Name: generation of a rat model of acute liver failure by combining 70% partial hepatectomy and acetaminophen
Uploaded: 2019-11-27T13:00:00
Description: Watch this Scientific Journal Video about Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen at JoVE.com

This work was supported by the core grant received from the Department of Biotechnology, Government of India to National Institute of Immunology, New Delhi.

The procedure described below has been approved by the Institutional Animal Ethics Committee of National Institute of Immunology, New Delhi. The serial reference number of the approval is IAEC#355/14.
1. Preparation
<ol>
	<li>Prepare for the surgical procedure as described earlier by Das B et al.26.</li>
	<li>Use 6&#8211;8-week-old inbred Wistar rats with a body weight of 200&#8211;250 g.</li>
	<li>House the animals under standard animal care conditions and feed them ...

The development of an appropriate animal model for ALF is paramount for the better understanding of pathogenesis and progression of ALF. A well characterized ALF animal model also provides the opportunity for the development and trial of new therapeutic approaches against ALF. Many attempts have been made to develop a clinically relevant model of ALF6,12,21,23,46</s...

Acute liver failure (ALF) is defined by the American Association for the Study of Liver Diseases as rapid development of acute liver injury without any prior signs of damage and is characterized by severe impairment of the synthetic, metabolic, and detoxifying functions of the liver1. ALF differs from chronic liver failure where the failure occurs as a result of liver injury caused over a long period of time and from acute chronic liver failure (ACLF), where abrupt liver damage takes place as a result of chronic liver diseases2,3,4. The only available cure for ALF is orthotopic liver transplant (OLT), or death may occur. Due to the shortage of liver donors, the rate of mortality in patients suffering from ALF is very high.
To study the potential of alternative therapeutic approaches and to better understand the pathophysiology of ALF, animal models that can reflect the ALF occurring in human beings are needed. Many of the already available ALF animal models have several shortcomings. Acetaminophen (APAP) effects are difficult to reproduce but have the closest similarities in terms of temporal, clinical, biochemical, and pathological parameters. APAP- induced animal models frequently encounter problems due to the presence of methemoglobinemia caused by the oxidation of hemoglobin by APAP and its intermediates5,6,7. Another problem is the lack of reproducibility reflected by unpredictable dose responses and the time of death. The ALF animal models produced using carbon tetra chloride (CCl4) have poor reproducibility8,9,10,11. Concavalin A (Con A) and lipoplysaccharide (LPS)-induced ALF animal models do not reflect the clinical pattern of the human disease, though they have advantages in the study of cellular mechanisms involved in autoimmune liver diseases and in the study of sepsis respectively12,13,14,15. Similarly, thioacetamide (TAA) also requires biotransformation to an active metabolite thioacetamide sulfoxide and shows species variation16,17,18,19. D-galactosamine (D-Gal) produces some biochemical, metabolic, and physiological changes similar to ALF but is not able to reflect the whole ALF pathological condition20,21,22,23. There have been very few attempts to combine two or more of these methods to develop an ALF model that is able to reflect the ALF syndrome in a better manner13. Therefore, further studies are required to develop a model that can reflect the disease parameters, has better reproducibility, and provides enough time to study the effects of a therapeutic intervention.
In the current study, an alternative ALF model in rats has been created by combining the effects of partial hepatectomy (PHx) and lower doses of a hepatotoxic reagent. APAP has a well-established role in causing liver injury5,24,25. It is a widely used analgesic and is toxic to the liver at supratherapeutic doses by forming toxic metabolites. APAP is the cause of many deaths in developed countries. Physical injury caused by partial hepatectomy initiates activation of various processes involved in inflammation as well as liver regeneration. Injection of the hepatotoxic agent APAP causes a hostile environment in the liver, preventing the proliferation of hepatocytes. This reduces the stress period on the animal, which when combined with smaller doses of hepatotoxin, leads to better reproducibility of the procedure. Therefore, using this model, a combinatory effect of two types of liver injuries has been studied. To characterize the developed ALF animal model, physiological and biochemical parameters have been studied. Successful reversibility of ALF was confirmed by transplantation of syngeneic healthy rat hepatocytes.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Acetaminophen (Biocetamol)</td>
			<td>EG Pharmaceuticals</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Alkaline Phosphatase Kit (DEA)</td>
			<td>Coral Clinical System, India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Automated analyser</td>
			<td>Tulip, Alto Santracruz, India</td>
			<td>Screen Maaster 3000</td>
