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Objective To explore the technological and therapeutic value of endoscope for removal of hepatobiliary necrosis after liver transplantation.Methods Data of 36 patients with suspected hepatobiliary diseases,who underwent choledochoscopy or duodenoscopy to remove necrosis after liver transplantation,were reviewed.Liver function before and after the treatment were compared.Results Hepatobiliary necrosis located in common bile duct (n =6),intrahepatic bile duct (hilar bile duct included) (n =24) and intraand extra-hepatic duct (n =6).The total success rate was 72.2％ (26/36).Full clearance of bile duct necrosis was accomplished in 16 patients,partial clearance in 15 patients and the necrosis could not be removed in 5 others.The serum bilirubin and transaminase decreased significantly,compared with those before endoscopic treatment (P ＜ 0.05).No serious complications or death related to endoscopy occurred during the treatment.After 6-84 month follow-up,in 17 survivals,3 patients underwent a second liver transplantation with good prognosis.All the survivals had a life of good quality with no placed drainage tube except for one with drainage tube for four years with unstable serum bilirubin.Nineteen patients died from biliary tract related complications or other diseases during the long-term follow-up,among which eleven patients survived beyond four years.Conclusion Endoscopy for hepatobiliary necrosis removal,a minimally invasive method,is effective and safe.
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Matrix metalloproteinases (MMPs) are a family of zinc-dependent endopeptidases, which as a group can degrade essentially all extracellular matrix components. The proteolytic property of the MMPs is important during wound healing to remove debris and facilitate cell migration. Targeting towards the decreased MMPs activities is a new treatment strategy for healing chronic wounds. Salvia miltiorrhiza is a popular Chinese herb that could promote chronic ulcers healing for topical use. Salvianolic acid B (Sal B) is the most abundant bioactive component in Salvia miltiorrhiza. The research was designed to explore the inhibitory effects of Sal B on MMP-1, MMP-2 and MMP-9 activities.
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AIM: To evaluate the effects of acetyl-11-keto-beta-boswellic acid (AKBA, a main active component from frankincense, one of the traditional Chinese herb for healing wounds) on the activities of matrix metalloproteinase(MMP)-1, MMP-2 and MMP-9.METHODS: Pure human interstitial collagenase (MMP-1) or gelatinase A (MMP-2) was activated by p-aminophenylmercuric acetate (APMA), and was incubated with AKBA for 1 h. The activities of the enzymes were observed by quenched fluorescent substrate. The lysates of rat polymorphonuclear neutrophils [PMNs, rich in gelatinase B (MMP-9)] was incubated with AKBA for 1 h, and activity of MMP-9 was tested by gelatin zymography. Three cell models: activated human dermal fibroblasts by TNF-α, activated THP-1 cells by PMA and fibroblasts-THP-1 co-culture system were established. AKBA was cultured with these cell models for 24 h. The levels of MMP-1, MMP-2 and MMP-9 in the cell culture supernatants were tested by ELISA and activities of MMP-2 and MMP-9 were tested by gelatin zymography assays.RESULTS: AKBA dose-dependently inhibited the activities of human MMP-1 and MMP-2 at the range of 0.1-0.8 mmol/L, with 50% inhibitory concentration (IC50) of 0.18 mmol /L and 0.27 mmol/L, respectively. In the range of 0.05-0.85 mmol/L, AKBA inhibited the MMP-9 activity (P<0.01). Although AKBA promoted fibroblasts to secrete MMP-2, the production of MMP-9 by THP-1 was inhibited. In the cell co-culture system, the inhibitory effects on MMP-1, MMP-2 and MMP-9 productions were also observed.CONCLUSION: AKBA, as a bioactive component of frankincense, has an inhibitory effect on MMPs production and activities, indicating the possible mechanism for healing chronic wounds by frankincense.