Evaluation of pulmonary reperfusion injury in rats subjected to mesenteric ischemia and reperfusion and protective effect of postconditioning on this process

Santos, Carlos Henrique Marques dos; Aydos, Ricardo Dutra; Neto, Ed Nogueira; Miiji, Luciana Nakao Odashiro; Cassino, Pedro Carvalho; Alves, Isadora Ishaq; Calheiros, Nádia Meneguesso; Garcia, Milena

doi:10.5935/1678-9741.20150067

Cited by 5 publications

(6 citation statements)

References 24 publications

(31 reference statements)

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“…This would be true when comparing these two studies evaluating IPC pulmonary action, since there was a difference in the method and this has been the greatest difficulty when comparing the numerous studies of IPC - the wide variation in the method used. The second question refers to the origin of ischemia: Dorsa et al [15] performed aortic clamping while Santos et al [16] and the present study used mesenteric ischemia. This factor may have some influence since in the aortic clamping, the harmful products of the I/R would spread to all the organs and tissues, whereas in the intestinal I/R, all blood is primarily drained to the liver, thus leading to increased toxic concentration of reactive oxygen species on this organ.…”

Section: Discussionmentioning

confidence: 98%

“…However, there is still a lot of controversy in the literature on the outcome of remote protection of IPC. Recently, Santos et al [16] also evaluated the possible protective action of IPC on lung parenchyma when performing mesenteric I/R in rats and found no benefits in using this technique. Similarly, the research presented here showed no liver protection with IPC on mesenteric I/R, leaving some possibilities to be considered, still with no clear answers.…”

Section: Discussionmentioning

confidence: 99%

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Ischemic Postconditioning Assessment in the Liver of Rats Undergoing Mesenteric Ischemia and Reperfusion

Santos¹,

Aydos²,

Neto³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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IntroductionIschemic postconditioning is a method that shows evidence of efficacy in minimizing reperfusion injury; however, its effectiveness in preventing injuries in distant organs is still unknown, especially in those who have undergone mesenteric ischemia and reperfusion.ObjectiveTo evaluate the effect of ischemic postconditioning in preventing reperfusion injury in the liver of rats submitted to mesenteric ischemia and reperfusion, comparing two different methods of ischemic postconditioning.Methods30 Wistar male rats were used, distributed into three groups: Group A: Ten rats submitted to intestinal ischemia for 30 minutes followed by reperfusion for 60 minutes; Group B: Ten rats subjected to ischemia and reperfusion; after ischemia, two cycles of reperfusion (two minutes each) interleaved with two cycles of ischemia (two minutes each); and Group C: Ten rats subjected to ischemia and reperfusion; after ischemia, four cycles of reperfusion (30 seconds each) interspersed with four cycles of ischemia (30 seconds each). After the experiment, the left lobe of the liver was resected for subsequent histological analysis, using the following classification: grade 1 - centrilobular congestion; grade 2 - centrilobular congestion with some degeneration of hepatocytes in one or two central veins; and grade 3 - multifocal centrilobular congestion and degeneration of portal hepatocytes.ResultsThe mean degree of liver damage found was 1.8 in group A, 1.7 in group B and 1.3 in group C. There was no statistically significant difference between the groups.ConclusionIschemic postconditioning was unable to minimize reperfusion injury in rats undergoing mesenteric ischemia and reperfusion.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Ischemic Postconditioning Assessment in the Liver of Rats Undergoing Mesenteric Ischemia and Reperfusion

Santos¹,

Aydos²,

Neto³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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“…Szijártó et al [ 13 ] also demonstrated IPC protection when IPC was performed on the lower limbs of rats, with three hours of ischemia and four hours of reperfusion. Santos et al [ 6 ] also performed mesenteric IR in rats, but used 30 minutes of ischemia and 60 minutes of reperfusion, causing intestinal lesions but not pulmonary lesions, thus demonstrating that these animals did not present significant damage to the lungs with these reduced periods of intestinal IR.…”

Section: Discussionmentioning

confidence: 99%

“…Some techniques for protection against reperfusion injury have already been tried and tested, and among them, ischemic postconditioning (IPC), which consists of one or more short cycles of reperfusion, followed by one or more short cycles of ischemia, immediately after the ischemic phase and before permanent reperfusion occurs. Although IPC has already shown a protective effect in many organs submitted to IR as well as in distance protection [ 6 ] , its efficacy in the prevention of remote lung injury is still very early [ 7 ] .…”

