Immunomodulatory effects of thalidomide in an experimental brain death liver donor model

Santana, Alexandre Chagas; Andraus, Wellington; Silva, Filipe Miranda Oliveira; Dellê, Humberto; Pepineli, Rafael; de Moraes, Edvaldo Leal; Scavone, Cristoforo; de Sá Lima, Larissa; Degaspari, Sabrina; Brasil, Sergio; Solla, Davi Jorge Fontoura; Ruiz, Liliane Moreira; de Oliveira-Braga, Karina Andrighetti; Nepomuceno, Natalia Aparecida; Pêgo-Fernandes, Paulo Manuel; Tullius, Stefan Gunther; Figueiredo, Eberval Gadelha

Brain death is characterized by a generalized inflammatory response that results in multiorgan damage. This process is mainly mediated through cytokines, which amplify graft immunogenicity. We investigated the immunological response in a brain death liver donor model and analysed the effects of thalidomide, a drug with powerful immunomodulatory properties. Brain death was induced in male Lewis rats. We studied three groups: Control (sham-operated rats in which trepanation was performed without inserting the balloon catheter), BD (rats subjected to brain death by increasing intracranial pressure) and BD + Thalid (BD rats receiving thalidomide after brain death). After 6 h, serum levels of AST, ALT, LDH, and ALP as well as systemic and hepatic levels of TNF-α, IL1-β, IL-6, and IL-10 were analysed. We also determined the mRNA expression of MHC Class I and Class II, NF-κB, and macrophage infiltration. NF-κB was also examined by electrophoretic mobility shift assay. Thalidomide treatment significantly reduced serum levels of hepatic enzymes and TNF-α, IL-1-β, and IL-6. These cytokines were evaluated at either the mRNA expression or protein level in liver tissue. In addition, thalidomide administration resulted in a significant reduction in macrophages, MHC Class I and Class II, and NF-κB activation. This study reveals that thalidomide significantly inhibited the immunologic response and graft immunogenicity, possibly through suppression of NF-κB activation.