Hemorheological and Microcirculatory Factors in Liver Ischemia-Reperfusion Injury-An Update on Pathophysiology, Molecular Mechanisms and Protective Strategies.
Hemorheological and Microcirculatory Factors in Liver Ischemia-Reperfusion Injury-An Update on Pathophysiology, Molecular Mechanisms and Protective Strategies.
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肝脏缺血再灌注损伤中的血液流变学和微循环因素——病理生理学、分子机制和保护策略的最新进展。
DOI：
10.3390/ijms22041864
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发表时间：
2021-02-13
影响因子：
5.6
通讯作者：
Tolba RH
中科院分区：
文献类型：
--
作者：
Nemeth N;Peto K;Magyar Z;Klarik Z;Varga G;Oltean M;Mantas A;Czigany Z;Tolba RH
肝缺血再灌注损伤（IRI）是一种多因素现象，与不良临床结果相关。 IRI 相关组织损伤的特征是根据实验模型或临床环境的不同时间顺序事件。尽管三十多年来，IRI 研究一直是科学界关注的焦点，多年来发表活动显着且持续增加，并且引入了大量的药物和手术治疗尝试，但这些策略中没有多少策略进入日常临床实践。此外，肝脏IRI的发病机制尚未完全阐明。在IRI的复杂过程中，血液的流动特性不容忽视。血液流变因素在决定组织灌注和协调机械剪切应力依赖性内皮功能方面发挥着重要作用。抗氧化剂和抗炎剂、缺血调理方案、动态器官保存技术可以改善再灌注后肝血流的流变特性并靶向内皮细胞，从而对肝脏IRI发挥有效的保护作用。在这篇综述文章中，我们在 IRI 和保肝方法的背景下，对肝循环的微循环、流变学和分子病理生理学方面进行了全面概述。
Hepatic ischemia-reperfusion injury (IRI) is a multifactorial phenomenon which has been associated with adverse clinical outcomes. IRI related tissue damage is characterized by various chronological events depending on the experimental model or clinical setting. Despite the fact that IRI research has been in the spotlight of scientific interest for over three decades with a significant and continuous increase in publication activity over the years and the large number of pharmacological and surgical therapeutic attempts introduced, not many of these strategies have made their way into everyday clinical practice. Furthermore, the pathomechanism of hepatic IRI has not been fully elucidated yet. In the complex process of the IRI, flow properties of blood are not neglectable. Hemorheological factors play an important role in determining tissue perfusion and orchestrating mechanical shear stress-dependent endothelial functions. Antioxidant and anti-inflammatory agents, ischemic conditioning protocols, dynamic organ preservation techniques may improve rheological properties of the post-reperfusion hepatic blood flow and target endothelial cells, exerting a potent protection against hepatic IRI. In this review paper we give a comprehensive overview of microcirculatory, rheological and molecular–pathophysiological aspects of hepatic circulation in the context of IRI and hepatoprotective approaches.
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