Ahmad Guni, Piyush Varma, Joe Zhang, Matyas Fehervari, Hutan Ashrafian
{"title":"Artificial Intelligence in Surgery: The Future is Now.","authors":"Ahmad Guni, Piyush Varma, Joe Zhang, Matyas Fehervari, Hutan Ashrafian","doi":"10.1159/000536393","DOIUrl":"https://doi.org/10.1159/000536393","url":null,"abstract":"<p><p>Background Clinical Artificial intelligence (AI) has reached a critical inflection point. Advances in algorithmic science and increased understanding of operational considerations in AI deployment are opening the door to widespread clinical pathway transformation. For surgery in particular, the application of machine learning algorithms in fields such as computer vision and operative robotics are poised to radically change how we screen, diagnose, risk-stratify, treat and follow-up patients, in both pre- and post-operative stages, and within operating theatres. Summary In this paper, we summarise the current landscape of existing and emerging integrations within complex surgical care pathways. We investigate effective methods for practical use of AI throughout the patient pathway, from early screening and accurate diagnosis to intraoperative robotics, post-operative monitoring and follow-up. Horizon scanning of AI technologies in surgery is used to identify novel innovations that can enhance surgical practice today, with potential for paradigm shifts across core domains of surgical practice in the future. Any AI-driven future must be built on responsible and ethical usage, reinforced by effective oversight of data governance, and of risks to patient safety in deployment. Implementation is additionally bound to considerations of usability and pathway feasibility, and the need for robust healthcare technology assessment and evidence generation. While these factors are traditionally seen as barriers to translating AI into practice, we discuss how holistic implementation practices can create a solid foundation for scaling AI across pathways. Key Messages The next decade will see rapid translation of experimental development into real-world impact. AI will require evolution of work practices, but will also enhance patient safety, enhance surgical quality outcomes, and provide significant value for surgeons and health systems. Surgical practice has always sat on a bedrock of technological innovation. For those that follow this tradition, the future of AI in surgery starts now.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139519961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Merel A Spiekerman van Weezelenburg, Loeki Aldenhoven, Sander M J van Kuijk, Elisabeth R M van Haaren, Alfred Janssen, Yvonne L J Vissers, Geerard L Beets, James van Bastelaar
{"title":"Fixation of Skin Flaps after Mastectomy Using Running or Interrupted Sutures for Combatting Seroma: A Protocol for a Randomised Controlled Trial (ANNIE).","authors":"Merel A Spiekerman van Weezelenburg, Loeki Aldenhoven, Sander M J van Kuijk, Elisabeth R M van Haaren, Alfred Janssen, Yvonne L J Vissers, Geerard L Beets, James van Bastelaar","doi":"10.1159/000542233","DOIUrl":"10.1159/000542233","url":null,"abstract":"<p><strong>Introduction: </strong>Flap fixation significantly reduces the incidence of seroma formation after mastectomy. Previous studies have compared running sutures, interrupted sutures, and tissue glue application with conventional wound closure. A recent systematic review with network meta-analysis showed running sutures to be the most optimal technique; however, direct comparisons and high adequate scientific evidence are lacking. This prospective trial aimed to directly compare running sutures with interrupted sutures to determine which technique of flap fixation using sutures is superior.</p><p><strong>Methods: </strong>This trial will combine a retrospective cohort of patients undergoing flap fixation using interrupted sutures from a previous trial, with a randomised prospective cohort with patients undergoing flap fixation using running sutures or flap fixation using interrupted sutures. This study design was chosen to acquire a sample size with sufficient power and the ability to conduct this study in an acceptable time frame. The primary endpoint is the incidence of complications requiring interventions, including clinically significant seroma, infections and haemorrhagic complications. Secondarily, the length of the procedure and cosmetic results will be compared.