Iloprost infusion decreases skeletal muscle ischemia-reperfusion injury

Abstract

Iloprost (a long-acting prostacyclin analog) has been demonstrated to decrease cardiac muscle infarct size after ischemia-reperfusion injury. We investigated the ability ofiloprost to decrease skeletal muscle injury and platelet sequestration after ischemia-reperfusion injury in a canine bilateral isolated gracilis muscle model. Anesthetized animals (n = 13) were subjected to 6 hours of gracilis muscle ischemia and 1 hour of reperfusion. Fifteen minutes before muscle reperfusion, the animals were infused with radium 111-labeled autogenous platelets. Experimental animals (n = 7) received a continuous preischemic intravenous infusion of iloprost (0.45 ~g/kg/hr) and two 0.45 ~g/kg intravenous injections of iloprost (10 minutes before the ischemic interval and 10 minutes before reperfusion). Muscle injury was measured with triphenyltetrazolium chloride histochemical staining. Platelet sequestration within ischemic muscle specimens was determined by measuring indium 111 activity in a gamma counter. Iloprost infusion decreased muscle infarct size from 57.0%-12.6% in control animals to 15.8% __. 4.4% in experimental animals (p < 0.05). Platelet uptake in experimental and control muscle was 1.2-0.21 x 10 ~ and 2.17-+ 0.48 x 107 platelets/gm ischemic muscle, respectively (p = 0.1). Although platelet sequestration was not altered significantly in this experiment, a reduction in skeletal muscle injury was confirmed. Further investigation on the mechanisms of action of iloprost in chronic and acute skeletal muscle ischemia is warranted.

The effects of iloprost and alprostadil on ischemia-reperfusion injury in preventing inflammation, tissue degeneration, and apoptosis in rat skeletal muscle

“…It also regulates microcirculation by decreasing the levels of proinflammatory cytokines (1). The effects of iloprost on injury caused by I/R in skeletal muscle (6)(7)(8)(9)(10)(11)(12)17) have been well documented, but they are still controversial in the literature. Earlier studies have focused on circulation research.…”

“…Iloprost and alprostadil are synthetic analogs of PGI 2 and PGE 1 , respectively. Several studies have been reported concerning the effect of iloprost in the setting of skeletal muscle ischemic injury (4,(7)(8)(9)(10)(11)(12). However, less is known regarding the protective effects of alprostadil on skeletal muscle following I/R injury (13)(14)(15).…”

“…Both the IL and AL groups were subjected to I/R injury and received the appropriate drugs. The dosages of iloprost and alprostadil were based on those used in previous studies (7,8).…”

Use of Microsurgery and Iloprost in the Infantile Arterial Injuries

“…9,12,20 Following the ischemiareperfusion, an interstitial edema with polymorphonuclear (PMN) sequestration might occur in the related extremity and the ischemia may become more severe. Prostacyclin might reduce this tissue edema and swelling mediated by PMN, 21 and can prevent the extension of ischemia in the related extremity after the reperfusion.…”

“…10 It is also proven to be effective in inhibiting the changes in the endothelial microvascular permeability occurring as a result of ischemia -reperfusion. 11,12 In the current study, we used an intravenous infusion of iloprost in addition to the conservative medical treatment to benefit from the effects mentioned above with respect to severe ischemia of lower extremity caused by artery injury in the infantile period (especially in 6 months). Our aim is to discuss the use of iloprost in addition to the conservative treatment and artery repair in arterial injuries during the infantile period with microsurgical methods.…”