			<td>Biochemical analyser for liver functional test</td>
		</tr>
		<tr>
			<td>Betadine (Povidon-Iodine Solution)</td>
			<td>Win-Medicare; India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Biological safety cabinet (Class I)</td>
			<td>Kartos international; India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Bright Field Microscope</td>
			<td>Olympus, Japan</td>
			<td>LX51</td>
			<td></td>
		</tr>
		<tr>
			<td>Cefotaxime (Taxim&#174;)</td>
			<td>AlKem; India</td>
			<td></td>
			<td>cefotaxime sodium injection, No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Cell Strainer</td>
			<td>Sigma; US</td>
			<td>CLS431752</td>
			<td></td>
		</tr>
		<tr>
			<td>Collagenase Type I</td>
			<td>Gibco by Life Technologies</td>
			<td>17100-017</td>
			<td></td>
		</tr>
		<tr>
			<td>Cotton Buds</td>
			<td>Pure Swabs Pvt Ltd; India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Drape Sheet</td>
			<td>JSD Surgicals, Delhi, India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>DPX Mountant</td>
			<td>Sigma; US</td>
			<td>6522</td>
			<td></td>
		</tr>
		<tr>
			<td>Eosin Y solution, alcoholic</td>
			<td>Sigma; US</td>
			<td>HT110132</td>
			<td></td>
		</tr>
		<tr>
			<td>Forceps</td>
			<td>Major Surgicals; India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Gas Anesthesia System</td>
			<td>Ugo Basile; Italy</td>
			<td>211000</td>
			<td></td>
		</tr>
		<tr>
			<td>Glucose</td>
			<td>Himedia, India</td>
			<td>GRM077</td>
			<td></td>
		</tr>
		<tr>
			<td>Hair removing cream (Veet&#174;)</td>
			<td>Reckitt Benckiser, India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Hematoxylin Solution, Mayer&#39;s</td>
			<td>Sigma; US</td>
			<td>MHS16</td>
			<td></td>
		</tr>
		<tr>
			<td>Heparin sodium salt</td>
			<td>Himedia; India</td>
			<td>RM554</td>
			<td></td>
		</tr>
		<tr>
			<td>Hyaluronidase From Sheep Testes</td>
			<td>Sigma; US</td>
			<td>H6254</td>
			<td></td>
		</tr>
		<tr>
			<td>I.V. Cannula (Plusflon)</td>
			<td>Mediplus, India</td>
			<td>Ref 1732411420</td>
			<td></td>
		</tr>
		<tr>
			<td>Insulin Syringes</td>
			<td>BD; US</td>
			<td>REF 303060</td>
			<td></td>
		</tr>
		<tr>
			<td>Isoflurane (Forane&#174;)</td>
			<td>Asecia Queenborough</td>
			<td>No B506</td>
			<td>Inhalation Anaesthetic</td>
		</tr>
		<tr>
			<td>Ketamine (Ketamax&#174;)</td>
			<td>Troikaa Pharmaceuticals Ltd.</td>
			<td></td>
			<td>Ketamine hydrochloride IP, No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Meloxicam (Melonex&#174;)</td>
			<td>Intas Pharmaceuticals Ltd; India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Micro needle holders straight &#38; 
			curved</td>
			<td>Mercian; England</td>
			<td>BS-13-8</td>
			<td></td>
		</tr>
		<tr>
			<td>Micro needle holders straight &#38; 
			curved</td>
			<td>Mercian; England</td>
			<td>BS-13-8</td>
			<td></td>
		</tr>
		<tr>
			<td>Microtome</td>
			<td>Histo-Line Laboratories, Italy</td>
			<td>MRS3500</td>
			<td></td>
		</tr>
		<tr>
			<td>Nylon Thread</td>
			<td>Mighty; India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Paraformaldehyde</td>
			<td>Himedia; India</td>
			<td>GRM 3660</td>
			<td></td>
		</tr>
		<tr>
			<td>Percoll&#174;</td>
			<td>GE Healthcare</td>
			<td>17-0891-01</td>
			<td></td>
		</tr>
		<tr>
			<td>Refresh Tears/Eyemist Gel</td>
			<td>Allergan India Private Limited/Sun Pharma, India</td>
			<td>P3060</td>
			<td>No specific Catalog Number</td>
		</tr>
		<tr>
			<td>RPMI</td>
			<td>Himedia; India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Scalpel</td>
			<td>Major Surgicals; India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Scissors</td>
			<td>Major Surgicals; India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>SGOT (ASAT) KIT</td>
			<td>Coral Clinical System, India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>SGPT (ALAT) KIT</td>
			<td>Coral Clinical System, India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Shandon Cryotome E Cryostat</td>
			<td>Thermo Electron Corporation; US</td>
			<td></td>
			<td>No specific Catalog Number</td>
		</tr>
		<tr>
			<td>Sucrose</td>
			<td>Sigma; US</td>
			<td>S0389</td>
			<td></td>
		</tr>
		<tr>
			<td>Surgical Blade No. 22</td>
			<td>La Medcare, India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Surgical Board</td>
			<td>Locally made</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Surgical White Tape</td>
			<td>3M India; India</td>
			<td>1530-1</td>
			<td>Micropore Surgical Tape</td>
		</tr>
		<tr>
			<td>Sutures</td>
			<td>Ethicon, Johnson &#38; Johnson, India</td>
			<td>NW 5047</td>
			<td></td>
		</tr>
		<tr>
			<td>Syringes (1ml, 26 G)</td>
			<td>Dispo Van; India</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>Trimmer (Clipper)</td>
			<td>Philips</td>
			<td>NL9206AD-4 DRACHTEN QT9005</td>
			<td></td>
		</tr>
		<tr>
			<td>Weighing Machine</td>
			<td>Braun</td>
			<td></td>
			<td>No specific Catalog Number (Local Procurement)</td>
		</tr>
		<tr>
			<td>William&#39;s E Media</td>
			<td>Himedia; India</td>
			<td>AT125</td>
			<td></td>
		</tr>
		<tr>
			<td>Xylazine (Xylaxin&#174;)</td>
			<td>Indian Immunologicals Limited</td>
			<td></td>
			<td>Sedative, Pre-Anaesthetic, Analgesic and muscle relaxant</td>
		</tr>
	</tbody>
</table>

