1
|
Effects of Lycopene Attenuating Injuries in Ischemia and Reperfusion. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:9309327. [PMID: 36246396 PMCID: PMC9568330 DOI: 10.1155/2022/9309327] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/25/2022] [Accepted: 09/15/2022] [Indexed: 11/18/2022]
Abstract
Tissue and organ ischemia can lead to cell trauma, tissue necrosis, irreversible damage, and death. While intended to reverse ischemia, reperfusion can further aggravate an ischemic injury (ischemia-reperfusion injury, I/R injury) through a range of pathologic processes. An I/R injury to one organ can also harm other organs, leading to systemic multiorgan failure. A type of carotenoid, lycopene, has been shown to treat and prevent many diseases (e.g., rheumatoid arthritis, cancer, diabetes, osteoporosis, male infertility, neurodegenerative diseases, and cardiovascular disease), making it a hot research topic in health care. Some recent researches have suggested that lycopene can evidently ameliorate ischemic and I/R injuries to many organs, but few clinical studies are available. Therefore, it is essential to review the effects of lycopene on ischemic and I/R injuries to different organs, which may help further research into its potential clinical applications.
Collapse
|
2
|
Mousavian A, Sabzevari S, Parsazad S, Moosavian H. Leech Therapy Protects Free Flaps against Venous Congestion, Thrombus Formation, and Ischemia/Reperfusion Injury: Benefits, Complications, and Contradictions. THE ARCHIVES OF BONE AND JOINT SURGERY 2022; 10:252-260. [PMID: 35514759 DOI: 10.22038/abjs.2022.55013.2736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 01/31/2022] [Indexed: 11/06/2022]
Abstract
The use of free cutaneous or myocutaneous flaps in some surgeries, especially in reconstructive surgeries, is routine and imperative; nevertheless, it is controversial because of fear of flap loss due to tissue congestion and partial or complete necrosis. Different mechanisms are discussed in this process, and based on the involved mechanisms, various agents and approaches are suggested for flap salvage. Among these agents and strategies, leech therapy (hirudotherapy) can be a valuable complementary treatment; however, in this way, full attention should be given to all beneficial and harmful aspects to reach the best results. This study included a literature review of the essential complications following free tissue transfer and explained the effects of leech therapy for the respective complications. Based on the review of the literature, the essential complications following free tissue transfer were (I) venous obstruction and congestion, (II) delay in blood flow reestablishment, (III) ischemia/reperfusion injuries, and (IV) thrombus formation. Leech therapy can protect free flaps against the mentioned complications as a complementary treatment. Leech therapy is an appropriate complement, however, not a definite approach for flap salvage. Therefore, in some patients, other alternative methods or even flap removal may be a better option.
Collapse
Affiliation(s)
- Alireza Mousavian
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Soheil Sabzevari
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shafagh Parsazad
- Anatomical and Clinical Pathology, University of Pittsburgh Medical Center, USA
| | - Hamidreza Moosavian
- Department of Clinical Pathology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| |
Collapse
|
3
|
Chen X, Xie Q, Zhu Y, Xu J, Lin G, Liu S, Su Z, Lai X, Li Q, Xie J, Yang X. Cardio-protective effect of tetrahydrocurcumin, the primary hydrogenated metabolite of curcumin in vivo and in vitro: Induction of apoptosis and autophagy via PI3K/AKT/mTOR pathways. Eur J Pharmacol 2021; 911:174495. [PMID: 34555398 DOI: 10.1016/j.ejphar.2021.174495] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/14/2021] [Accepted: 09/06/2021] [Indexed: 12/14/2022]
Abstract
Tetrahydrocurcumin (THC) is an essential metabolite of curcumin, a major active component of the Curcuma species, which have been used traditionally for the treatment of cardiovascular diseases. The PI3K/AKT/mTOR signaling pathways serve a vital role during myocardial ischemia-reperfusion (MI/R) injury. The aim of the present study was to investigate the cardioprotective potential and mechanism of THC. In the in vivo study, an animal model of MI/R was induced by coronary occlusion. Results indicated that THC (50 mg/kg/day) protected the rat hearts from MI/R-induced heart failure by increasing ejection fraction (EF) and fractional shortening (FS) and decreasing left ventricular end systolic diameter (LVESD) and left ventricular end systolic volume (LVESV). THC also reduced myocardial infarct size and apoptosis. Furthermore, H9c2 cells were incubated with THC (20 μM) to explore its potential effect following exposure to hypoxia and reoxygenation (H/R). THC post-treatment significantly augmented cell viability and prevented lactate dehydrogenase (LDH) release after H/R exposure. THC effectively improved antioxidant activity by increasing SOD and CAT activities and decreasing MDA level. THC also enhanced mitochondrial membrane potential, inhibited apoptotic cell death, diminished the Bax/Bcl-2 ratio and cleaved caspase-3 level relative to the H/R model. In addition, THC effectively decreased Beclin1 expression and LC3 II/LC3 I ratio, but increased p62 expression, compared with the H/R model group, and decreased the formation of H/R-induced autophagosomes and autolysosomes. Furthermore, THC promoted the phosphorylation of PI3K/AKT/mTOR and induced the expression of hypoxia-inducible factor 1α (HIF-1α) after H/R. However, these effects on H9c2 cells were notably abolished by the PI3K inhibitor LY294002 and mTOR inhibitor rapamycin. In conclusion, THC effectively inhibited H/R-induced autophagy and apoptosis via, at least partially, activating the PI3K/AKT/mTOR pathways. THC might have the potential to be further developed into a potential candidate for the treatment of MI/R injury.
Collapse
Affiliation(s)
- Xiaoying Chen
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Qingfeng Xie
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, PR China; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Ying Zhu
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, PR China
| | - Jiamin Xu
- The Second School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Guoshu Lin
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Shujun Liu
- The Second School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Ziren Su
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, PR China; Dongguan Institute of Guangzhou University of Chinese Medicine, Dongguan, PR China
| | - Xiaoping Lai
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, PR China; Dongguan Institute of Guangzhou University of Chinese Medicine, Dongguan, PR China.
| | - Qian Li
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China; State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, PR China
| | - Jianhui Xie
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China; State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, PR China
| | - Xiaobo Yang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China; State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, PR China.
| |
Collapse
|
4
|
Seyid M, Tiftikcioglu Y, Erdem M, Akdemir O, Tatar BE, Uyanıkgil Y, Ercan G. The Effect of Ceruloplasmin Against Ischemia-Reperfusion Injury in Epigastric Island Flap in Rats. J Surg Res 2021; 267:627-635. [PMID: 34273792 DOI: 10.1016/j.jss.2021.05.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 04/20/2021] [Accepted: 05/26/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Flap surgery is frequently used in plastic surgery to close tissue defects. Ischemia-reperfusion (I/R) injury is a significant problem resulting in partial or total flap necrosis. This study aimed to investigate the effect of ceruloplasmin on I/R injury in epigastric island flaps in rats. MATERIAL AND METHOD A total of 32 male Sprague-Dawley rats were divided into four groups with eight rats in each group: The flap was not elevated in Group I; the flap was elevated without ischemia or any application in Group II, after the intraperitoneal saline and ceruloplasmin application the flaps were elevated and ischemia was created in group III-IV, respectively. Bilateral epigastric artery flap was elevated in all groups except Group I. After 6 h of ischemia, the flap was reperfused and inset. Samples were taken from the right and left side of the flap area in other groups at the postoperative 24th h for biochemical analysis (catalase and malondialdehyde-MDA) and the seventh postoperative day for histopathological analysis (Modified Verhofstad score and epidermal thicknesses), respectively. Image analysis for necrosis areas was performed on photos taken on the 7th d. RESULTS Catalase level was significantly higher in Group IV.(0.15 ± 0.04 U/mg protein) (P < 0.05) Necrosis area percentage(14.4% ± 3.3%),MDA(3.6 ± 0.9 nmol/mg protein), edema(3), necrosis(2.75), and polymorphonuclear leukocyte infiltration(2.87) scores were significantly higher in group III.(P < 0.05). Fibroblast proliferation, collagen density (0.25), vascular density (0.25) scores and epidermal thickness (15.68 µm,) was significantly lower in group III. (P < 0.05) CONCLUSIONS: Our study demonstrated that ceruloplasmin application before ischemia reduced I/R injury in epigastric island flaps in rats.
