovascular system: The role of treprostinil, a synthetic prostacyclin analog. World J Gastrointest Surg 2023; 15(9): 1858-1870
- URL: https://www.wjgnet.com/1948-9366/full/v15/i9/1858.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v15.i9.1858