The 'nothing dehydrogenase' reaction and the detection of ischaemic damage.

The 'nothing dehyrogenase' reaction is defined as the reduction of tetrazolium salts in media lacking specific substrates for dehydrogenases. In this investigation, the kinetics of the 'nothing dehydrogenase' reaction were studied in cryostat sections of rat heart and liver with the use of various polyvinyl alcohol-containing incubation media. Formazan production was measured at 585 nm with a cytophotometer. The 'nothing dehydrogenase' reaction was substantially lower in the heart than in the liver which was due to low levels of endogenous lactate and the absence of proteins containing thiol groups, such as albumin, in the heart. In vitro ischaemia resulted in a reduced 'nothing dehydrogenase' reaction due to loss of NAD+, possibly as a consequence of its breakdown by glycohydrolase activity. One hour reperfusion following one hour ischaemia caused a decreased 'nothing dehydrogenase' reaction in certain areas of the liver. This reduction was a result of leakage of lactate dehydrogenase and thiol-containing molecules. It appeared at the ultrastructural level that parenchymal and endothelial cells were heavily damaged in the areas containing a low 'nothing dehydrogenase' activity. In conclusion, early ischaemic damage in liver can be detected with the 'nothing dehydrogenase' reaction.

A quantitative histochemical study of 5'-nucleotidase activity in rat liver after ischaemia.

The lead salt method of Wachstein and Meisel15 has been applied using incubation media containing polyvinyl alcohol for the localization and quantification of 5'-nucleotidase (E.C.3.1.3.5) activity in cryostat sections from rat liver after ischaemia in vitro and ischaemia in vivo followed by different periods of re-perfusion. 5'-Nucleotidase activity at the bile canaliculi, especially in the pericentral areas, had already decreased after 60 min of ischaemia in vitro, although the total activity as measured densitometrically was not changed. After 120-240 min of ischaemia, a significant decrease of the total 5'-nucleotidase activity was found. At that stage, signs of irreversible cell damage were recognized. Short periods of re-perfusion (1 h) after ischaemia in vivo induced a decreased bile canalicular 5'-nucleotidase activity throughout the entire liver, but a restoration after longer periods of re-perfusion was observed (5, 24, and 48 h). Necrotic areas recognized by a decreased lactate dehydrogenase activity after all periods of re-perfusion showed decreased total 5'-nucleotidase activities. A correlation was observed between the decrease in bile canalicular 5'-nucleotidase activity and the disappearance of microvilli of the bile canaliculi. It is concluded that a decrease in the bile canalicular 5'-nucleotidase activity can be used as a very sensitive marker for ischaemic liver cell damage. Assessment of the irreversibility of the cell injury has to be determined using additional parameters such as a decreased lactate dehydrogenase activity.

Ultrastructural changes in the rat liver during Euro-Collins storage, compared with hypothermic in vitro ischemia.

The ultrastructural alterations in liver tissue induced by in vitro ischemia at 4 degrees C under conditions commonly used for transplantation (Euro-Collins perfused and stored liver tissue) have been compared with changes due to hypothermic in vitro ischemia in non-perfused liver. It was found that the process of cell deterioration in non-perfused liver occurred very slowly; signs of irreversible damage appeared in sinusoidal lining cells before hepatocytes (after 24 and 96 h, respectively). Liver perfused with, and stored in Euro-Collins solution showed acceleration of the ischemical damage in both types of cell (irreversible damage to sinusoidal lining cells after 12 h and to hepatocytes after 52 h), compared with non-perfused liver. These findings indicate that the safe period for storage of rat liver in Euro-Collins before damage to the microcirculatory system is less than 12 h. It might also be questioned whether Euro-Collins treatment is the optimal procedure for tissue preservation before liver transplantation.

Death of osteocytes. Electron microscopy after in vitro ischaemia.

Ischaemia kills osteocytes, but opinions differ as to how long they can survive. These differences are due to the varying methods of inducing ischaemia, and to the different criteria for diagnosing cell death. Using rabbit bone and a technique of in vitro ischaemia at 37 degrees C, we have shown by electron microscopy that, after up to two hours, the changes which occur are probably reversible; after four hours, the cells were irreversibly damaged. This difference could not be detected by light microscopy. After 24 hours of ischaemia, most lacunae were empty or contained only osteocyte debris. We conclude that osteocytes suffer irreversible damage after in vitro ischaemia of about two hours, which is much the same response as that of most other mammalian cells.

A histochemical study of changes in mitochondrial enzyme activities of rat liver after ischemia in vitro.

Changes in the activity of three mitochondrial enzymes in rat liver after in vitro ischemia have been determined by enzyme histochemical methods. The changes were correlated with the appearance in the electron microscope of flocculent densities in the mitochondria indicative of irreversible cell injury. The flocculent densities were observed in rat liver after about 2 h of ischemia in vitro at 37 degrees C. At the same time the activity of glutamate dehydrogenase, localized in the mitochondrial matrix, started to decrease. However, the activities of succinate dehydrogenase localized in the inner membrane of mitochondria, as well as monoamine oxidase of the mitochondrial outer membrane did not change at that stage. It is concluded from the results of this study and those of others that flocculent densities are formed by denaturation of proteins of the mitochondrial matrix in which glutamate dehydrogenase takes part. It should be considered more as a sign than as the cause of cell death.

Quantitative analysis of mitochondrial flocculent densities in rat hepatocytes during normothermic and hypothermic ischemia in vitro.