Collapse
Affiliation(s)
- Mircafer Seyid
- Baku Medical Plaza, Department of Plastic Surgery, Baku, Azerbaijan.
| | - Yigit Tiftikcioglu
- Ege University Faculty of Medicine, Department of Plastic Surgery, Izmir, Turkey
| | - Mehmet Erdem
- University of Health Sciences, Bagcılar Training and Research Hospital, Department of Plastic Surgery, Istanbul, Turkey
| | - Ovunc Akdemir
- Esenyurt University, Department of Plastic Surgery, Istanbul, Turkey
| | - Burak Ergün Tatar
- University of Health Sciences, Bagcılar Training and Research Hospital, Department of Plastic Surgery
| | - Yigit Uyanıkgil
- Ege University Faculty of Medicine, Department of Histology and Embryology, Izmir, Turkey
| | - Gülinnaz Ercan
- Ege University Faculty of Medicine, Department of Biochemistry, Izmir Turkey
| |
Collapse
|
5
|
Sun YD, Gao YS, Xu LW, Zhang YF, Cheng C, Wei KC, Lin J, Chen G, Liu CY, Li QF. Protective effects of sodium ferulate on flap transplantation via anti-inflammatory modulation and oxidative stress inhibition. ACTA ACUST UNITED AC 2021; 54:e10520. [PMID: 34008753 PMCID: PMC8130058 DOI: 10.1590/1414-431x2020e10520] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/02/2021] [Indexed: 11/29/2022]
Abstract
Ischemia-reperfusion injury (IRI) has brought attention to flap failure in reconstructive surgery. To improve the prognosis of skin transplantation, we performed experimental IRI by surgical obstruction of blood flow and used sodium ferulate (SF) to prevent IRI in rats. After SF treatment, the morphological and histological changes of the skin flaps were observed by H&E and Masson's trichrome staining. We also detected the expression levels of COX-1, HO-1, and Ki67 by immunohistochemical and western blot analysis. Moreover, enzyme-linked immunosorbent assay was used to identify the content of tumor necrosis factor (TNF)-α, myeloperoxidase (MPO), malondialdehyde (MDA), and nitric oxide (NO) in peripheral blood and skin tissue. Compared with the model group, SF treatment significantly improved the recovered flap area (%) and promoted collagen synthesis. Cyclooxygenase-2 (COX-2) expression was significantly inhibited by heme oxygenase-1 (HO-1) induction after SF treatment. Furthermore, SF significantly inhibited the levels of TNF-α in peripheral blood, MPO and MDA in the skin tissue, and the increased synthesis of NO. Our results showed the protective effects of SF on IRI after flap transplantation and we believe that the protective effects of SF was closely related to the alleviation of the inflammatory response and the inhibition of the oxidative stress injury.
Collapse
Affiliation(s)
- Y D Sun
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y S Gao
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - L W Xu
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y F Zhang
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - C Cheng
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - K C Wei
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Lin
- Department of Orthopedics, Xinhua Hospital (Chongming) Affiliated to Medical College, Shanghai Jiao Tong University, Shanghai, China
| | - G Chen
- Department of Plastic Surgery, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China
| | - C Y Liu
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Plastic Surgery, Changzheng Hospital of Navy Medical University, Shanghai, China
| | - Q F Li
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
6
|
Güney T, Kocman AE, Ozatik O, Akyüz F. The effect of fucoidin on kidney and lung injury in a rat infrarenal aortic ischemia-reperfusion model. Perfusion 2021; 37:198-207. [PMID: 33461417 DOI: 10.1177/0267659120982839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study was to investigate the effects of fucoidin on rat kidney and lung in an infraaortic ishemia reperfusion model. METHODS Forty Wistar rats were randomly divided into five groups (n = 8) as sham, control (IR), before ischemia (BI), before reperfusion (BR), and before ischemia and before reperfusion (BI/BR). Rats were subjected to 120 minutes ischemia followed by 120 minutes reperfusion with application of infrarenal aortic clamping. BI received intravenous fucoidin (25 mg/kg) ten minutes before establishing ischemia and BR received ten minutes before reperfusion. BI/BR group received half equal doses of fucoidin both before ischemia (12.5 mg/kg) and reperfusion (12.5 mg/kg) periods, respectively. After sacrification blood and tissue samples were obtained for biochemical (Malondialdehyde (MDA), Nitric oxide (NO), Myeloperoxidase (MPO), Catalase (CAT), Plasma Chitotriosidase (CHIT) and serum ischemia modified albumin (IMA)) and histologic examinations. RESULTS MDA, NO, MPO, CAT, and IMA levels were lower in BR and BI/BR groups compared to control group (p < 0.001). Plasma CHIT levels in BR and BI/BR groups were lower than in control group (p < 0.05). According to histological examination kidney and lung injury scores were lower in BR and BI/BR groups compared to control group (p < 0.01 and p < 0.001, respectively). CONCLUSION The study showed that fucoidin is effective in preventing kidney and lung injury if administered before reperfusion or both before ischemia and reperfusion. However, it has no effect if administered only before ischemia.
Collapse
Affiliation(s)
- Türkan Güney
- Department of Medical Biochemistry, Beykent University Faculty of Medicine, Istanbul, Turkey
| | - Atacan Emre Kocman
- Department of Plastic Reconstructive Aesthetic Surgery, Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Orhan Ozatik
- Department of Histology and Embryology, Kütahya Health Sciences University Faculty of Medicine, Kutahya, Turkey
| | - Fahrettin Akyüz
- Department of Biochemistry, Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| |
Collapse
|
7
|
Preventive effect of trimetazidine against ischemia-reperfusion injury in rat epigastric island flaps: an experimental study. EUROPEAN JOURNAL OF PLASTIC SURGERY 2020. [DOI: 10.1007/s00238-020-01757-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
8
|
Cui H, Feng Y, Shu C, Yuan R, Bu L, Jia M, Pang B. Dietary Nitrate Protects Against Skin Flap Ischemia-Reperfusion Injury in Rats via Modulation of Antioxidative Action and Reduction of Inflammatory Responses. Front Pharmacol 2020; 10:1605. [PMID: 32038262 PMCID: PMC6987438 DOI: 10.3389/fphar.2019.01605] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/10/2019] [Indexed: 01/09/2023] Open
Abstract
Dietary nitrate, found abundant in green vegetables, can be absorbed into the blood and be converted to nitric oxide (NO) in the body. Dietary nitrate has been proved to have many positive physiological functions in the body. Here, we evaluated the therapeutic effects of dietary nitrate on skin flap recovery following ischemia reperfusion (IR). Wistar rats were pretreated with nitrate from one week prior to ischemia to the end of reperfusion. It was found that oral administration of nitrate increased serum nitrate and nitrite levels, protected cells from apoptosis, and attenuated flap tissue edema. In the meantime, the oxidative stress marker malondialdehyde was reduced, while the activities of antioxidant enzymes were restored after nitrate treatment. Moreover, the macrophage and neutrophil infiltration in the flap was significantly attenuated by nitrate supplementation, as were the pro-inflammatory cytokines. In sum, we found that oral administration of nitrate can attenuate skin flap IR injury through the regulation of oxidative stress and inflammatory response.
