RESUMO
Rat inferior caval vein (ICV) ligation (up to the right ovarian vein (ROV)) commonly represents a recapitulation of Virchow: with ligation leading to vessel injury, stasis, thrombosis and hemodynamic changes. We revealed that BPC 157's therapy collectively attenuated or counteracted all these events and the full syndrome. METHODS: We applied BPC 157 (10⯵g, 10â¯ng/kg) as an early regimen or as a delayed therapy. Assessment includes gross assessment by microcamera; microscopy, venography, bleeding, blood pressure, ECG, thermography, MDA and NO-level in plasma and ICV, and gene expression. RESULTS: Direct vein injury, thrombosis, thrombocytopenia, prolonged bleeding were all counteracted. Also, rapid presentation of collaterals and redistribution of otherwise trapped blood volume (bypassing through the left ovarian vein (LOV) and other veins), with venous hypertension, arterial hypotension and tachycardia counteraction were shown. BPC 157-rats presented raised plasma NO-values, but normal MDA-values; in ICV tissue reverted low NO-values and counteracted increased MDA-levels. Altered expression of EGR, NOS, SRF, VEGFR and KRAS in ICV, ROV and LOV revealed increased or decreased levels, while some genes continuously remained unchanged. CONCLUSION: As a new insight, BPC 157 application largely attenuated or even completely eliminated all consequences of ICV ligation in rats.
Assuntos
Fibrinolíticos/farmacologia , Fragmentos de Peptídeos/farmacologia , Proteínas/farmacologia , Veia Cava Inferior/cirurgia , Trombose Venosa/prevenção & controle , Animais , Biomarcadores/sangue , Circulação Colateral/efeitos dos fármacos , Modelos Animais de Doenças , Eletrocardiografia , Feminino , Regulação da Expressão Gênica , Hemodinâmica/efeitos dos fármacos , Hemorragia/prevenção & controle , Ligadura , Masculino , Malondialdeído/sangue , Óxido Nítrico/sangue , Flebografia , Ratos Wistar , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Termografia , Trombocitopenia/sangue , Trombocitopenia/prevenção & controle , Fatores de Tempo , Veia Cava Inferior/metabolismo , Veia Cava Inferior/patologia , Veia Cava Inferior/fisiopatologia , Trombose Venosa/sangue , Trombose Venosa/genética , Trombose Venosa/fisiopatologiaRESUMO
A surgical resection is the only curative method in the therapy of colorectal carcinoma and liver metastases. Along with the development of interventional radiological techniques the indications for surgery widen. The number of metastases and patients age should not present a contraindication for surgical resection. However, there are still some doubts concerns what to resect first in cases of synchronous colorectal carcinoma and liver metastases and how to ensure the proper remnant liver volume in order to avoid postoperative liver failure and achieve the best results. Through this review the surgical therapy of colorectal carcinoma and liver metastases was revised in the setting of "liver-first" approach and the problem of ensuring of remnant liver volume.