Propofol post-conditioning alleviates hepatic ischaemia reperfusion injury via BRG1-mediated Nrf2/HO-1 transcriptional activation in human and mice

J Cell Mol Med. 2017 Dec;21(12):3693-3704. doi: 10.1111/jcmm.13279. Epub 2017 Jul 27.

Abstract

To explore the effects of propofol post-conditioning (PPC) on hepatic ischaemia/reperfusion injury (HIRI) and the potential mechanisms that might be involved in the interaction of Brahma-related gene1(BRG1) and Nuclear-related factor 2(Nrf2). Patients were randomized into PPC(n = 16) and non-PPC(NPC)( n = 21) groups. Propofol(2 mg/kg) was infused within 10 min. of the onset of liver reperfusion during liver transplantation in the PPC group. Liver function tests, as well as Brg1, Nrf2, Heme oxygenase-1(HO-1) and NADPH:quinone oxidoreductase1(NQO1) expression levels were evaluated. CMV-Brg1 mice were designed to investigate the role of Brg1 overexpression during HIRI. Brg1 and Nrf2 siRNA were used to examine the relationship between Brg1 and Nrf2/HO-1 pathways in propofol-mediated effects in a human hepatocyte(L02) hypoxia/reoxygenation(H/R) model. In patients, PPC attenuated both donor liver pathological and function injury, and reducing oxidative stress markers, compared to the NPC group, 24 hrs after surgery. PPC increased liver Brg1, Nrf2, HO-1 and NQO1 expression. In mice, PPC reduced HIRI by decreasing liver oxidative stress and activating Nrf2/HO-1 pathway, accompanied by up-regulation of BRG1 expression. BRG1 overexpression activated Nrf2/HO-1 transcription in CMV-BRG1 mice during HIRI. In vitro, PPC significantly elevated expression of Nrf2, HO-1 and NQO1, resulting in a reduction of cell DCFH-DA and 8-isoprostane levels and decreased lactate dehydrogenase levels, leading to an overall increase in cell viability. Moreover, the protective effects of propofol were partially abrogated in Nrf2-knock-down or BRG1-knock-down hepatocytes. Nrf2-knock-down drastically reduced protein expression of HO-1 and NQO1, while Brg1-knock-down decreased HO-1 expression. Propofol post-conditioning alleviates HIRI through BRG1-mediated Nrf2/HO-1 transcriptional activation.

Keywords: Brahma-related gene 1; ischaemia reperfusion injury; liver transplantation; nuclear-related factor 2; post-conditioning; propofol; reactive oxygen species.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Animals
  • Antioxidants / therapeutic use*
  • Cell Line
  • DNA Helicases / genetics*
  • DNA Helicases / metabolism
  • Drug Repositioning
  • Female
  • Gene Expression Regulation
  • Heme Oxygenase-1 / genetics*
  • Heme Oxygenase-1 / metabolism
  • Hepatitis / metabolism
  • Hepatitis / pathology
  • Hepatitis / surgery
  • Hepatocytes / drug effects
  • Hepatocytes / metabolism
  • Hepatocytes / pathology
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Liver / metabolism
  • Liver / pathology
  • Liver / surgery
  • Liver Neoplasms / metabolism
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery
  • Liver Transplantation / methods*
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Middle Aged
  • NF-E2-Related Factor 2 / genetics*
  • NF-E2-Related Factor 2 / metabolism
  • Nuclear Proteins / genetics*
  • Nuclear Proteins / metabolism
  • Oxidative Stress / drug effects
  • Propofol / therapeutic use*
  • Prospective Studies
  • Reperfusion Injury / genetics
  • Reperfusion Injury / metabolism
  • Reperfusion Injury / pathology
  • Reperfusion Injury / prevention & control*
  • Transcription Factors / genetics*
  • Transcription Factors / metabolism

Substances

  • Antioxidants
  • Hypnotics and Sedatives
  • NF-E2-Related Factor 2
  • NFE2L2 protein, human
  • Nuclear Proteins
  • Transcription Factors
  • HMOX1 protein, human
  • Heme Oxygenase-1
  • SMARCA4 protein, human
  • DNA Helicases
  • Propofol