Collapse
Affiliation(s)
- Hao Cui
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China.,School of Stomatology of Qingdao University, Qingdao, China
| | - Yuanyong Feng
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China.,School of Stomatology of Qingdao University, Qingdao, China
| | - Chuanliang Shu
- Department of Stomatology, The Affiliated Qingdao Hiser Hospital of Qingdao University, Qingdao, China
| | - Rongtao Yuan
- Qingdao Municipal Hospital, Affiliated to Shandong University, Qingdao, China
| | - Lingxue Bu
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China.,School of Stomatology of Qingdao University, Qingdao, China
| | - Muyun Jia
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China.,School of Stomatology of Qingdao University, Qingdao, China
| | - Baoxing Pang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China.,School of Stomatology of Qingdao University, Qingdao, China
| |
Collapse
|
9
|
Ballestín A, Casado JG, Abellán E, Vela FJ, Álvarez V, Usón A, López E, Marinaro F, Blázquez R, Sánchez-Margallo FM. Ischemia-reperfusion injury in a rat microvascular skin free flap model: A histological, genetic, and blood flow study. PLoS One 2018; 13:e0209624. [PMID: 30589864 PMCID: PMC6307726 DOI: 10.1371/journal.pone.0209624] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 12/07/2018] [Indexed: 12/29/2022] Open
Abstract
Ischemia reperfusion injury is associated with tissue damage and inflammation, and is one of the main factors causing flap failure in reconstructive microsurgery. Although ischemia-reperfusion (I/R) injury is a well-studied aspect of flap survival, its biological mechanisms remain to be elucidated. To better understand the biological processes of ischemia reperfusion injury, and to develop further therapeutic strategies, the main objective of this study was to identify the gene expression pattern and histological changes in an I/R injury animal model. Fourteen rats (n = 7/group) were randomly divided into control or ischemia-reperfusion group (8 hours of ischemia). Microsurgical anastomoses were objectively assessed using transit-time-ultrasound technology. Seven days after surgery, flap survival was evaluated and tissue samples were harvested for anatomopathological and gene-expression analyses.The I/R injury reduced the survival of free flaps and histological analyses revealed a subcutaneous edema together with an inflammatory infiltrate. Interestingly, the Arginase 1 expression level as well as the ratio of Arginase 1/Nitric oxide synthase 2 showed a significant increase in the I/R group. In summary, here we describe a well-characterized I/R animal model that may serve to evaluate therapeutic agents under reproducible and controlled conditions. Moreover, this model could be especially useful for the evaluation of arginase inhibitors and different compounds of potential interest in reconstructive microsurgery.
Collapse
Affiliation(s)
- Alberto Ballestín
- Department of Microsurgery, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
- * E-mail:
| | - Javier G. Casado
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Elena Abellán
- Department of Microsurgery, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - F. Javier Vela
- Department of Microsurgery, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Verónica Álvarez
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Alejandra Usón
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Esther López
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Federica Marinaro
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Rebeca Blázquez
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Francisco Miguel Sánchez-Margallo
- Department of Microsurgery, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| |
Collapse
|
10
|
Liu H, Zhang M, Dong X, Liu Y, Hao Y, Wang Y. Necrostatin-1 protects against ischemia/reperfusion injury by inhibiting receptor-interacting protein 1 in a rat flap model. J Plast Reconstr Aesthet Surg 2018; 72:194-202. [PMID: 30509738 DOI: 10.1016/j.bjps.2018.10.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 09/17/2018] [Accepted: 10/28/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The failure of reconstructive surgeries remains a challenge for plastic surgeons. Ischemia reperfusion (I/R) injury is considered to be one of the major problems in flap surgery. Necroptosis is a recently discovered and caspase-3-independent programed necrosis. Necrostatin-1 (Nec-1) is a specific inhibitor of necroptosis. Reports indicate that Nec-1 provides protection in ischemic models, such as brain, kidney, and heart. The aim of this study is to investigate the influence of Nec-1 on the I/R process in rat abdominal skin flaps. METHODS Twenty male Sprague-Dawley rats, weighing 280-320 g, were randomly divided into three groups. The extended epigastric skin flap (6 cm × 9 cm) of rats was used. Three hours of complete ischemia was performed using a clamp, and the clamp was then removed to reperfusion the flap. Twenty-four hours after the onset of the reperfusion, the rats were assessed for flap survival and perfusion analysis. One sample (1 cm × 1 cm) was taken for H&E, TUNEL, electron microscopy, IHC staining for RIP-1, and ELISA analysis for caspase-3 activity. RESULTS Compared to the CTL group, the flap in the Nec-1 group showed a higher survival rate and better blood perfusion. In histological observation, skin flap in the Nec-1 group showed less inflammatory infiltration than the CTL group. The AI in the CTL group was higher than that in the Nec-1 group and showed typical morphological changes of apoptotic cells. In IHC study, RIP-1 expression was higher in the CTL group. But there was no significant difference between the two groups in caspase-3 activity detection. CONCLUSION Nec-1 has a protective effect against I/R injury through the inhibition of RIP-1 on the skin flap model; this makes it a promising novel strategy in clinical setting.
Collapse
Affiliation(s)
- Hao Liu
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China; Chiese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingzi Zhang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Xinhang Dong
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yifang Liu
- Beijing Vocational College of Agriculture, China
| | - Yan Hao
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Youbin Wang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.
| |
Collapse
|
11
|
Petrovics L, Nagy T, Hardi P, Bognar L, Pavlovics G, Tizedes G, Takacs I, Jancso G. The effect of trimetazidine in reducing the ischemia-reperfusion injury in rat epigastric skin flaps. Clin Hemorheol Microcirc 2018; 69:405-415. [DOI: 10.3233/ch-170335] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Laura Petrovics
- Department of Surgical Research and Techniques, Medical School, University of Pécs, Hungary
| | - Tibor Nagy
- Department of Surgical Research and Techniques, Medical School, University of Pécs, Hungary
| | - Peter Hardi
- Department of Surgical Research and Techniques, Medical School, University of Pécs, Hungary
| | - Laura Bognar
- Department of Surgical Research and Techniques, Medical School, University of Pécs, Hungary
| | | | | | - Ildiko Takacs
- Department of Surgical Research and Techniques, Medical School, University of Pécs, Hungary
| | - Gabor Jancso
- Department of Surgical Research and Techniques, Medical School, University of Pécs, Hungary
| |
Collapse
|
12
|
Hsu CE, Shyu VBH, Wen CJ, Wei FC, Huang XT, Cheng HY. The rat groin flap model redesigned for evaluating treatment effects on ischemia-reperfusion injury. J Surg Res 2017; 222:160-166. [PMID: 29273367 DOI: 10.1016/j.jss.2017.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/08/2017] [Accepted: 10/12/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Although there is a wide application of the rat extended groin flap (epigastric skin flap) in studying different clinical issues, inconsistency arises between studies because many parameters of the extended groin flap have not been well defined. MATERIALS AND METHODS The flap is based on the superficial inferior epigastric vessels, which give into a lateral and a medial branch distally. Herein, three steps were taken to redesign this model: First, the ventral vascular anatomy was visualized through an imaging study to determine the flap borders. Second, different ischemic durations were induced on five groups of Lewis rats (n = 5 in each group) by clamping the femoral artery; group 1 (sham group) received no ischemic insult after elevation and was immediately repositioned, and groups 2, 3, 4, and 5 received 12-, 14-, 16-, and 18-hour ischemia, respectively. Percentage of necrosis area was measured after 5 days. Third, the redesigned groin flap model was tested with the ischemic postconditioning for validation. RESULTS The flap borders were determined such that both branches of the superficial inferior epigastric vessels were always included to ensure blood supply consistency. As the 14-hour ischemia induced the least variation in necrotic area on rats, it was chosen for further studies. In addition, ischemic postconditioning after 14-hr ischemia resulted in significant reduction of necrosis in this model. CONCLUSIONS We have redesigned the extended groin flap model with better-defined borders and consistent vascular anatomy. The ischemia duration was calibrated with predictable necrosis pattern and the practicality was demonstrated. With this model, precise assessment of treatment efficacies on ischemia-reperfusion injury could be achieved in future studies.
