Efficacy of preconditioning with N-acetylcysteine against reperfusion injury after prolonged cold ischaemia in rats liver in which glutathione had been reduced by buthionine sulphoximine

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Abstract
Objective: To investigate the ability of N‐acetylcysteine (NAC) to prevent cold ischaemic‐reperfusion injury and improve hepatic integrity in a glutathione‐depleted condition. Design: Open laboratory study. Setting: University hospitals, Japan and France. Materials: 40 male Wistar rats. Interventions: To produce a glutathione‐depleted liver, buthionine sulphoximine (BSO) was injected intraperitoneally 2 hours before either NAC or 5% dextrose was infused 15 minutes before the liver was harvested. We used an isolated perfused rat liver model that had undergone prolonged hypothermic ischaemia, cold‐storage for 48 hours and reperfusion for 120 minutes. Main outcome measures: Concentrations of hepatic enzymes released into samples of perfusate, concentration of adenosine triphosphate in liver tissue, concentrations of reduced and oxidized glutathione in perfusate, and bile production. Results: The concentrations of the hepatocellular enzymes and oxidised glutathione in the perfusate samples were significantly reduced in the NAC group compared with the 5% dextrose group. Bile production improved significantly in the NAC group compared with the 5% dextrose group. The concentration of reduced glutathione in liver tissue was not increased by NAC. Conclusion: In a glutathione‐depleted liver NAC prevented hepatic injury and improved liver integrity after a cold ischaemic‐reperfusion injury, by acting not as a substrate for glutathione synthesis but as a direct free radical scavenger. Copyright © 1998 Taylor and Francis Ltd.
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