Role of angiotensin-1 receptor blockade in cirrhotic liver resection

Liver Int. 2011 May;31(5):642-55. doi: 10.1111/j.1478-3231.2011.02493.x. Epub 2011 Mar 9.

Abstract

Background: The regeneration capacity of cirrhotic livers might be affected by angiotensin-1 (AT1) receptors located on hepatic stellate cells (HSC). The effect of AT1 receptor blockade on microcirculation, fibrosis and liver regeneration was investigated.

Materials and methods: In 112 Lewis rats, cirrhosis was induced by repetitive intraperitoneal injections of CCl(4) . Six hours, 3, 7 and 14 days after partial hepatectomy or sham operation, rats were sacrificed for analysis. Animals were treated with either vehicle or 5 mg/kg body weight losartan pre-operatively and once daily after surgery by gavage. Microcirculation and portal vein flow were investigated at 6 h. The degree of cirrhosis was assessed by Azan Heidenhein staining, activation of HSC by desmin staining, apoptosis by ssDNA detection and liver regeneration by Ki-67 staining. Changes in expression of various genes important for liver regeneration and fibrosis were analysed at 6 h and 3 days. Haemodynamic parameters and liver enzymes were monitored.

Results: Losartan treatment increased sinusoidal diameter, sinusoidal blood flow and portal vein flow after partial hepatectomy (P<0.05), but not after sham operation. AT1 receptor blockade resulted in increased apoptosis early after resection. HSC activation was reduced and after 7 days, a significantly lower degree of cirrhosis in resected animals was observed. Losartan increased the proliferation of hepatocytes at late time-points and of non-parenchymal cells early after partial hepatectomy (P<0.05). Tumour necrosis factor (TNF)-α was significantly upregulated at 6 h and stem cell growth factor (SCF) was downregulated at 3 days (P<0.05).

Conclusion: Losartan increased hepatic blood flow, reduced HSC activation and liver fibrosis, but interfered with hepatocyte proliferation after partial hepatectomy in cirrhotic livers.

MeSH terms

  • Analysis of Variance
  • Angiotensin II Type 1 Receptor Blockers / pharmacology*
  • Animals
  • Apoptosis / drug effects
  • Biomarkers / blood
  • Carbon Tetrachloride
  • Cell Proliferation / drug effects
  • Gene Expression Regulation
  • Hepatectomy*
  • Hepatic Stellate Cells / drug effects
  • Hepatic Stellate Cells / metabolism
  • Hepatic Stellate Cells / pathology
  • Hepatocytes / drug effects
  • Hepatocytes / metabolism
  • Hepatocytes / pathology
  • Liver / blood supply
  • Liver / drug effects*
  • Liver / metabolism
  • Liver / surgery
  • Liver Circulation / drug effects
  • Liver Cirrhosis, Experimental / chemically induced
  • Liver Cirrhosis, Experimental / drug therapy*
  • Liver Cirrhosis, Experimental / genetics
  • Liver Cirrhosis, Experimental / metabolism
  • Liver Cirrhosis, Experimental / physiopathology
  • Liver Cirrhosis, Experimental / surgery
  • Liver Regeneration / drug effects*
  • Losartan / pharmacology*
  • Male
  • Microcirculation / drug effects
  • Rats
  • Rats, Inbred Lew
  • Receptor, Angiotensin, Type 1 / drug effects*
  • Receptor, Angiotensin, Type 1 / metabolism
  • Time Factors

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Biomarkers
  • Receptor, Angiotensin, Type 1
  • Carbon Tetrachloride
  • Losartan