Collapse
Affiliation(s)
- Chung-En Hsu
- Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Gueishan, Taiwan
| | - Victor Bong-Hang Shyu
- Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Gueishan, Taiwan; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Gueishan, Taiwan
| | - Chih-Jen Wen
- Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Gueishan, Taiwan; College of Medicine, Chang Gung University, Gueishan, Taiwan
| | - Fu-Chan Wei
- Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Gueishan, Taiwan; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Gueishan, Taiwan; College of Medicine, Chang Gung University, Gueishan, Taiwan
| | - Xiao-Ting Huang
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Gueishan, Taiwan
| | - Hui-Yun Cheng
- Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Gueishan, Taiwan.
| |
Collapse
|
13
|
Jin Q, Ju J, Xu L, Liu Y, Li Z, Fu Y, Hou R. Estradiol postconditioning relieves ischemia/reperfusion injury in axial skin flaps of rats, inhibits apoptosis and alters the MKP-1/ERK pathway. Mol Med Rep 2017; 16:1472-1478. [PMID: 29067454 DOI: 10.3892/mmr.2017.6708] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 03/10/2017] [Indexed: 11/06/2022] Open
Abstract
Previous studies have suggested that estradiol can reduce the ischemia/reperfusion (I/R) injury in skin flaps. However, the mechanism, particularly the signal pathways involved in this protective effect are not well established. In the current study, an I/R injury model was established in rats to explore the connection between estradiol protection during I/R injury and extracellular signal‑regulated kinase (ERK) signaling. Healthy male Wistar rats were divided into five groups (n=10): Control group (group I), I/R group (group II), saline group (group III), estradiol group (group IV) and inhibitor (PD‑98059) group (group V). The survival rate of the flap was compared between groups, morphological changes were observed by hematoxylin and eosin staining of sections, and terminal deoxynucleotidyl transferase dUTP nick end labeling was performed to identify apoptotic cells and determine the apoptotic index. To further investigate the mechanism, western blot analysis was performed to assess the protein level of ERK1/2, phospho‑ERK1/2, and mitogen‑activated protein kinase phosphatase 1 (MKP‑1). The results of the present study demonstrated that estradiol therapy can reduce I/R injury and decrease the apoptosis index in an axial skin flap model. The inhibitor of the ERK pathway (PD‑98059) partially abolished the effects of estradiol, which involve the phosphatase enzyme MKP‑1. Taken together, the findings of the present study indicate that estradiol may act by reducing the expression of MKP‑1, mediating the expression/activation changes of the ERK pathway and subsequently reduce the level of apoptosis and the I/R injury the axial flap. Estrogen may be used to mitigate the adverse reaction caused by ischemia‑reperfusion injury and effectively improve the survival rate and survival quality of free skin flap and improve patient prognosis.
Collapse
Affiliation(s)
- Qianheng Jin
- Institute of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215100, P.R. China
| | - Jihui Ju
- Institute of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215100, P.R. China
| | - Lei Xu
- Institute of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215100, P.R. China
| | - Yuefei Liu
- Institute of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215100, P.R. China
| | - Zhimin Li
- Institute of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215100, P.R. China
| | - Yi Fu
- Department of Human Anatomy, Histology and Embryology, School of Biology and Basic Medical Sciences, Soochow University, Suzhou, Jiangsu 215100, P.R. China
| | - Ruixing Hou
- Institute of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215100, P.R. China
| |
Collapse
|
14
|
Rah DK, Min HJ, Kim YW, Cheon YW. Effect of Platelet-Rich Plasma on Ischemia-Reperfusion Injury in a Skin Flap Mouse Model. Int J Med Sci 2017; 14:829-839. [PMID: 28824320 PMCID: PMC5562190 DOI: 10.7150/ijms.19573] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/18/2017] [Indexed: 01/14/2023] Open
Abstract
Background: Ischemia-reperfusion (I/R) injury is a leading cause of surgical skin flap compromise and organ dysfunction. Platelet-rich plasma (PRP) is an abundant reserve of various growth factors. Activated platelets play a role in endothelial damage during I/R injury; however, exogenous PRP could inhibit the production of reactive oxygen species. The goal of this study was to investigate the effect of PRP on I/R injury. Methods: Four groups (n=30) of C57BL/6N mice with lateral thoracic artery island flaps were used. Group A, the control group, received flap elevation and repositioning. Group B received PRP and repositioning. Group C had 4 hours of ischemia and then were reperfused. Group D received PRP, had 4 hours of ischemia, and then were reperfused. The survival area of flap tissue and blood perfusion were assessed. Histological evaluation included neutrophil counts. Reactive oxygen species and proinflammatory cytokines were measured to evaluate I/R injury. Protein expression of phosphorylated apoptosis signaling regulating kinase-1 (pASK-1), p38MAPK, and pNF-κB was measured by western blot. Results: PRP treatment enhanced the survival area and perfusion of the flap, reduced neutrophil accumulation in mice subjected to I/R injury. PRP treatment also showed a protective effect, with decreases in nitric oxide, myeloperoxidase, malondialdehyde concentrations. Additionally, PRP suppresses monocyte chemotactic protein-1, TNF-α, IL-1β, and IL-6. Finally, PRP decreased ASK-1 and NF-κB expression in tissues with I/R injury. Conclusion: PRP acts as a protective factor during flap I/R injury by reducing reactive oxygen species level and proinflammatory cytokines via decreased expression of pASK-1 and pNF-κB.
