Ischaemia‐reperfusion Injury to the Intestine

Abstract

Ischaemia-reperfusion injury (IRI) is of obvious relevance in situations where there is an interruption of blood supply to the gut, as in vascular surgery, or in the construction of free intestinal grafts. It is now appreciated that IRI also underlies the gut dysfunction that occurs in early shock, sepsis, and trauma. The events that occur during IRI are complex. However, recent advances in cellular biology have started to unravel these underlying processes. The aim of this review is to provide an outline of current knowledge on the mechanisms and consequences of IRI.Initially, IRI appears to be mediated by reactive oxygen metabolites and, at a later stage, by the priming and activation of polymorphonuclear neutrophils (PMN). Ischaemia-reperfusion injury can diminish the barrier function of the gut, and can promote an increase in the leakage of molecules (intestinal permeability) or the passage of microbes across the wall of the bowel (bacterial translocation). Ischaemia-reperfusion injury to the gut can result in the generation of molecules that may also harm distant tissues.

Intraluminal injection of short chain fatty acids diminishes intestinal mucosa injury in experimental ischemia-reperfusion

“…Both at the jejunum (control = 2 [0-4]; saline = 3 [1][2][3][4]) and at the ileum segments (control = 2 [0-4]; saline = 4 [1][2][3][4][5]), the attributed score of the mucosal injury was higher in the saline sac than in control sacs (p=0.02 for both jejunum The SCFA treated sacs showed lesser score at the ileum (p=0.03) but were not significantly different at the jejunum (p=0.83) when compared with saline sacs (Figures 2 and 3). …”

“…In brief, large amounts of xanthine dehydrogenase are converted to xanthine oxidase during ischemia by a calcium-dependent proteolytic process. Superoxide, hydrogen peroxide, and hydroxyl radical are formed and may then cause mucosal injury both by direct action and by secondary activation of PMN 1,3 . Other consequence of the ischemic bowel injury is the disruption of the gut mucosal barrier predisposing the egress of harmful microorganisms and/or their toxins in a phenomenon called bacterial translocation.…”

“…In addition, reperfusion may increase the primary lesion promoting further tissue damage 1 . Mortality rate in this condition is usually high and even when bowel ischemia is under control, death may occur due to multiple organ failure 2 .…”

“…Mortality rate in this condition is usually high and even when bowel ischemia is under control, death may occur due to multiple organ failure 2 . The mechanisms involved during ischemiareperfusion injury (IRI) are complex and seems to be mediated by reactive oxygen metabolites followed by priming and activation of polymorphonuclear neutrophils (PMN) 1 . In brief, large amounts of xanthine dehydrogenase are converted to xanthine oxidase during ischemia by a calcium-dependent proteolytic process.…”

R-spondin3 prevents mesenteric ischemia/reperfusion-induced tissue damage by tightening endothelium and preventing vascular leakage

“…Mesenteric ischemia (ischemia of the small intestine) is a common life-threatening abdominal emergency encountered in a variety of clinical and surgical settings (1)(2)(3). Acute mesenteric ischemia induces local cellular changes such as cytoskeletal disorganization, up-regulation of adhesion molecules, and neoantigen expression that provokes an intense inflammatory response and endothelial barrier dysfunction during subsequent reperfusion.…”