</p><p><strong>Conclusions: </strong>This is the first trial comparing two suturing techniques for flap fixation after mastectomy. Results will be used to optimise flap fixation techniques for these patients to prevent seroma formation.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"130-136"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current Basic Research in Normothermic Machine Perfusion.","authors":"Sarah A Hosgood, Michael L Nicholson","doi":"10.1159/000542290","DOIUrl":"10.1159/000542290","url":null,"abstract":"<p><strong>Background: </strong>Normothermic machine perfusion (NMP) is gradually being introduced into clinical transplantation to improve the quality of organs and increase utilisation. This review details current understanding of the underlying mechanistic effects of NMP in the heart, lung, liver, and kidney. It also considers recent advancements to extend the perfusion interval in these organs and the use of NMP to introduce novel therapeutic interventions, with a focus on organ modulation.</p><p><strong>Summary: </strong>The re-establishment of circulation during NMP leads to the upregulation of inflammatory and immune mediators, similar to an ischaemia-reperfusion injury response. The level of injury is determined by the condition of the organ, but inflammation may also be exacerbated by the passenger leucocytes that emerge from the organ during perfusion. There is evidence that damaged organs can recover and that prolonged NMP may be advantageous. In the liver, successful 7-day NMP has been achieved. The delivery of therapeutic agents to an organ can aid repair and be used to modify the organ to reduce immunogenicity or change the structure of the blood group antigens to create a universal donor blood group organ.</p><p><strong>Key messages: </strong>The application of NMP in organ transplantation is a growing area of research and is increasingly being used in the clinic. In the future, NMP may offer the opportunity to change practice. If organs can be preserved for days on an NMP system, transplantation may become an elective rather than an emergency procedure. The ability to introduce therapies during NMP is an effective way to treat an organ and avoid the complexity of treating the recipient.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"137-145"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yitian Fang, Hendrikus J A N Kimenai, Ron W F de Bruin, Dorottya K de Vries, Bart-Jeroen Petri, Michiel C Warlé, Ignace F J Tielliu, Jorinde van Laanen, Mirza M Idu, Robert A Pol, Robert C Minnee
{"title":"Treatment of Renal Artery Aneurysm by ex situ Repair and Autotransplantation: A Nationwide Cohort Study.","authors":"Yitian Fang, Hendrikus J A N Kimenai, Ron W F de Bruin, Dorottya K de Vries, Bart-Jeroen Petri, Michiel C Warlé, Ignace F J Tielliu, Jorinde van Laanen, Mirza M Idu, Robert A Pol, Robert C Minnee","doi":"10.1159/000541814","DOIUrl":"10.1159/000541814","url":null,"abstract":"<p><strong>Introduction: </strong>Renal artery aneurysm (RAA) is a rare vascular disease with a mortality rate of up to 80% upon rupture. This study aimed to investigate the safety and efficacy of ex situ repair and autotransplantation for endovascularly untreatable RAA.</p><p><strong>Methods: </strong>A retrospective nationwide cohort study was conducted in RAA patients undergoing ex situ repair and autotransplantation in the Netherlands. Surgical techniques, postoperative complications, and graft outcomes were assessed.</p><p><strong>Results: </strong>Ex situ repair was performed in 9 patients with 11 RAAs. Eight RAAs were located at the first bifurcation, one on the main trunk, one on the first branch, and one on the second branch. Nephrectomy was performed via laparoscopy (n = 7), robotic-assisted laparoscopy (n = 1), and laparotomy (n = 1). Postoperative complications were recorded in 4 patients, including bowel obstruction, delirium, pneumonia, and hydronephrosis due to double-J dislocation. The median estimated glomerular filtration rate was 83 mL/min/1.73 m2 pretransplant and 88 mL/min/1.73 m2 posttransplant. By an average follow-up of 32 months, 2 patients had died due to lung adenocarcinoma and stroke, while all autotransplanted kidneys had good patency and remained functional.</p><p><strong>Conclusions: </strong>Ex situ repair and autotransplantation are safe and feasible for endovascularly untreatable RAA cases. Larger cohorts with longer follow-up periods are necessary to further evaluate the role of this surgical approach.