Collapse
Affiliation(s)
- Dong Kyun Rah
- Department of Plastic and Reconstructive Surgery, Yonsei University, College of Medicine, Seoul, Republic of Korea
| | - Hyung Jun Min
- Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yang Woo Kim
- Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Young Woo Cheon
- Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| |
Collapse
|
15
|
Lee YK, Nata'atmaja BS, Kim BH, Pak CS, Heo CY. Protective effect of telomerase-based 16-mer peptide vaccine (GV1001) on inferior epigastric island skin flap survivability in ischaemia-reperfusion injury rat model. J Plast Surg Hand Surg 2016; 51:210-216. [PMID: 27670432 DOI: 10.1080/2000656x.2016.1235046] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Ischaemia-reperfusion injury (IRI) results in oxidative damage and a profound inflammatory reaction, leading to cell death. GV 1001 is a telomerase-based 16-mer peptide vaccine developed against cancer. However, it has also been reported to possess antioxidant and anti-inflammatory properties. The aim of this study was to determine if GV 1001 can reduce the negative effects caused by IRI in a rat skin flap model owing to its anti-oxidant and anti-inflammatory properties. MATERIALS AND METHODS In order to evaluate the effect of GV 1001, 5 × 5 cm2 inferior epigastric artery based island skin flaps were dissected in 39 8-week-old Sprague-Dawley rats weighing 220-270 g. The rats were divided into three groups: (I) non-ischaemic group; (II) IRI with saline; and (III) IRI with 10 mg GV 1001 treatment. Drugs were administered intra-muscularly directly before and after ischaemia. Flap survival area, neutrophil infiltration, cytokine levels (interleukin [IL]-1, IL-6, and tumour necrosis factor-α), malondialdehyde (MDA) level, and superoxide dismutase (SOD) activity were measured. Flap survivability was analysed at 7 days after surgery. RESULTS Flap survival area was significantly larger in group III than in group II. Cytokine release level was also significantly lower in group III. Neutrophil infiltration grade, MDA level, and SOD activity slightly decreased in Group III; however, the changes were not statistically significant. CONCLUSION These results imply that GV 1001 exerts a protective effect against IRI through antioxidant effects, reducing reactive oxygen species, and suppressing the inflammatory cascade.
Collapse
Affiliation(s)
- Yung Ki Lee
- a Department of Plastic & Reconstructive Surgery, College of Medicine , Kyung Hee University , Seoul , Korea
| | - Beta Subakti Nata'atmaja
- b Department of Plastic and Reconstructive Surgery , Dr. Soetomo General Hospital ? Airlangga University School of Medicine , Surabaya , Indonesia
| | - Byung Hwi Kim
- c Department of Biomedical Engineering , Seoul National University College of Medicine , Seoul , Korea
| | - Chang Sik Pak
- d Department of Plastic and Reconstructive Surgery , Seoul National University Bundang Hospital , Seongnam , Korea
| | - Chan Yeong Heo
- c Department of Biomedical Engineering , Seoul National University College of Medicine , Seoul , Korea.,d Department of Plastic and Reconstructive Surgery , Seoul National University Bundang Hospital , Seongnam , Korea
| |
Collapse
|
16
|
Gürsul C, Ekinci Akdemir FN, Akkoyun T, Can İ, Gül M, Gülçin İ. Protective effect of Naringin on experimental hindlimb ischemia/reperfusion injury in rats. J Enzyme Inhib Med Chem 2016; 31:56-61. [DOI: 10.3109/14756366.2016.1167050] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Cebrail Gürsul
- Department of Physiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey,
| | | | - Turan Akkoyun
- Department of Physiology, Faculty of Veterinary, Siirt University, Siirt, Turkey,
| | - İsmail Can
- Department of Histology, Faculty of Medicine, Kafkas University, Kars, Turkey,
| | - Mustafa Gül
- Department of Physiology, Faculty of Medicine, Atatürk University, Erzurum, Turkey,
| | - İlhami Gülçin
- Department of Chemistry, Faculty of Sciences, Atatürk University, Erzurum, Turkey, and
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
17
|
The protective effect of lycopene on hypoxia/reoxygenation-induced endoplasmic reticulum stress in H9C2 cardiomyocytes. Eur J Pharmacol 2016; 774:71-9. [PMID: 26845695 DOI: 10.1016/j.ejphar.2016.02.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/27/2016] [Accepted: 02/01/2016] [Indexed: 01/10/2023]
Abstract
Nowadays, drugs protecting ischemia/reperfusion (I/R) myocardium become more suitable for clinic. It has been confirmed lycopene has various protections, but lacking the observation of its effect on endoplasmic reticulum stress (ERS)-mediated apoptosis caused by hypoxia/reoxygenation (H/R). This study aims to clarify the protective effect of lycopene on ERS induced by H/R in H9C2 cardiomyocytes. Detect the survival rate, lactic dehydrogenase (LDH) activity, apoptosis ratio, glucose-regulated proteins 78 (GRP78), C/EBP homologous protein (CHOP), c-Jun-N-terminal protein Kinase (JNK) and Caspase-12 mRNA and protein expression and phosphorylation of JNK (p-JNK) protein expression. LDH activity, apoptosis ratio and GRP78 protein expression increase in the H/R group, reduced by lycopene. The survival rate reduces in the H/R and thapsigargin (TG) groups; lycopene and 4-phenyl butyric acid (4-PBA) can improve it caused by H/R, lycopene also can improve it caused by TG. The apoptosis ratio, the expression of GRP78, CHOP and Caspase-12 mRNA and protein and p-JNK protein increase in the H/R and TG groups, weaken in the lycopene+H/R, 4-PBA+H/R and lycopene+TG groups. There is no obvious change in the expression of JNK mRNA or protein. Hence, our results provide the evidence that 10 μM lycopene plays an obviously protective effect on H/R H9C2 cardiomyocytes, realized through reducing ERS and apoptosis. The possible mechanism may be related to CHOP, p-JNK and Caspase-12 pathways.
Collapse
|
18
|
|
19
|
Silva JJDL, Pompeu DG, Ximenes NC, Duarte ASG, Gramosa NV, Carvalho KDM, Brito GADC, Guimarães SB. Effects of Kaurenoic Acid and Arginine on Random Skin Flap Oxidative Stress, Inflammation, and Cytokines in Rats. Aesthetic Plast Surg 2015; 39:971-7. [PMID: 26408387 DOI: 10.1007/s00266-015-0559-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 08/18/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Kaurenoic acid (KA), a diterpene extracted from copaíba oil-resin, is known to have potent antioxidant and anti-inflammatory properties. L-Arginine (LA) is an amino acid and a nitrogenous precursor for the synthesis of nitric oxide (NO). NO paper in wound healing has already been well documented. The aim of this study was to investigate the protective effects of LA and KA against ischemia reperfusion injury in a randomized skin flap model in rats. METHODS A modified McFarlane flap model measuring 2.5 wide × 8 cm long was established in 36 anesthetized rats and evaluated within 3 groups: group control, group L-arginine, and group kaurenoic acid. Each group was subdivided into two subgroups (T1 and T2, n = 6 each). Samples were collected 24 h (T1)/48 h (T2) postoperatively for oxidative stress (glutathione), as non-protein thiols, malondialdehyde (MDA), NO2, inflammation [myeloperoxidase (MPO)], and cytokines TNF-α and IL-1β assays. RESULTS KA promoted a significant decrease of TNF-α and IL-1 expression and MPO activity at T1/T2 time points. NSGH levels increased significantly in KA-treated rats, while MDA levels decreased significantly in the same rats. Arginine promoted a significant decrease in MDA levels at the T1 time point and a significant increase in non-protein thiols concentrations at T1/T2 time points. NO2 concentration also decreased at the T1 time point. CONCLUSIONS KA may attenuate the oxidative stress and the inflammation, thereby reducing tissue damage induced by ischemia/reperfusion in rats subjected to dorsal skin flaps. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.
