Lidocaïne test for easier and less time consuming assessment of liver function in several hepatic injury models

Hepatology International - Tập 5 - Trang 941-948 - 2011
Dorra Ben Said1,2, Ridha Ben Ali1,2, Henda Ferchichi1,2, Issam Salouage1,2, Lobna Ouanes3,2, Emna Gaïes1,2, Sameh Trabelsi1,2, Emna Kooli1, Nadia Kourda4, Jaouida Abdelmoula5, Mohamed Lakhal1,2, Anis Klouz1,2
1Service de Pharmacologie Clinique, Centre National de Pharmacovigilance, Tunis, Tunisia
2Unité d’expérimentation animale, Faculté de Médecine de Tunis, Tunis, Tunisia
3Laboratoire de Physiologie, Faculté de Médecine de Tunis, Tunis, Tunisia
4Service Anatomo-pathologie, Hopital Charles Nicolle, Tunis, Tunisia
5Service de Biochimie, Hopital Charles Nicolle, Tunis, Tunisia

Tóm tắt

In this study, we developed an ex vivo functional assay to assess liver metabolic capacity adapted from the lidocaïne test in rats. Animals used were subjected to different models of liver injury: hypothermic ischemia (H/I, n = 8), ischemia-reperfusion (I/R, n = 8) and CCl4 induced liver cirrhosis (n = 11), and compared with sham operated rats (n = 5). Livers were then extracted and a fragment of whole tissue was incubated with lidocaïne for 15, 30, 60, 120, 240, 360, and 720 min at which both lidocaïne and its major metabolite monoethylglycinexylidide (MEGX) were measured by high performance liquid chromatography (HPLC). A histological study and biochemical assays (transaminase levels) were also performed to further evaluate and confirm our data. Pharmacokinetic profile of lidocaïne metabolism in sham-operated animals revealed that the maximum concentration of MEGX is achieved at 120 min. Both lidocaïne metabolism and MEGX formation levels were significantly altered in all three models of hepatic injury. The extent of hepatic damage was confirmed by increased levels of transaminase levels and alteration of hepatocyte’s structure with areas of necrosis. Our method provides reliable and reproducible results using only a small portion of liver which allows for a fast and easy assessment of liver metabolic capacity. Moreover, our method presents an alternative to the in vivo technique and seems more feasible in a clinical setting.