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"123-129"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Role of Enhanced Recovery after Surgery in Pancreaticoduodenectomy: A Systematic Review and Meta-Analysis.","authors":"Despoina Liotiri, Alexandros Diamantis, Ismini Paraskeva, Alexandros Brotis, Dimitrios Symeonidis, Eleni Arnaoutoglou, Dimitrios Zacharoulis","doi":"10.1159/000539785","DOIUrl":"10.1159/000539785","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to compare the safety and short-term outcomes of Enhanced Recovery After Surgery (ERAS) with standard care for patients undergoing pancreatoduodenectomy (PD) based on literature published following the first publication of ERAS guidelines for PD.</p><p><strong>Methods: </strong>Five medical databases were searched for studies that compared ERAS to standard care in adults undergoing PD. Data on postoperative complications, length of hospitalization, readmissions, and time to chemotherapy were analyzed using either a fixed- or random-effects model meta-analysis. Meta-regressions were conducted to investigate the role of operative technique, study origin, and study design.</p><p><strong>Results: </strong>Our analysis included 22 studies involving 4,043 patients. ERAS was associated with fewer complications (relative risk [RR]: 0.83; 0.75-0.91), particularly Clavien-Dindo (CD) grade 1 and 2 complications (RR: 0.82; 0.72-0.92), delayed gastric emptying (RR: 0.69; 0.52-0.93), and postoperative fistula (POPF) (RR: 0.76; 0.66-0.89), and a shorter time to chemotherapy (standardized mean difference [SMD]: -0.68; 95% CI: -0.88 to -0.48). ERAS did not affect the risk for CD grade 3 and 4 complications (RR: 1.00; 0.72-1.38), post-pancreatectomy hemorrhage (RR: 0.88; 0.67-1.14), length of stay (SMD: -0.56; 95% CI: -1.12 to 0.01), readmission (RR: 1.01; 0.84-1.21), and mortality (RR: 0.81; 0.54-1.22). The continent of origin was an effect moderator in the role of ERAS in CD grade 1 and 2 complications (p = 0.047) and POPF (p = 0.02).</p><p><strong>Conclusion: </strong>Implementing ERAS principles in PD improves surgical outcomes without compromising safety. ERAS may also accelerate time to chemotherapy, an essential issue for future research.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"95-115"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Safety of Percutaneous Dilatational Tracheostomy in Critically Ill Patients with Liver Cirrhosis.","authors":"Roee Noy, Flóra Macsi, Yotam Shkedy, Omri Simchon, Natalia Gvozdev, Danny Epstein","doi":"10.1159/000539106","DOIUrl":"10.1159/000539106","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous dilatational tracheostomy (PDT) is a safe and cost-effective alternative to surgical tracheostomy. Cirrhotic patients often require ICU admission and prolonged mechanical ventilation. Patients with liver cirrhosis (LC) are known to have coagulopathy and relatively safe and simple procedures such as tracheostomy may be associated with high complication rates, specifically high bleeding rates. Current guidelines are unable to make a specific recommendation on the safety of PDT among cirrhotic patients. We aimed to evaluate the safety of PDT in critically ill patients with LC.</p><p><strong>Methods: </strong>A retrospective chart review identified critically ill patients who underwent PDT between January 2012 and March 2023. The study group was defined as all patients with a diagnosis of LC. The primary outcome was early (7-day) bleeding, categorized as minor or major. Secondary outcomes were PDT-related and 30-day all-cause mortality. Propensity score matching was performed to adjust the imbalances between the groups.</p><p><strong>Results: </strong>A total of 1,628 were included in the analysis. Thirty-three of them (2.0%) had LC. In the LC group, only 1 patient (3.0%, 95% CI: 0.0-15.8%) developed early bleeding. Intra-operative, early, late bleeding, and PDT-related mortality rates did not differ significantly between those with LC and those without.</p><p><strong>Conclusion: </strong>This retrospective cohort study indicates that PDT can be safely performed in critically ill cirrhotic patients, without significantly increasing the risk of bleeding complications.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"69-73"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ümit Mert, Rald Victor Maria Groven, Johannes Greven, Zhizhen He, Mohamad Agha Mahmoud, Martijn van Griensven, Markus Huber-Lang, Tom Eirik Mollnes, Elizabeth Rosado Balmayor, Klemens Horst, Frank Hildebrand