Collapse
Affiliation(s)
- Joaquim José de Lima Silva
- Department of Surgery, Federal University of Ceará (UFC), Rua Professor Costa Mendes, 1608/3º andar, Bloco Didático, Fortaleza, CE, 60430-140, Brazil.
| | - Débora Gramosa Pompeu
- Course of Chemical Engineering (UFC), Av. da Universidade, 2853 - Benfica, Fortaleza, CE, 60020-181, Brazil.
| | - Naiara Coelho Ximenes
- Faculty of Pharmacy, Dentistry and Nursing (UFC), Rua Alexandre Baraúna, 949 - Rodolfo Teófilo, Fortaleza, CE, 60430-160, Brazil.
| | | | - Nilce Viana Gramosa
- Department of Organic and Inorganic Chemistry (UFC), Campus do Pici, bloco 940 Bairro Pici, Fortaleza, CE, 60451-970, Brazil.
| | - Krishnamurti de Morais Carvalho
- Clinical Pharmacology and Molecular Laboratory, School of Medicine, Ceara State University (UECE), Av. Dr. Silas Muguba, 1700 - Campus do Itaperi, Fortaleza, CE, 60740-000, Brazil.
| | - Gerly Anne de Castro Brito
- Department of Morphology (UFC), Rua Delmiro de Farias s/n - Rodolfo Teófilo, Fortaleza, CE, 60416-030, Brazil.
| | - Sergio Botelho Guimarães
- Department of Surgery, Federal University of Ceará (UFC), Rua Professor Costa Mendes, 1608/3º andar, Bloco Didático, Fortaleza, CE, 60430-140, Brazil.
| |
Collapse
|
20
|
Song K, Zhang M, Hu J, Liu Y, Liu Y, Wang Y, Ma X. Methane-rich saline attenuates ischemia/reperfusion injury of abdominal skin flaps in rats via regulating apoptosis level. BMC Surg 2015; 15:92. [PMID: 26228913 PMCID: PMC4520019 DOI: 10.1186/s12893-015-0075-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 07/16/2015] [Indexed: 11/25/2022] Open
Abstract
Background In plastic surgery, skin damage induced by ischemia/reperfusion (I/R) is a multifactorial process that often occurs. Methane gas has been reported to be a new therapeutic gas for attenuating I/R injury. In this study, we assessed the effects of methane-rich saline (MRS) in regulating apoptosis on skin flap I/R injury. Methods Male Sprague–Dawley rats, 6–8 weeks old, were divided randomly into three groups: one sham surgery group (SH) and two surgery groups. After undergoing 6 h of I/R management of an abdominal skin flap, surgery groups were treated with physiological saline (I/R-P) or methane-rich saline (I/R-M). On the 3rd postoperative day, a laser Doppler flowmeter was used to measure flap blood supply, and hematoxylin and eosin (H&E) staining was used to observe morphological changes. TdT-mediated dUTP-X nick end labeling (TUNEL) staining was also used to observe early apoptosis and is presented as the percentage of TUNEL-positive cells. Moreover, pASK-1, pJNK, Bcl-2 and Bax were detected by immunohistochemical technology. Caspase-3 activity was also measured to evaluate the effects of MRS. Results Compared to the I/R-P group, the flaps in the I/R-M group presented a larger survival area and better blood perfusion with less inflammatory infiltration and cell apoptosis, a higher expression of Bcl-2, a lower expression of pASK-1, pJNK and Bax, and a lower caspase-3 activity. Conclusion According to the results, MRS attenuated I/R injury by regulating apoptosis and has the potential to be applied as a new therapy for improving skin flap survival.
Collapse
Affiliation(s)
- Kexin Song
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Mingzi Zhang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Jianqiang Hu
- Department of Orthopaedics, Qingdao Huangdao District Hospital of Traditional Chinese Medicine, Qingdao, Shandong, China
| | - Yunqi Liu
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, China
| | - Yifang Liu
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, China
| | - Youbin Wang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.
| | - Xuemei Ma
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, China
| |
Collapse
|
21
|
Liu YQ, Liu YF, Ma XM, Xiao YD, Wang YB, Zhang MZ, Cheng AX, Wang TT, Li JL, Zhao PX, Xie F, Zhang X. Hydrogen-rich saline attenuates skin ischemia/reperfusion induced apoptosis via regulating Bax/Bcl-2 ratio and ASK-1/JNK pathway. J Plast Reconstr Aesthet Surg 2015; 68:e147-56. [PMID: 26003800 DOI: 10.1016/j.bjps.2015.03.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 12/18/2014] [Accepted: 03/05/2015] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Many pathways have been reported involving the effect of hydrogen-rich saline on protecting skin flap partial necrosis induced by the inflammation of ischemia/reperfusion injury. This study focused on the influence of hydrogen-rich saline treatment on apoptosis pathway of ASK-1/JNK and Bcl-2/Bax radio in I/R injury of skin flaps. METHODS Adult male Sprague-Dawley rats were divided into three groups. Group 1 was sham surgery group, Group 2 and 3 were ischemia/reperfusion surgery treated with physiological saline and hydrogen-rich saline respectively. Blood perfusion of flap was measured by Laser doppler flowmeters. Hematoxylin and eosin staining was used to observe morphological changes. Early apoptosis in skin flap was observed through TUNEL staining and presented as the percentage of TUNEL-positive cells of total cells. pASK-1, pJNK, Bcl-2 and Bax were examined by immunodetection. In addition Bcl-2, Bax and caspase-3 were detected by qPCR. Caspase-3 activity was also measured. RESULTS Compared to the Group 2, tissues from the group 3 were observed with a high expression of Bcl-2 and a low expression of pASK-1, pJNK, and Bax, a larger survival area and a high level of blood perfusion. Hydrogen-rich saline ameliorated inflammatory infiltration and decreased cell apoptosis. CONCLUSION The results indicate that hydrogen-rich saline could ameliorate ischemia/reperfusion injury and improve flap survival rate by inhibiting the apoptosis factor and, at the same time, promoting the expression of anti-apoptosis factor.
Collapse
Affiliation(s)
- Yun-Qi Liu
- College of Life Science and Bioengineering, Beijing University of Technology, Chaoyang, Beijing, China
| | - Yi-Fang Liu
- College of Life Science and Bioengineering, Beijing University of Technology, Chaoyang, Beijing, China
| | - Xue-Mei Ma
- College of Life Science and Bioengineering, Beijing University of Technology, Chaoyang, Beijing, China.
| | - Yi-Ding Xiao
- Department of Plastic Surgery, Peking Union Medical College Hospital, Dongcheng, Beijing 100124, China
| | - You-Bin Wang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Dongcheng, Beijing 100124, China.
