Terapêutica medicamentosa na isquemia e reperfusão mesentérica: revisão da literatura

Santos, Carlos Henrique Marques dos; Pontes, José Carlos Dorsa Vieira; Gomes, Otoni Moreira

doi:10.1590/s0101-98802006000100003

Cited by 10 publications

(9 citation statements)

References 24 publications

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“…The ischemia-reperfusion lesion may complicate many clinical conditions and plays an important role in the pathogenesis and survival following mesenteric blood flow reduction [3][4][5] , and an extensive research approach have been done [6][7][8][9][10] to understand the mechanisms of ischemia-reperfusion intestinal injury to obtain the best protection. The occlusion by selective clamping of the cranial mesenteric artery and the one hour ischemic time used being the routine procedure until now in most reported research but not comparatively studied until now the importance of different collateral blood supply due to anatomic variations specie dependents.…”

Section: Discussionmentioning

confidence: 99%

Ischemia-reperfusion histopathology alterations of the rabbit intestinal wall with and without exclusion of the collateral mesenteric circulation supply

Gomes¹,

Filho

Porto

et al. 2010

Acta Cir. Bras.

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Purpose:To evaluate the histopathology alterations of the intestinal mucosa of rabbits submitted to different times of mesenteric artery ischemia and reperfusion with and without celiac artery collateral circulation supply. Methods: Two groups of eight male New Zealand white rabbits (weight 2.2-3.5 kg) were used in this study. In the Group 1 animals, the proximal mesenteric artery was occluded for 60 min with an atraumatic vascular clamp, followed by reperfusion for 60 min. In the Group 2 animals the small bowel and mesentery were cut 30cm and 60cm far from the gastroduodenal pyloric transition before the proximal mesenteric artery occlusion. Small bowel biopsies were obtained before ischemia (control), after 30 min and 60 min of mesenteric ischemia and at 30 and 60 min. of mesenteric artery reperfusion. Results: In the Group I animals, the followings histopathology grade results were observed: t1, mean 0.4 + 0.29; t2, mean 1.9 ± 0.38; t3, 1.9 ± 0.33; t4, 1.2 ± 0.36 and t5, 1.2 ± 0.32. Differences between t0 and t2 and between t3 and t4 were statistically significant (p<0.05). Differences between t2 and t3 and t4 and t5 were not significant (p>0.5). In the Group II animals, it was observed: t1, mean 1.6 ± 0.33; t2, 2.4 ± 0.36; t3, 3.0 ± 0.35; t4 3.4 ± 0.31; t5, 3 ± 031. Differences between t0 and t1, t1 and t2, and t2 and t3 were significant (p<0.05). Differences between histopathology grades results of samples t1 to t5 in Group 1 and 2 were statistically significant (p<0.5). Conclusion: Microscopic examination of the biopsies revealed significant evidence of worse small bowel wall ischemiareperfusion lesions by exclusion of the celiac artery collateral circulation supply. Key words: Mesenteric Vascular Occlusion. Vascular Diseases. Splanchnic Circulation. Rabbits. RESUMOObjetivo: Avaliar as alterações histopatológicas da mucosa intestinal de coelhos submetidos à isquemia-reperfusão com e sem exclusão da circulação mesentérica colateral. Métodos: Foram estudados dois grupos de oito coelhos Nova Zelândia machos com pesos variáveis entre 2,2 e 3,5 kg de peso corpóreo. Nos animais do Grupo 1, a artéria mesentérica proximal foi ocluida por pinçamento atraumático durante 60 min, seguido de reperfusão por 60 min. No Grupo 2 o intestino delgado e o mesentério foram seccionados 30 cm e 60 após a transição pilórica gastroduodenal antes da oclusão da artéria mesentérica cranial. Biópsias da parede intestinal foram obtidas antes da isquemia (controle), após 30 e 60 min. de isquemia. Resultados: No Grupo I foram observados os seguintes graus de lesões: t1,média de 0.4 + 0.29; t2, média 1.9 ± 0.38; t3, 1.9 ± 0.33; t4, 1.2 ± 0.36 e t5, 1.2 ± 0.32. As diferenças entre t0 e t2 e entre t3 e t4 foram significantes (p<0.05). As diferenças entre t2 e t3 e t4 e t5 não foram significantes (p>0.5). No Group II observou-se: t1, média de 1.6 ± 0.33; t2, 2.4 ± 0.36; t3, 3.0 ± 0.35; t4 3.4 ± 0.31; t5, 3 ± 031. As diferenças entre t0 e t1, t1 e t2, e t2 e t3 foram significantes (p<0.05). As diferenças entre os resultados histopato...