{"title":"Damage Control Orthopaedics Induced Less Trauma-Induced Coagulopathy than Early Total Care in a Porcine Polytrauma Model.","authors":"Ümit Mert, Rald Victor Maria Groven, Johannes Greven, Zhizhen He, Mohamad Agha Mahmoud, Martijn van Griensven, Markus Huber-Lang, Tom Eirik Mollnes, Elizabeth Rosado Balmayor, Klemens Horst, Frank Hildebrand","doi":"10.1159/000541399","DOIUrl":"10.1159/000541399","url":null,"abstract":"<p><strong>Introduction: </strong>Coagulopathic disorders (CDs) complicate treatment in polytraumatised patients. Against this background, operative strategies for fracture management are controversial in this cohort. This study therefore investigated the effects of two established operative concepts, early total care (ETC) and damage control orthopaedics (DCO), on CD in a large-animal polytrauma (PT) model.</p><p><strong>Methods: </strong>Twenty-two animals (Sus scrofa domesticus) sustained PT involving blunt-chest trauma, liver laceration, bilateral femur fracture, and pressure-controlled haemorrhagic shock. After resuscitation, animals were allocated to ETC (n = 8), DCO (n = 8), or served as a non-traumatised control group (CG, n = 6). Animals were ventilated and monitored under ICU standards for 72 h. Blood samples were collected at baseline and post-trauma after 1.5, 2.5, 24, 48, and 72 h. Plasminogen activator inhibitor-1 (PAI-1) and thrombin-antithrombin (TAT) complex concentrations were determined by ELISA.</p><p><strong>Results: </strong>Compared to the CG, ETC and DCO subjects had significantly increased plasma concentrations of PAI-1 after 2.5 h (CG vs. ETC: p = 0.0050, CG vs. DCO: p = 0.0016). Furthermore, the ETC group showed significantly increased plasma PAI-1 concentrations after 24 h compared to the CG and DCO groups (CG vs. ETC: p = 0.0002, DCO vs. ETC: p = 0.0004). During the later clinical course, concentrations of TAT were significantly increased in the ETC group compared to the CG and DCO group after 72 h (CG vs. ETC: p = 0.0290, DCO vs. ETC: p = 0.0322).</p><p><strong>Conclusion: </strong>PT is strongly associated with CD in the early post-traumatic course. In comparison to DCO, ETC appeared to be negatively associated with CD. Future studies must investigate this impact, especially in those patients admitted with trauma-induced coagulopathy, to improve outcomes.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"115-122"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lucía Aragone, Ramiro Arrechea, Mariana Toffolo, Walter Nardi, Daniel Pirchi
{"title":"Conversion Rates, Causes, and Preoperative Associated Factors in 3,411 Laparoscopic Appendectomies: Insights after Nearly Three Decades of Laparoscopy and an Analysis of the Learning Curve.","authors":"Lucía Aragone, Ramiro Arrechea, Mariana Toffolo, Walter Nardi, Daniel Pirchi","doi":"10.1159/000541183","DOIUrl":"10.1159/000541183","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic appendectomy is the current gold standard in treating acute appendicitis. Despite the low frequency of conversion to open surgery, it remains necessary in certain cases. Our primary outcome was to identify the conversion rate of laparoscopic appendectomy to open surgery and how this rate has changed over the learning curve. Second, we aim to determine the causes of conversion, their changes in frequency over time and to identify preoperative factors associated with conversion.</p><p><strong>Methods: </strong>A retrospective comparative study with prospective case registry was conducted. All patients who underwent laparoscopic appendectomy from January 2000 to December 2023 at a high-volume center were analyzed. The series was divided into six periods, each spanning 4 years. All patients who underwent totally laparoscopic appendectomy and those requiring conversion to open appendectomy were included.</p><p><strong>Results: </strong>A total of 3,411 appendectomies were performed during the study period, with an overall conversion rate of 0.96% (33/3,411). Our analysis showed that after the first three periods (12 years), the conversion rate decreased and reached a plateau of approximately 0.4%. The most common causes of conversion were perforation of the appendix base (9/33), abdominal cavity adhesions (8/33), and pneumoperitoneum intolerance (3/33). Age over 65, American Society of Anesthesiologists (ASA) score III/IV and symptom duration exceeding 24 h were preoperative factors significantly associated with conversion at univariate analysis. However, only age (p 0.0001) and symptoms exceeding 24 h (p 0.01) remained independently associated with conversion after multivariate analysis.</p><p><strong>Conclusion: </strong>In experienced centers, conversion from laparoscopic appendectomy to open appendectomy is uncommon, but remains necessary in certain cases. Despite identifying a population with higher association with conversion which should be advised preoperatively, due to the low incidence of conversions once the learning curve is overcome, an initial laparoscopic approach is the preferred choice.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"108-114"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yael Berger, Vyacheslav Bard, Muhammad Abbas, Daniel Solomon, Nikolai Menasherov, Hanoch Kashtan
