3), thereby confirming its anticoagulative effect. Importantly, heparin-treated mice survived the FasL-induced liver injury longer compared with heparin-untreated mice (Fig. 5E). Taken together, these data indicate that prophylactic pretreatment with heparin reduces
the extent of FasL-induced apoptotic liver injury in FVB/N mice. Most cases of ALF occur in the context of an unanticipated exposure to an insult.23, 24 Therefore, it is important to identify potential compounds that can be used as a treatment, although prophylactic drugs do have a role. Given the significant benefit imparted by heparin when administered before the FasL insult, we examined its effect as a therapeutic. In a preliminary experiment, we verified Smoothened Agonist in vitro the rapid onset heparin action to be as early as 15 minutes after subcutaneous injection (Supporting Fig. 4). For the treatment experiment, mice were first given FasL, then heparin 1, 2, 2.5, and 3 hours after FasL injection. At 4.5 hours (i.e., the same time point used for the experiments in Fig. 1 and Fig. 5) after FasL injection,
mice were sacrificed to evaluate the extent of injury using histological, serological, and KU-57788 supplier biochemical means. Notably, treatment with heparin 1 hour and even 2 hours after FasL administration significantly reduced hemorrhage compared with heparin-untreated mice (Fig. 6A, Supporting Fig. 5). Serum ALT levels were markedly lower (7.3-fold) in mice that received heparin treatment 1 hour after FasL injection, but not at subsequent times (Fig. 6B). Quantification of the apoptotic cells MCE showed a protective
effect when heparin was given 1 hour or 2 hours after FasL administration (Fig. 6C), which is paralleled by findings using TUNEL staining (Fig. 6A). Similarly, the levels of activated caspases 3/7 and formation of the K18 apoptotic fragment were decreased, particularly at the 1-hour time point (Fig. 6D). Therefore, early treatment with heparin significantly reduces FasL-induced mouse liver injury. We addressed the time course of apoptosis progression versus IC within the liver. Administration of FasL followed by analysis of the livers at hourly intervals demonstrated that the readily detectable activation of caspases and keratin cleavage during apoptosis occur concurrently with FIB-γ dimer formation (Fig. 7). Notably, FIB-γ dimer formation shows a sharp rise, then remains relatively constant as injury progresses, whereas caspase activation and keratin fragmentation also display a sharp rise but continue to increase with time (compare lanes 6 and 7 with 8 and 9). An independent experiment using analysis at 0.5-hour intervals showed similar findings (Supporting Fig. 6). Our findings provide a model for FIB-γ dynamics during mouse liver injury (Fig. 8). Upon apoptotic liver injury, plasma fibrinogen moves from plasma and is deposited within liver parenchyma as part of an intrahepatic IC that is triggered by the apoptotic cell injury.