The development of flocculent densities in mitochondria as a sign of irreversible cell injury in rat hepatocytes has been studied by quantitative electron microscopy during in vitro ischemia under both normothermic (37 degrees C) and hypothermic (4 degrees C) conditions. At 37 degrees C flocculent densities first appear after 1 h ischemia; at this stage they are small in diameter (170 nm) and occur in only 8% of mitochondria. After 1.5 hour ischemia, flocculent densities increase in diameter (207 nm) and are seen in 37% of mitochondria. Death of the majority of hepatocytes seems to occur between 1.5 and 2 h ischemia since at this stage the percentage of mitochondria containing flocculent densities reaches a maximum (48%). However, flocculent densities continue to increase in size (to 337 nm diam.) up to between 2 and 4 h ischemia (the prenecrotic phase). In contrast, at 4 degrees C signs of ischemic damage to hepatocytes are considerably delayed. Flocculent densities of comparable size and frequency to those observed after 1 h ischemia at 37 degrees C are not seen till as late as 4 days at 4 degrees C. At the latter temperature, only after 7 days ischemia a substantial rise (to about 25%) in the proportion of mitochondria containing flocculent densities occurs. A further slow increase in size and in the percentage of mitochondria containing densities occurs up to 14 days ischemia at 4 degrees C. It is concluded that the development of flocculent densities may be used only as a parameter of irreversible damage in cells with a sufficient number of mitochondria, such as hepatocytes, under normothermic conditions. With ischemia at 4 degrees C, possibly due to a different protein denaturation pattern, the development of flocculent densities is of much less value as an indication of irreversible cell damage and cannot, therefore, be considered as a reliable sign of cellular damage in organs stored at 4 degrees C for transplantation purposes.

Electron microscopic study of the localization of ferric iron in chorionic epithelium of the sheep placenta.

The ferrocyanide method has been used to study, at the ultrastructural level, the maternal-fetal iron transfer in the chorionic epithelium of the haemophagous regions of the sheep placenta during the third trimester of gestation (at the 126th and the 145th day of gestation). No significant differences could be found in the distribution pattern of the ferrocyanide precipitate product with the chorionic epithelium in both stages of gestation. The presence of ferrocyanide reaction product in lysosomal structures, involved in the breakdown of maternal erythrocytes ingested by chorionic epithelial cells, confirmed that trivalent iron is liberated from digested haemoglobin. Ferric iron was also detected in the epithelial cytoplasmic matrix especially in the vicinity of erythrolysosomal structures, between the lateral surfaces of neighbouring epithelial cells, along the complex of interdigitating folds and the basal plasma membrane. Only on one occasion was the presence of ferric iron observed in the basal lamina, between the junctions of the endothelial cells and in their cytoplasmic matrix. The results of the present study indicate that after the ferric iron is liberated from maternal haemoglobin its ionic state, subcellular distribution and, probably, its route of transport seem to be similar to that in the guinea-pig placenta which is characterized by the uptake of iron from maternal transferrin.

Biochemical and ultrastructural changes in rat liver plasma membranes after temporary ischemia.

In this study we have attempted to correlate reversible and irreversible cell damage induced by in vivo or in vitro ischemia with characteristics of the plasma membranes of liver parenchymal cells, as detected biochemically and ultrastructurally. The effects of in vivo or in vitro ischemia appeared to be similar. It was virtually impossible to isolate a substantial membrane fraction from ischemic livers, probably because of changes in the physical properties of the membranes by ischemia. The isolated membranes of ischemic liver cells show ultrastructural changes including the occurrence of many vesicular profiles and alterations in junctional complexes expressed by extended and smudged electron densities along the lateral surfaces. The microvilli of the bile canaliculi disappeared after only 15 min ischemia and cytoplasmic densities associated with junctional complexes also appeared extended and smudged. These changes correspond with the alterations observed in ischemic isolated membranes. After 30 min in vivo ischemia the activity of 5'-mononucleotidase used as a marker enzyme for plasma membranes, decreased by 75%, whereas the activity of thymidine 5'-phosphodiesterase was reduced only slightly. The changes in these enzyme activities were more prominent after in vitro ischemia than after in vivo. The morphological and biochemical changes observed in rat hepatocyte plasma membrane during the early stage of injury have no value in predicting the occurrence of necrosis in a later phase of the process since profound changes occur in plasma membrane properties after even short periods of ischemia (i.e. during the reversible stage).

The value of enzyme leakage for the prediction of necrosis in liver ischemia.

Following the clamping of the afferent vessels of the left lateral and median lobes in rat liver, a considerable part of these lobes show signs of necrosis 24 h after 90 min of ischemia, whereas no necrotic areas can be detected after 30 min interruption of the blood flow. The purpose of this study was to examine the value of an analysis of the leakage of enzymes from the liver parenchyma in the early phase after restoration of the blood flow after ischemia for a prediction of the occurrence of necrosis. Leakage of the enzymes GPT, GOT and LDH can be detected in the blood plasma with a maximum activity between 1 and 5 h both following 30 and 90 min of ischemia; a considerable difference in clearance is observed, however, in the period afterwards, the normal situation being reached after 24 h with the 30-min ischemic period, but not following the 90-min period. With use of an enzyme histochemical reaction, in situ a depletion of LDH-activity in the hepatocytes could be detected within a short period of time after 30 min temporary ischemia and a restoration during the following period of 24 h; the decrease in LDH-activity persisted during 24 h with a 90-min period of ischemia. Electronmicroscopically cytoplasmic blebs arisen from hepatocytes are observed in the lumen of sinusoids immediately after 30 min of ischemia, whereas after 90 min of ischemia actual leakage of cytoplasmic material takes place through the damaged surface of the hepatocytes. Enzyme leakage probably takes place via these both types of shedding of cytoplasm. It is concluded that the enzyme leakage as such cannot be used as a discriminating test between reversible and irreversible damage of the liver parenchyma.