Original Article
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 28, 2014; 20(48): 18249-18259
Published online Dec 28, 2014. doi: 10.3748/wjg.v20.i48.18249
Delayed ethanol elimination and enhanced susceptibility to ethanol-induced hepatosteatosis after liver resection
Xu Liu, Ayako Hakucho, Jinyao Liu, Tatsuya Fujimiya
Xu Liu, Ayako Hakucho, Jinyao Liu, Tatsuya Fujimiya, Department of Legal Medicine, Yamaguchi University Graduate School of Medicine, Yamaguchi 755-8505, Japan
Author contributions: Liu X and Liu J designed the research; Liu X, Hakucho A and Liu J performed the research; Liu X, Liu J, Hakucho A and Fujimiya T analyzed and interpreted the data; Liu X and Liu J wrote the paper.
Supported by Japan Society for the Promotion of Science’s Grants-in-Aid for Scientific Research, No. 22590635
Correspondence to: Jinyao Liu, MD, PhD, Department of Legal Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. czhliu@yamaguchi-u.ac.jp
Telephone: +81-836-222234 Fax: +81-836-222232
Received: June 4, 2014
Revised: July 4, 2014
Accepted: July 29, 2014
Published online: December 28, 2014
Abstract

AIM: To investigate ethanol-induced hepatic steatosis after liver resection and the mechanisms behind it.

METHODS: First, the preliminary examination was performed on 6 sham-operated (Sham) and 30 partial hepatectomy (PH) male Wistar rats (8-wk-old) to evaluate the recovery of the liver weight and liver function after liver resection. PH rats were sacrificed at the indicated time points (4, 8, and 12 h; 1, 3, and 7 d) after PH. Second, the time point for the beginning of the chronic ethanol exposure (1 wk after sham- or PH-operation) was determined based on the results of the preliminary examination. Finally, pair-feeding was performed with a controlled diet or with a 5-g/dL ethanol liquid diet for 28 d in another 35 age-matched male Wistar rats with a one-week recovery after undergoing a sham- (n = 15) or PH-operation (n = 20) to evaluate the ethanol-induced liver injury after liver resection. Hepatic steatosis, liver function, fatty acid synthase (Fas) gene expression level, the expression of lipid metabolism-associated enzyme regulator genes [sterol regulatory element binding protein (Srebp)-1 and peroxisome proliferator-activated receptor (Ppar)-α], the mediators that alter lipid metabolism [plasminogen activator (Pai)-1 gene expression level and tumor necrosis factor (Tnf)-α production], and hepatic class-1 alcohol dehydrogenase (Adh1)-associated ethanol elimination were investigated in the 4 groups based on histological, immunohistochemical, biochemical, Western blotting, reverse transcriptase chain reaction, and blood ethanol concentration analyses. The relevant gene expression levels, liver weight, and liver function were assessed before and 1 wk after surgery to determine the subject’s recovery from the liver resection using the rats that had been subjected to the preliminary examination.

RESULTS: In the PH rats, ethanol induced marked hepatic steatosis with impaired liver functioning, as evidenced by the accumulation of fatty droplets within the hepatocytes, the higher increases in their hepatic triglyceride and blood alanine aminotransferase and blood aspartate aminotransferase levels after the 28-d pair-feeding period. The Sham-ethanol rats, not the PH-ethanol rats, demonstrated the up-regulation of Srebp-1 and the down-regulation of Ppar-α mRNA expression levels after the 28-d pair-feeding period. The 28-d ethanol administration induced the up-regulation of Pai-1 gene expression level and an overproduction of TNF-α in the Sham and the PH rats; however, the effect was more significant in the PH rats. The PH-ethanol rats (n = 4) showed higher residual blood ethanol concentrations than did the Sham-ethanol rats (n = 6) after a 5-h fast (0.66 ± 0.4 mg/mL vs 0.2 ± 0.1 mg/mL, P < 0.05); these effects manifested without up-regulation of Adh1 gene expression, which was present in the Sham-ethanol group after the 28-d pair-feeding period. One week after the liver resection, the liver weight, function, the gene expression levels of Fas, Srebp-1, Ppar-α, Pai-1 and Tnf-α recovered; however, the Adh1 gene expression did not recover in rats.

CONCLUSION: Desensitization to post-hepatectomy ethanol treatment and slow recovery from PH in Adh1 gene expression enhanced the susceptibility to ethanol-induced hepatic steatosis after PH in rats.

Keywords: Ethanol, Hepatic class-1 alcohol dehydrogenase, Ethanol elimination, Hepatic steatosis, Liver function, Liver resection

Core tip: Pair-feeding was performed with control or ethanol liquid diet for 28 d in sham-operated (Sham) and partial hepatectomy (PH) rats. In PH rats, ethanol induced hepatic steatosis with liver dysfunction and higher residual blood ethanol concentrations without up-regulation of hepatic class-1 alcohol dehydrogenase (Adh1) gene expression, which was present in the Sham-ethanol rats. One week after PH, liver weight, function, and lipid metabolism-related gene expressions recovered; but Adh1 gene expression did not. Desensitization to post-hepatectomy ethanol treatment and the slow recovery of Adh1 expression from PH enhanced the susceptibility to ethanol-induced hepatic steatosis in the rats post PH.