Tài liệu tham khảo

Zimmermann H, Reichen J. Assessment of the Liver Function in the Surgical Patient. In Fong Y. Blugmart LH, editors. Surgical of the Liver and Biliary Tract. London: Saunders;2000. 35–64 Barstow L, Small RE. Liver function assessment by drug metabolism. Pharmacotherapy 1990;10(4):280–288 Sakka SG. Assessing liver function. Curr Opin Crit Care 2007;13(2):207–214 Huang LS, Lee SD, Deng JF, Wu JC, Lu RH, Lin YF, Wang YJ, Lo KJ. Measuring lidocaine metabolite—monoethylglycinexylidide as a quantitative index of hepatic function in adults with chronic hepatitis and cirrhosis. J Hepathol 1993;19(1):140–147 Van Thiel DH, Hassanein T. Assessment of liver function: the current situation. J Okla State Med Assoc 1995;88(1):11–16 Oellerich M, Armstrong VW. The MEGX test: a tool for the real-time assessment of hepatic function. Ther Drug Monit 2001;23(2):81–92. Caesar J SS, Chiandussi L, Guevara L, Sherlock S. The use of indocyanine green in the measurement of hepatic blood flow and as a test of hepatic function. Clin Sci 1961;21:43–57 Tygstrup N. Determination of the hepatic elimination capacity (Lm) of galactose by single injection. Scand J Clin Lab Invest Suppl 1966;18:118–125 Desmond PV, et al. Impaired elimination of caffeine in cirrhosis. Dig Dis Sci 1980;25(3):193–197 Oellerich M, et al. Monoethylglycinexylidide formation kinetics: a novel approach to assessment of liver function. J Clin Chem Clin Biochem 1987;25(12):845–853 Fan ST, et al. Evaluation of indocyanine green retention and aminopyrine breath tests in patients with malignant biliary obstruction. Aust N Z J Surg 1994;64(11):759–762 Gao L, Ramzan I, Baker AB. Potential use of pharmacological markers to quantitatively assess liver function during liver transplantation surgery. Anaesth Intensive Care 2000;28(4):375–385 Bargetzi MJ, et al. Lidocaine metabolism in human liver microsomes by cytochrome P450IIIA4. Clin Pharmacol Ther 1989;46(5):521–527 Imaoka SEK, Oda Y, Asada A, Fujimori M, Shimada T, Fujita S, Guengerich FP, Funae Y. Lidocaine metabolism by human cytochrome P-450s purified from hepatic microsomes: comparison of those with rat hepatic cytochrome P-450s. J Pharmacol Exp Ther 1990;255(3):1385–1391 Fairchild R, et al. Prognostic value of the monoethylglycinexylidide liver function test in assessing donor liver suitability. Arch Surg 1996;131(10):1099–1102 Kupcová V. Importance of determination of monoethylglycinexylidide (MEGX)—as a liver function test in hepatology and liver transplantation. Bratisl Lek Listy 1999;100(1):49–53 Tanaka E, Inomata S, Yasuhara H. The clinical importance of conventional and quantitative liver function tests in liver transplantation. J Clin Pharm Ther 2000;25(6):411–419 Testa R, et al. Lidocaine elimination and monoethylglycinexylidide formation in patients with chronic hepatitis or cirrhosis. Hepatogastroenterology 1998;45(19):154–159 Ercolani GGG, Callivà R, Pierangeli F, Cescon M, Cavallari A, Mazziotti A. The lidocaine (MEGX) test as an index of hepatic function: its clinical usefulness in liver surgery. Surgery 2000;27(4):464–471 Blumer J, Strong JM, Atkinson AJ Jr. The convulsant potency of lidocaine and its N-dealkylated metabolites. J Pharmacol Exp Ther 1973;186(1):31–36 Rademaker AW, et al. Character of adverse effects of prophylactic lidocaine in the coronary care unit. Clin Pharmacol Ther 1986;40(1):71–80 Kaneko H, Otsuka Y, Katagiri M, Maeda T, Tsuchiya M, Tamura A, Ishii T, Takagi S, Shiba T. Reassessment of monoethylglycinexylidide as preoperative liver function test in a rat model of liver cirrhosis and man. Clin Exp Med 2001;1(1):19–26 Oda Y, et al. Metabolism of lidocaine by purified rat liver microsomal cytochrome P-450 isozymes. Biochem Pharmacol 1989;38(24):4439–4444 Alexson SE, et al. Involvement of liver carboxylesterases in the in vitro metabolism of lidocaine. Drug Metab Dispos 2002;30(6):643–647 Nauta RJ, Uribe M, Walsh DB, Miller D, Butterfield A. Description of a chronic in vivo model for the study of warm hepatic ischemia-reperfusion injury. Surg Res Commun 1989;6:241–246 Ishak K, Baptista A, Bianchi L, Callea F, De Groote J, Gudat F, Denk H, Desmet V, Korb G, MacSween RN, et al. Histological grading and staging of chronic hepatitis. J Hepatol 1995;22(6):696–699 Olinga P, et al. Value of the in vitro or in vivo monoethylglycinexylidide test for predicting liver graft function. Transplantation 1997;64(1):60–65 Wang JS, et al. Involvement of CYP1A2 and CYP3A4 in lidocaine N-deethylation and 3-hydroxylation in humans. Drug Metab Dispos 2000;28(8):959–965 Orlando R, Piccoli P, De Martin S, Padrini R, Floreani M, Palatini P. Cytochrome P450 1A2 is a major determinant of lidocaine metabolism in vivo: effects of liver function. Clin Pharmacol Ther 2004;75(1):80–88 Imamura H, Sano K, Sugawara Y, Koduko N, Makuuchi M. Assessment of hepatic reserve for indication of hepatic resection: decision tree incorporating indocyanine green test. J Hepatobiliary Pancreat Surg 2005;12(1):16–22 Oda Y, Kariya N, Nakamoto T, Nishi S, Asada A, Fujimori M. The monoethylglycinexylidide test is more useful for evaluating liver function than indocyanine green test: case of a patient with remarkably decreased indocyanine green half-life. Ther Drug Monit 1995;17(2):207–210 Testa R, Caglieris S, Risso D, Arzani L, Campo N, Alvarez S, Giannini E, Lantieri PB, Celle G. Monoethylglycinexylidide formation measurement as a hepatic function test to assess severity of chronic liver disease. Am J Gastroenterol 1997;92(12):2268–2273 Bhise SB, Dias RJ. Monoethylglycinexylidide (MEGX) as a liver function test in cirrhosis. Indian J Gastroenterol 2007;26(4):167–169 Dresing K, Armstrong VW, Leip CL, Streit F, Burchardi H, Stürmer KM, Oellerich M. Real-time assessment of hepatic function is related to clinical outcome in critically ill patients after polytrauma. Clin Biochem 2007;40:1194–2200 Limdi JK, Hyde GM. Evaluation of abnormal liver function tests. Postgrad Med J 2003;79(932):307–312 Yamamoto S, et al. Genistein suppresses cellular injury following hepatic ischemia/reperfusion. Transplant Proc 1996;28(2):1111–1115 Borghi-Scoazec G, et al. Apoptosis after ischemia-reperfusion in human liver allografts. Liver Transpl Surg 1997;3(4):407–415 Kohli V, et al. Endothelial cell and hepatocyte deaths occur by apoptosis after ischemia-reperfusion injury in the rat liver. Transplantation 1999;67(8):1099–1105 Duval M, et al. Implication of mitochondrial dysfunction and cell death in cold preservation–warm reperfusion-induced hepatocyte injury. Can J Physiol Pharmacol 2006;84(5):547–554 Gawronska-Szklarz B, et al. Lidocaine metabolism in isolated perfused liver from streptozotocin-induced diabetic rats. J Pharm Pharmacol 2006;58(8):1073–1077 Wang ZR, Zhang RM, Yan LN, Wang WT, Jia QB. Evaluation of the liver reserve using lidocaine test on experimental liver injuries in rats. Zhonghua Gan Zang Bing Za Zhi 2006;14(6):445–448