generation of a rat model of acute liver failure by combining 70% partial hepatectomy and acetaminophen

Acute liver failure (ALF) is a clinical condition caused by various etiologies resulting in the loss of metabolic, biochemical, synthesizing, and detoxifying functions of the liver. In most irreversible liver damage cases, orthotropic liver transplant (OLT) remains the only available treatment. To study the therapeutic potential of a treatment for ALF, its prior testing in an animal model of ALF is essential. In the current study, an ALF model in rats was developed by combining 70% partial hepatectomy (PHx) and injections of acetaminophen (APAP) that provides a therapeutic window of 48 h. The median and left lateral lobes of the liver were removed to excise 70% of the liver mass and APAP was given 24 h postsurgically for 2 days. Survival in ALF-induced animals was found to be severely decreased. The development of ALF was confirmed by altered serum levels of the enzymes alanine amino transferase (ALT), aspartate amino transferase (AST), alkaline phosphatase (ALP); changes in prothrombin time (PT); and assessment of the international normalized ratio (INR). Study of the gene expression profile by qPCR revealed an increase in expression levels of genes involved in apoptosis, inflammation, and in the progression of liver injury. Diffused degeneration of hepatocytes and infiltration of immune cells was observed by histological evaluation. The reversibility of ALF was confirmed by the restoration of survival and serum levels of ALT, AST, and ALP after intrasplenic transplantation of syngeneic healthy rat hepatocytes. This model presents a reliable alternative to the available ALF animal models to study the pathophysiology of ALF as well as to evaluate the potential of a novel therapy for ALF. The use of two different approaches also makes it possible to study the combined effect of physical and drug-induced liver injury. The reproducibility and feasibility of current procedure is an added benefit of the model.

Survival percentage in animal models of ALF 
The optimum dose of APAP to cause ALF in combination with 70% PHx was standardized as 750 mg/kg body weight. The treatment regimen started 24 h after 70% PHx, when the animals had completely recovered from surgery, and consisted of two APAP doses at 24 h intervals. Mortality was observed at the rate of 80% after the administration of the second dose of APAP, 48 h post-surgery. The survival percentage was analyzed and plotted via the Kaplan-Meier method (<...

Watch this Scientific Journal Video about Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen at JoVE.com

Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen

The acute liver failure animal model developed in the current study presents a feasible alternative for the study of potential therapies. The current model employs the combined effect of physical and drug-induced hepatic injury and provides a suitable time window to study the potential of novel therapies.

Acute liver failure (ALF) is a clinical condition caused by various etiologies resulting in the loss of metabolic, biochemical, synthesizing, and ...

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