Increased expression of toll-like receptor 4 enhances endotoxin-induced hepatic failure in partially hepatectomized mice

Background/Aims Liver failure associated with infections after hepatectomy remains a cause of mortality. It has recently been reported that toll-like receptor 4 (TLR4) is involved in recognizing lipopolysaccharides (LPS). The aim of this study was to investigate the role of TLR4 in endotoxin-induced liver injury after hepatectomy. Methods C3H/HeN and C3H/HeJ mice underwent 70% hepatectomy or sham surgery, and LPS was administered 48 h after surgery. Expression of TLR4 mRNA, nuclear factor-κB (NF-κB) activation, tumor necrosis factor-α (TNF-α) and serum ALT levels, histological findings, and myeloperoxidase content were examined. Survival after LPS administration was also determined. Results Hepatic expression of TLR4 was significantly increased 6–72 h after hepatectomy. In mice with endotoxemia after hepatectomy, hepatic NF-κB activation was greatly increased. Hepatic mRNA and serum levels of TNF-α, and ALT levels were significantly elevated compared with sham operated controls. Focal necrosis with neutrophil infiltration was apparent, which is consistent with increased myeloperoxidase contents in endotoxemia after hepatectomy in C3H/HeN mice. These were completely absent in C3H/HeJ mice. Survival of C3H/HeN mice with endotoxemia after hepatectomy was significantly lower than that of C3H/HeJ mice. Conclusions Upregulated TLR4 expression and function after hepatectomy plays a pivotal role in endotoxin-induced liver injury after hepatectomy.