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Section: Discussionmentioning

confidence: 99%

Ischemia-reperfusion histopathology alterations of the rabbit intestinal wall with and without exclusion of the collateral mesenteric circulation supply

Gomes¹,

Filho

Porto

et al. 2010

Acta Cir. Bras.

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“…However, there is no medicine to benefit large enough to use in clinical practice for patients with ischemia 6 .…”

Section: Introductionmentioning

confidence: 99%

Postconditioning effect in the hepatic ischemia and reperfusion in rats

Santos¹,

Pontes²,

Miiji

et al. 2010

Acta Cir. Bras.

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Purpose:To evaluate the effect of postconditioning protection in liver tissue of rats submitted to ischemia and reperfusion. Methods: 25 Wistar male rats were randomized in three groups: Group A (ischemia and reperfusion -I/R), with 10 rats, which was made ischemia by vascular clamp application in hepatic hilum for 30 minutes and reperfusion for 60 minutes by removal of the clamp; Group B (Postconditioning -IPo), with 10 rats, with same procedure plus postconditioning (3 cycles of reperfusion inserted by 3 cycles of ischemia, 30 seconds for each phase, between ischemia and reperfusion phases); and Group C (Sham), with 5 rats, which took place only laparotomy and manipulation of the hepatic hilum. Specimens were examined (histological evaluation) and dosage of serum AST and ALT was made. The statistical analysis was made with t Student test, with significant difference when p<0.05. Results: In the Sham group there was no histological or enzymatic changes; In group A the mean tissue lesion was 1.6 and in group B 1.1 (p=0.014). In group A the mean ALT level was 355U/l and in group B was 175.9U/l (p=0.016). The mean of AST was 828.8U/l in group A and 295.5U/l in group B (p=0.001). Conclusion: The postconditioning was able to minimize the severity of liver injury in rats submitted to ischemia and reperfusion. Key words: Ischemia. Reperfusion. Liver. Rats. RESUMO Objetivo:Avaliar o efeito do pós-condicionamento isquêmico na proteção tecidual hepática de ratos submetidos à isquemia e reperfusão. Métodos: Foram utilizados 25 ratos da linhagem Wistar provenientes do Biotério da Universidade Federal de Mato Grosso do Sul, distribuídos em três grupos: A) grupo isquemia/reperfusão (I/R) (10 ratos), em que foi realizada isquemia e reperfusão hepática pela aplicação e retirada de clampe do hilo hepático durante 30 e 60 minutos, respectivamente; B) grupo pós-condicionamento isquêmico (PoCI) (10 ratos), em que foi realizado procedimento semelhante ao anterior, exceto pela realização do pós-condicionamento isquêmico entre as fases de isquemia e reperfusão, consistindo na retirada e colocação do clampe do hilo hepático por 30 segundos cada fase, durante 3 ciclos; grupo C (Sham) (5 ratos), em que realizou-se apenas laparotomia e manipulação do hilo hepático. Foram analisados os espécimes (avaliação histológica), dosagem sorológica de AST e ALT. Resultados: No grupo Sham não se observou alterações histológicas nem enzimáticas; no grupo A a média de lesão tecidual foi 1,6 e no grupo B 1,1 (p=0,014). No grupo A a média de ALT foi 355U/l e no grupo B 175,9U/l (p=0,016). A média de AST foi de 582,8U/l no grupo A e 295,5U/l no grupo B (p=0,001). Conclusão: O pós-condicionamento isquêmico foi capaz de minimizar a intensidade das lesões hepáticas de ratos submetidos à isquemia e reperfusão. Descritores: Isquemia. Reperfusão. Fígado. Ratos.