| | - Ming-Zi Zhang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Dongcheng, Beijing 100124, China
| | - Ai-Xin Cheng
- Faculty of Life Sciences, The University of Manchester, Manchester, UK
| | - Ting-Ting Wang
- College of Life Science and Bioengineering, Beijing University of Technology, Chaoyang, Beijing, China
| | - Jia-La Li
- College of Life Science and Bioengineering, Beijing University of Technology, Chaoyang, Beijing, China
| | - Peng-Xiang Zhao
- College of Life Science and Bioengineering, Beijing University of Technology, Chaoyang, Beijing, China
| | - Fei Xie
- College of Life Science and Bioengineering, Beijing University of Technology, Chaoyang, Beijing, China
| | - Xin Zhang
- College of Life Science and Bioengineering, Beijing University of Technology, Chaoyang, Beijing, China
| |
Collapse
|
22
|
Wang SP, Lan ZY, Xia W, Zhao X, Ma GJ, Liu B, Pan BH, Guo SZ. The effects of vasonatrin peptide on random pattern skin flap survival. Ann Plast Surg 2014; 72:94-9. [PMID: 23403542 DOI: 10.1097/sap.0b013e318255a3eb] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND A lot of methods have been intensively investigated to improve random skin flap survival. Decreasing inflammation and alleviating tissue injury have been reported to be effective in improving survival ratio. Vasonatrin peptide (VNP) is a chimera of atrial natriuretic peptide (ANP) and C-type natriuretic peptide (CNP). The current study demonstrates that VNP possesses the venodilating actions of CNP, the natriuretic actions of ANP, and the unique arterial vasodilating actions not associated with either ANP or CNP. However, its effects on skin flap survival have not been previously reported. METHODS Sprague-Dawley rats, weighing 220 to 260 g, were randomly divided into 2 groups, namely, the VNP-treated group and the control group. Rectangular random dorsal skin flaps measuring 3 × 9 cm including the panniculus carnosus were elevated, then the flaps were sutured into their original places. In the VNP group, 0.1 mg/kg of VNP was administered intravenously (IV) after surgery and then daily for 3 days. In the control group, 1 mL/kg of saline was administered IV after surgery and then daily for 3 days. To observe the effects of VNP, blood perfusion, histopathological examination, the inflammatory mediators (tumor necrosis factor α, interleukin 1β, and interferon γ), and biochemical analysis (malondialdehyde, glutathione, and myeloperoxidase) were detected and the flap viability was evaluated 7 days after surgery by measuring necrotic flap area and total flap area. RESULTS The viability measurements showed the percentage of flap survival was increased in the VNP-treated group (76.53% ± 6.36%) as compared with the control group (61.12% ± 4.92%) (P < 0.05), and the histological and biochemical assays corroborated the data. The blood perfusion of flaps in the VNP-treated group was higher than the control group (P < 0.05). The inflammatory mediators (tumor necrosis factor α, interleukin 1β, and interferon γ) were significantly lower in the VNP-treated group than the control group (P < 0.05). CONCLUSIONS This study found that VNP, which could elevate the tissue blood perfusion and mitigate the tissue damage and inflammatory reaction, is associated with a higher percentage of survival random pattern skin flap area.
Collapse
Affiliation(s)
- Shi-Ping Wang
- From the Institute of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Effects of nebivolol on skin flap survival: A randomized experimental study in rats. Curr Ther Res Clin Exp 2014; 69:449-58. [PMID: 24692819 DOI: 10.1016/j.curtheres.2008.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Skin flaps are among the basic treatment options in the reconstruction of soft tissue defects. To improve skin flap survival, a variety of methods, including pharmacologic agents, have been investigated. The effectiveness of anticoagulants, antioxidants, anti-inflammatory drugs, and vasodilatory drugs in improving flap survival has been studied. Nebivolol is a new-generation selective β1-adrenoreceptor blocking agent that has vasodilatory, antithrombotic, antioxidative, and anti- inflammatory effects. OBJECTIVE The aim of this experimental study was to investigate the effects of nebivolol (50 mg/kg/d) on random pattern skin flap survival in rats. METHODS Male Wistar rats weighing 290 to 310 g were randomly divided into 2 groups-the nebivolol group and the control group. Random patterned, caudally-based, ~3 × 10-cm skin flaps were elevated on the back of each rat. In the nebivolol group, nebivolol 50 mg/kg/d (1 mL, of a racemic solution of nebivolol) was administered orally 2 days before surgery to reach steady-state drug blood concentrations and was continued for 6 days. In the control group, 1 mL/d of sterile saline solution was orally administered 2 days before surgery and was continued for 6 days. To observe the effects of nebivolol, cutaneous blood flow was examined using a laser Doppler flow-meter before and after surgery on days 1, 3, 5, and 7, and flap tissue, malondialdehyde (MDA) and glutathione (GSH) concentrations, and superoxide dismutase (SOD) activity were measured 7 days postsurgery. Flap viability was evaluated 7 days after surgery by measuring necrotic flap area and total flap area. RESULTS All 20 rats (nebivolol group, n = 10; control group, n = 10) survived throughout the study period. Mean (SD) MDA concentration was significantly lower in the nebivolol group than in the control group (69.25 [5.82] vs 77.67 [6.87] nmol/g tissue; P = 0.009). GSH concentration was significantly higher in the nebivolol group than in the control group (2.14 [0.15] vs 1.88 [0.22] nmol/mg tissue; P = 0.004). SOD activity was significantly greater in the nebivolol group than in the control group (49.28 [5.49] vs 42.09 [4.95] U/g tissue; P = 0.007). The percentage of the flap that was necrotic was significantly lower in the nebivolol group than in the control group (40.27 [4.08] vs 48.87 [6.35]; P = 0.007). CONCLUSIONS This small, experimental, in vivo animal study found that nebivolol was associated with reduced necrotic random pattern skin flap area. Further studies are needed to clarify these findings.
Collapse
|
24
|
Gideroglu K, Yilmaz F, Aksoy F, Bugdayci G, Cakici H, Hapa O. The effects of montelukast on random pattern skin flap survival: An experimental study in rats. Curr Ther Res Clin Exp 2014; 69:459-65. [PMID: 24692820 DOI: 10.1016/j.curtheres.2008.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND A variety of methods to improve skin flap survival, including the use of pharmacologic agents, have been intensively investigated. Decreasing neutrophil-mediated inflammation and tissue injury has been reported to be effective in improving flap survival. Montelukast is a selective reversible cysteinyl leukotriene receptor-1 antagonist that has been found to have protective effects against renal ischemia reperfusion injury and burn-induced oxidative injury of the skin in rats. However, its effects on skin flap survival have not been previously reported. OBJECTIVE The aim of this study was to investigate the effects of montelukast on neutrophil-mediated random pattern skin flap survival. METHODS Male Sprague-Dawley rats weighing 230 to 250 g were randomly divided into 2 groups-the montelukast-treated group and the control group. Caudally based rectangular random pattern skin flaps 3 × 9 cm were elevated on the backs of the rats. The flaps were sutured into their original places. In the montelukast group, 1 mL of solution containing 10 mg/kg montelukast was administered intraperitoneally (IP) 30 minutes before surgery and then daily for 6 days. In the control group, 1 mL of saline was administered IP 30 minutes before surgery and then daily for 6 days. To observe the effects of montelukast, myeloperoxidase (MPO) activity, an index of tissue neutrophil infiltration, was measured from extracted skin tissue 12 hours after flap elevation. Flap viability was evaluated 7 days after surgery by measuring necrotic flap area and total flap area. RESULTS Sixteen rats (mean [SD] weight, 240.6 [6.6] g) were equally divided between the 2 groups. All rats survived throughout the study period. Mean (SD) MPO activity in flap tissue was significantly lower in the montelukast group than in the control group (14.57 [2.33] vs 21.28 [4.86] U/g protein; P = 0.005). The percentage of necrotic flap area was significantly lower in the montelukast group than in the control group (17.17 [7.95] vs 37.51 [10.72]; P = 0.001). CONCLUSION This small, experimental, in vivo animal study found that montelukast was associated with both lower MPO activity and a lower percentage of necrotic random pattern skin flap area. Future studies are needed to clarify these findings.