{"title":"Thoracic Duct Visualization in Esophageal Resection: A Pilot Trial.","authors":"Yael Berger, Vyacheslav Bard, Muhammad Abbas, Daniel Solomon, Nikolai Menasherov, Hanoch Kashtan","doi":"10.1159/000538691","DOIUrl":"10.1159/000538691","url":null,"abstract":"<p><strong>Introduction: </strong>Inadvertent thoracic duct injury is common during esophagectomy and may result in postoperative chylothorax. This study's objective was to investigate utility of patent blue injection as a modality for intraoperative thoracic duct visualization.</p><p><strong>Methods: </strong>A prospective, single-arm, interventional study of patients undergoing minimally invasive esophagectomy was performed. Patients were injected with patent blue dye into both groins prior to thoracic stage of surgery and assessed for duct visualization. Control group was formed by propensity score matching using retrospectively collected data regarding patients who underwent esophagectomy.</p><p><strong>Results: </strong>A total of 25 patients were included in analysis, compared to a control of 50 patients after matching. Thoracic duct was visualized in 60% of patients in the study group (15/25 patients). Significant differences were found between study and control groups (p < 0.05) with regards to median operative time (422 vs. 285 min, respectively), overall complications (16 vs. 34%, respectively), and median postoperative length of stay (13.5 vs. 10 days, respectively). There was a difference in rate of chyle leak between study and control groups; however, this was not significant (0 vs. 12%, respectively, p = 0.17).</p><p><strong>Conclusion: </strong>Patent blue injection represents a simple method for thoracic duct visualization during minimally invasive esophagectomy which may improve surgical outcomes.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"60-68"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"MicroRNA-216a-5p Alleviates Acute Kidney Injury of Mice via Suppressing FAS Ligand Expression.","authors":"Biying Zhou, Ruirui Luo, Yanlin Sun, Aixiang Yang","doi":"10.1159/000539980","DOIUrl":"10.1159/000539980","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this present work was to investigate the mechanism of the microRNA (miR)-216a-5p/FASL axis in mice with acute kidney injury (AKI).</p><p><strong>Methods: </strong>Mice kidney ischemia/reperfusion (I/R) injury was used as AKI models in this study. I/R mice were injected with miR-216a-5p- and FASL-related constructs to investigate potential mechanisms of kidney protection. Kidney function, inflammation, oxidative stress, and kidney cell apoptosis were assessed after 24 h of reperfusion. In vitro, the hypoxia-reoxygenation (H/R) model was used with kidney tubular epithelial cells (TECs) to mimic kidney I/R injury. H/R-treated TECs were transfected with miR-216a-5p- and FASL-related constructs to detect cell viability, inflammation, and oxidative stress. MiR-216a-5p and FASL expression levels in mouse kidney tissues and in H/R-treated TECs were detected.</p><p><strong>Results: </strong>MiR-216a-5p was downregulated and FASL was upregulated in kidney tissues of I/R mice and H/R-treated TECs. Upregulating miR-216a-5p attenuated kidney cell apoptosis and the damage of kidney function, and reduced inflammatory factor levels and oxidative stress response in kidney tissues of I/R mice. Upregulating miR-216a-5p advanced cell viability and reduced inflammatory factor levels and oxidative stress response in H/R-treated TECs. Downregulation of FASL effectively reversed the influences of downregulation of miR-216a-5p on kidney injury in mice and kidney TEC survival.</p><p><strong>Conclusion: </strong>Our study reveals that miR-216a-5p reduces I/R-induced pathological kidney damage in AKI via suppressing FASL.</p>","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":" ","pages":"83-94"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}