Section: Introductionmentioning

confidence: 99%

Effect of Ischemic Postconditioning and Atorvastatin in the Prevention of Remote Lung Reperfusion Injury

Santos¹,

Dourado²,

Silva³

et al. 2018

Braz J Cardiovasc Surg

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ObjectiveThe aim of the present study was to evaluate the ability of ischemic postconditioning, atorvastatin and both associated to prevent or minimize reperfusion injury in the lung of rats subjected to ischemia and reperfusion by abdominal aortic clamping.MethodsWe used 41 Wistar norvegic rats, which were distributed into 5 groups: ischemia and reperfusion (I/R), ischemic postcondictioning (IPC), postconditioning + atorvastatin (IPC+A), atorvastatin (A) and SHAM. It was performed a medium laparotomy, dissection and isolation of the infra-renal abdominal aorta; except for the SHAM group, all the others were submitted to the aortic clamping for 70 minutes (ischemia) and posterior clamp removal (reperfusion, 70 minutes). In the IPC and IPC+A groups, postconditioning was performed between the ischemia and reperfusion phases by four cycles of reperfusion and ischemia lasting 30 seconds each. In the IPC+A and A groups, preceding the surgical procedure, administration of 3.4 mg/day of atorvastatin was performed for seven days by gavage. After the surgical procedure, the right caudal lobe was removed from the lung for histological study, using tissue injury score ranging from grade 1 (normal tissue) to grade 4 (intense lesion).ResultsThe mean lung injury was 3.6 in the I/R group, 1.6 in the IPC group, 1.2 in the IPC+A group, 1.2 in the A group, and 1 in the SHAM group (P<0.01).ConclusionIschemic postconditioning and atorvastatin were able to minimize lung reperfusion injury, alone or in combination.

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“…(23) It also increases the expression of other cytokines such as interlukin-6 as well TNF-α. (23,24) Pulmonary thromboendarterectomy is a potentially curative procedure in chronically thromboembolic pulmonary artery hypertension. The early mortality rate in 54 patients between 1989 and 1992 was 22.2% (12/54) and currently below 7%.…”

Section: Mechanismsmentioning

confidence: 99%

Pulmonary reperfusion injury

2017

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Pulmonary reperfusion injury is a clinical syndrome with no single and recognized pathophysiologic mechanism. It is a major cause of morbidity and mortality following lung transplantation, cardiogenic shock, or cardiopulmonary bypass. The underlying mechanisms remain uncertain. Lung inflammatory injury induced by lipopolysaccharide, characterized by rapid sequestration of neutrophils in response to inflammatory chemokines and cytokines released in the lungs is an acceptable theory. Structural or functional impairment of surfactant has been noted in pulmonary reperfusion injury. The pathological changes may include bilateral pulmonary infiltrates, reduced lung compliance and worsening of gas exchange in the immediate posttransplant period. Recruitment maneuver and high positive end-expiratory pressure can relieve postoperative respiratory failure, especially in the patient with reperfusion pulmonary edema after pulmonary thromboendarterectomy. Pharmaceutical agents, including inhaled nitric oxide, soluble complement receptor type 1, prostaglandin E1 and exogenous surfactant, attenuate pulmonary reperfusion injury through distinct mechanisms. Extracorporeal membrane oxygenation and Novalung are temporary assistance in bridging to lung transplantation, stabilization of hemodynamics during transplantation and treatment of severe lung dysfunction and primary graft failure. Modulation of heme oxygenase-1 expression, ischemic conditioning and gene therapy are future directions for pulmonary reperfusion injury management.

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Evaluation of pulmonary reperfusion injury in rats subjected to mesenteric ischemia and reperfusion and protective effect of postconditioning on this process

Cited by 5 publications

References 24 publications

Ischemic Postconditioning Assessment in the Liver of Rats Undergoing Mesenteric Ischemia and Reperfusion

Ischemic Postconditioning Assessment in the Liver of Rats Undergoing Mesenteric Ischemia and Reperfusion

Effect of Ischemic Postconditioning and Atorvastatin in the Prevention of Remote Lung Reperfusion Injury

Pulmonary reperfusion injury

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