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“…In the last 20 years, many forms of treatment for ischemia and reperfusion were tested without great success [17,18]. With the advent of IPreC, there was great progress in the treatment of Ischemia-Reperfusion Syndrome, however, specifically in relation to mesenteric ischemia and reperfusion, its use is limited due the fact that in most cases the ischemia is already installed at the time of diagnosis [19].…”

Section: Discussionmentioning

confidence: 99%

Avaliação do pós-condicionamento isquêmico no tratamento da isquemia mesentérica: estudo experimental em ratos

Santos¹,

Pontes²,

Gomes³

et al. 2009

Rev Bras Cir Cardiovasc

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Avaliação do pós-condicionamento isquêmico no tratamento da isquemia mesentérica. Estudo experimental em ratosEvaluation of ischemic postconditioning effect on mesenteric ischemia treatment. Experimental study in rats Abstract Objective: To assess the preconditioning and postconditioning effect on intestinal mucosal lesions in rats undergone mesenteric ischemia and reperfusion procedure.Methods: Thirty Wistar rats were studied and divided into three groups: Group A, 10 rats undergone mesenteric ischemia (30 minutes) and reperfusion (60 minutes); Group B, 10 rats undergone mesenteric ischemia and reperfusion preceded by ischemic preconditioning for three cycles of ischemia and reperfusion for two minutes each; Group C, 10 rats undergone mesenteric ischemia and reperfusion and, preceding the beginning of reperfusion, ischemic postconditioning was performed for three cycles of reperfusion and ischemia for two minutes each. Then, a segment of small intestine was resected for histological analysis. We assessed the results by Chiu et al. score and the statistical analysis was performed.Results: According to Chiu et al. score, the means of lesion degree were: In the group A, 3.5; Group B, 1.2; Group C, 1. The difference between group A with the groups B and C was considered statistically significant (P < 0.05).Conclusion: Ischemic pre-and postconditioning were capable of minimizing -in a similar intensity -the tissue injury on the intestinal mucosa of rats undergone mesenteric ischemia and reperfusion process. Resumo Objetivo: Avaliar o efeito do pré e pós-condicionamento isquêmico sobre a lesão tecidual na mucosa intestinal de ratos submetidos ao processo de isquemia e reperfusão mesentérica. DescriptorsMétodos: Foram estudados 30 ratos Wistar, distribuídos em três grupos: grupo A, em que se realizou isquemia (30 minutos) e reperfusão (60 minutos) mesentérica; grupo B, isquemia e reperfusão mesentérica precedidos pelo pré-condicionamento isquêmico por três ciclos de isquemia e reperfusão com duração de dois minutos cada; grupo C, isquemia e reperfusão mesentérica e, precedendo o início da reperfusão, foi realizado o pós-condicionamento isquêmico por três ciclos de reperfusão e isquemia com duração de dois minutos cada. Ao final, ressecouse um segmento do intestino delgado para análise histológica. Avaliaram-se os resultados pela classificação de Chiu et al. e procedeu-se ao tratamento estatístico.Resultados: As médias dos graus de lesão tecidual segundo a classificação de Chiu et al. foram: no grupo A, 3,5; grupo B, 1,2; grupo C, 1. A diferença entre o resultado do grupo A com os resultados dos grupos B e C foi considerada estatisticamente significativa (P < 0,05).Conclusão: O pré e pós-condicionamento isquêmico foram capazes de minimizar, com intensidade semelhante, a lesão tecidual na mucosa intestinal de ratos submetidos ao processo de isquemia e reperfusão mesentérica.Descritores: Isquemia. Traumatismo por reperfusão. Precondicionamento isquêmico.

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Terapêutica medicamentosa na isquemia e reperfusão mesentérica: revisão da literatura

Cited by 10 publications

References 24 publications

Ischemia-reperfusion histopathology alterations of the rabbit intestinal wall with and without exclusion of the collateral mesenteric circulation supply

Ischemia-reperfusion histopathology alterations of the rabbit intestinal wall with and without exclusion of the collateral mesenteric circulation supply

Postconditioning effect in the hepatic ischemia and reperfusion in rats

Avaliação do pós-condicionamento isquêmico no tratamento da isquemia mesentérica: estudo experimental em ratos

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