Liver ischemia/reperfusion injury, a setting in which the functional mass is reduced and the role of PDE5 inhibitor

Liver ischemia reperfusion is induced during surgical procedures like liver transplantation and resection. Multiple mechanisms have been postulated to liver damage following liver ischemia reperfusion injury, such as oxidative stress and inflammatory reactions. The present study declares the possible mechanism of tadalafil, toward modulating the inflammatory response. Forty-eight rats were divided into 4 groups as follows; Sham group subjected to midline laparotomy only. Tadalafil group administered Tadalafil 10 mg/kg intraperitoneal 45 min before sham operation. I/R (Ischemia-reperfusion) group, rats undergo 60 min of hepatic ischemia followed by 60 min of reperfusion. Tadalafil + I/R group rats undergo a similar pattern of I/R after the treatment with Tadalafil 10 mg/kg, 45 min before ischemia. At the end of the reperfusion, the blood samples were collected for estimation of biochemical markers including liver enzymes using colorimetric assay method and serum: TNF-alpha (tumor necrosis factor-alpha), IL-6 (interleukin 6) levels, ICAM-1 (Intercellular Adhesion Molecule-1) were measured. Tissues were evaluated by semi-quantitative and morphometrical approaches. Tadalafil succeeded in restoring normal levels of liver enzymes and ameliorating the oxidative stress as evidenced by decreasing MDA and restoring reduced glutathione levels in liver tissue homogenate. Also, Tadalafil exhibits anti-inflammatory effects, as it significantly decreased the levels of TNF-alpha, IL6 and ICAM-1. The findings are supported by BCL-2, TNF-alpha immunomarkers. It is concluded that modulation of the inflammatory response might be one of the mechanisms of Tadalafil-mediated hepatoprotection, so it is recommended as an adjuvant therapy in liver surgery.