Changes of Insulin and Somatostatin and Their Relationship to Liver Regeneration in Experimental Obstructive Jaundice

實驗性阻塞性黃疸肝臟再生功能相關Insulin及Somatostatin 濃度之研究

陳榮祥(Jong-Shyong Chen) ； 柯成國(Chen-Guo Ker) ； 李金德(King-Teh Lee) ； 沈柏青(Pai-Ching Sheen)

《The Kaohsiung Journal of Medical Sciences》 13卷11期 (1997/11) Pp. 653-660

https://doi.org/10.6452/KJMS.199711.0653

摘要

本研究以實驗動物手術形成阻塞性黃疸，然後再手術改善黃疸。藉此研究黃疸形成時和減黃手術後，肝臟再生功能的變化，以便經由此實驗結果更進一步於黃疸時保護和改善肝臟功能。
我們經由檢測肝臟再生功能促進劑（Hepa - totrophic）-Insulin和抑制劑－Somatostatin 來瞭解肝臟再生功能的變化。而肝臟再生功能以檢測能代表肝細胞核仁DNA Loop的Nucleolar Organizer Regions ( NORs）為工具。
我們於研究中發現（l）阻塞性黃疸開始形成時，肝臟再生功能增加，此變化和肝切除或肝炎時結果相似。但黃疸持續不變且加重時，肝臟再生功能反而下降。( 2 ) Insulin 濃度伴隨黃疸持續增加而緩慢下降。減黃手術可改善，併促使Insulin 濃度上升。但於黃疸開始改善時，我們觀察Insulin濃度和肝臟再生功能並不立即改善。兩者恢復期都比預期長，並不伴隨膽紅素值減輕而改善。（3）雖然Somatostatin對肝臟再生功能有抑制作用，但於黃疸形成或改善時，Somatostatin 對肝臟再生功能的影響輕微。（4）研究中發現，早期減輕黃疸，能促進肝臟再生能力提早恢復，提供胰島素可能促使肝臟再生能力更進一步改善，進而保護黃疸中的肝臟功能。

並列摘要

The liver is a parenchymal organ that has a substantial capacity to regenerate after damage. Obstructive jaundice is a common surgical disease and potentially risky. A successful outcome of operations depends upon the hepatic regeneration reserve. Insulin is one of factors responsible for hepatotrophic regeneration and somatostatin has a reversal suppressive action. Experimental obstructive jaundice was introduced and relieved. In addition, serum insulin and somatostatin concentrations were measured. We used immuno-histochemical study of pancreatic tissue by immunogold to express the tissue relative insulin and somatostatin concentrations. Nucieolar organizer regions (NORs) were used to predict the nucleolar activity of liver cells. In our studies, we observed the serum concentrations of insulin and somatostatin were similar to the relative tissue concentration in pancreatic tissues. The relative tissue gold- particle score of insulin in group A (rats with common bile duct tied), was CONT: T4:T7: T14=100%: 90.5%: 68.3%: 46.2%; of somatostatin was 100%: 120%: 118.2%: 115.5% respectively. In group B (common bile duct tied for 4 days then relieved), the gold-particle score of insulin was T4: T4R4: T4R7: T4R14=90.5%: 62.8%: 72.2%: 95.4%; of somatostatin was 120.2%: 114.3%: 108.1%: 106.2% respectively. In group C (common bile duct tied for 7 days then relieved), the gold-particle score of insulin was T7: T7R4: T7R7: T7R14=68.3%: 53.3%: 73.5%; of somatostain was 118.2%: 109.4%: 104.6%: 102.1% respectively. The mean numbers of AgNORs in group A revealed CONT: T4: T7: T14=2.24±0.24: 3.02±0.96: 3.26± 1.02: 3.08±0.84. group B was T4: T4R4: T4R7: T4R14=3.02±0.96: 3.03±0.73: 3.36±1.12: 3.72±1.46, and group C showed T7: T7R4: T7R7: T7R14 = 3.26±1.02: 3.26±0.84: 3.31±1.24: 3.54±1.24. In conclusion, our studies suggested: (1) liver regeneration appeared promptly after obstructive jaundice developed, but prolonged cholestasis inhibited this process.(2) Insulin levels gradually fell during the process of obstructive jaundice. Those levels elevated when choiestasis was improved. Nevertheless, both insulin and hepatic regeneration power could not reflect the initial improvement of cholestasis simultaneously. It took a longer time for the improvement of cholestasis and the recovery of the liver function. (3) Patho-physiologically, somatostatin had a weak influence on hepatic regeneration during obstructive jaundice. (4) Our studies provided clues that early biliary drainage might improve hepatic regeneration capacity. Supplement of insulin during the obstructive jaundice might be helpful for the Improvement of hepatic regeneration power.

並列關鍵字

insulin ； somatostatin ； regeneration