Collapse
Affiliation(s)
- Kaan Gideroglu
- Medical Faculty, Department of Aesthetic, Plastic, and Reconstructive Surgery, Abant Izzet Baysal University, Bolu, Turkey
| | - Fahrettin Yilmaz
- Medical Faculty, Department of Otorhinolaryngology and Head and Neck Surgery, Abant Izzet Baysal University, Bolu, Turkey
| | - Fadullah Aksoy
- Otorhinolaryngology and Head and Neck Surgery Clinics, Haseki Education and Research Hospital, Istanbul, Turkey
| | - Guler Bugdayci
- Medical Faculty, Department of Biochemistry, Abant Izzet Baysal University, Bolu, Turkey
| | - Husamettin Cakici
- Medical Faculty, Department of Orthopedics, Abant Izzet Baysal University, Bolu, Turkey
| | - Onur Hapa
- Orthopedic Clinic, State Hospital, Bolu, Turkey
| |
Collapse
|
25
|
Kang N, Hai Y, Liang F, Gao CJ, Liu XH. Preconditioned hyperbaric oxygenation protects skin flap grafts in rats against ischemia/reperfusion injury. Mol Med Rep 2014; 9:2124-30. [PMID: 24676940 PMCID: PMC4055471 DOI: 10.3892/mmr.2014.2064] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 02/24/2014] [Indexed: 11/18/2022] Open
Abstract
Hyperbaric oxygen (HBO) therapy is an effective therapy for ischemia/reperfusion (I/R) injury of the brain, small intestine, testes and liver. However, the detailed molecular mechanisms underlying the effect of HBO therapy remain undetermined. In the current study, the hypothesis that preconditioning rats with HBO protects grafted skin flaps against subsequent I/R injury was investigated. In addition, the molecular mechanisms underlying HBO therapy were characterized by analyzing the roles of the following important inflammatory factors: High mobility group protein 1 (HMGB1) and nuclear factor-κ B (NF-κB). A total of 40 rats were randomly divided into the following five groups: (i) Sham surgery (SH); (ii) ischemia followed by reperfusion 3 days following surgery (I/R3d); (iii) ischemia followed by reperfusion 5 days following surgery (I/R5d); (iv) HBO preconditioning (HBO-PC) and ischemia followed by reperfusion 3 days following surgery (HBO-PC+3d); and (v) HBO-PC and ischemia followed by reperfusion 5 days following surgery (HBO-PC+5d). For the surgical procedure, all pedicled skin flaps were first measured and elevated (9×6 cm). The feeding vessels of the skin flaps were subsequently clamped for 3 h and released to restore blood flow. The rats in the HBO-PC+3d and HBO-PC+5d groups received 1 h HBO for 3 and 5 consecutive days, respectively, prior to surgery. Following surgery, the rats were euthanized, and grafted tissues were collected for western blotting and immunohistochemistry. HBO-PC increased blood perfusion in epigastric skin flaps and attenuated I/R injury following skin flap graft. Additionally, the elevated expression of HMGB1 and NF-κB proteins during I/R injury was attenuated by HBO-PC treatment. HBO-PC may therefore be applied to reduce I/R injury and improve the survival rate of grafted skin flaps. The molecular mechanisms underlying the effect of HBO therapy are associated with the attenuation of inflammatory responses.
Collapse
Affiliation(s)
- Nan Kang
- Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China
| | - Yong Hai
- Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China
| | - Fang Liang
- Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China
| | - Chun-Jin Gao
- Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China
| | - Xue-Hua Liu
- Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China
| |
Collapse
|
26
|
Dong X, Xing Q, Li Y, Han X, Sun L. Dexmedetomidine protects against ischemia-reperfusion injury in rat skeletal muscle. J Surg Res 2013; 186:240-5. [PMID: 24007817 DOI: 10.1016/j.jss.2013.07.052] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 07/14/2013] [Accepted: 07/26/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND Dexmedetomidine (DEX) has been shown to decrease ischemia-reperfusion (I/R) injury in kidney and brain tissues. In this study, the effects of DEX were evaluated in skeletal muscle during I/R injury. MATERIALS AND METHODS Animals were divided into four groups: sham-operated (sham group), saline + I/R, DEX + I/R, and α-tocopherol + I/R groups. Hind limb ischemia was induced by clamping the common femoral artery and vein. After 4 h of ischemia, the clamp was removed and the animals underwent 2 h of reperfusion. Animals in the drug treatment group received DEX or α-tocopherol by intraperitoneal injection 1 h before reperfusion. We measured plasma concentrations of interleukin 1β and tumor necrosis factor α levels using an enzyme-linked immunosorbent assay. The right gastrocnemius muscle was harvested and immediately stored at -80°C for the assessment of superoxide dismutase (SOD) and catalase (CAT) activities as well as glutathione (GSH), malondialdehyde (MDA), and protein oxidation (PO) levels. DEX (25 μg/kg) and normal saline (10 mL/kg) were administered by intraperitoneal injection 1 h before reperfusion. RESULTS Plasma tumor necrosis factor α or interleukin 1β levels increased significantly in the I/R group (P < 0.01 compared with sham group) and decreased significantly in the DEX group (P < 0.01 compared with I/R group). Muscle tissues of the I/R group had significantly decreased SOD, GSH, and CAT activities and increased levels of MDA and PO content compared with the sham group. The activity of antioxidant enzymes in the DEX + I/R group was greatly elevated compared with that in the I/R group (SOD, 1.068 ± 0.120 versus 0.576 ± 0.072 U/mg protein; GSH, 2.436 ± 0.144 versus 1.128 ± 0.132 μmol/g; and CAT, 69.240 ± 6.456 versus 31.884 ± 6.312 U/mg protein; P < 0.01), whereas the levels of MDA and PO content were clearly reduced (23.268 ± 3.708 versus 53.604 ± 5.972 nmol/g protein and 1.908 ± 0.192 versus 5.208 ± 0.612 nmol/mg protein, respectively; P < 0.01). Moreover, DEX exhibited more potent antioxidant activity than vitamin E in the skeletal muscle I/R. CONCLUSIONS We found that DEX exhibits protective effects against skeletal muscle I/R injury. These results underscore the necessity of human studies with DEX to determine if it is beneficial for preventing skeletal muscle I/R injury.
Collapse
Affiliation(s)
- Xu Dong
- Department of Anesthesiology, The First Affiliated Hospital, Henan Science and Technology University, Luoyang, Henan, China
| | | | | | | | | |
Collapse
|
27
|
Erkanli K, Erkanli Senturk G, Aydin U, Arbak S, Ercan F, Tuncdemir M, Isiksacan N, Bakir I. Oxytocin Protects Rat Skeletal Muscle Against Ischemia/Reperfusion Injury. Ann Vasc Surg 2013; 27:662-70. [DOI: 10.1016/j.avsg.2012.10.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Revised: 10/05/2012] [Accepted: 10/23/2012] [Indexed: 11/28/2022]
|
28
|
Lawton B, Boyette JR, Hu M, Lian TS. Selectin blockade decreases postischemic recruitment of bone marrow stromal cells. Laryngoscope 2013; 123:2993-5. [PMID: 23712829 DOI: 10.1002/lary.24217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 04/30/2013] [Accepted: 04/30/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS Investigate the localization mechanisms of bone marrow stromal cells following transient ischemia-reperfusion injury in a murine flap model. STUDY DESIGN Controlled laboratory study. METHODS A cutaneous flap based on the inferior epigastric artery was elevated, and transient ischemia of 3.5 hours using a microvascular clamp was achieved. Fucoidan was injected intravenously 24 hours before the ischemic period. Following the period of ischemia, radiolabeled bone marrow stromal cells were injected intravenously, and radioactivity was determined postoperatively. RESULTS Attenuation of the uptake of bone marrow stromal cells into postischemic tissue was observed in those mice treated with fucoidan as indicated by gamma counts measured in the flaps when compared with controls (P < . 001). CONCLUSIONS Decreased uptake of radiolabeled bone marrow stromal cells into postischemic tissues pretreated with fucoidan indicates selectin-mediated bone-marrow stromal cell recruitment in a murine cutaneous flap model.
Collapse
Affiliation(s)
- Brian Lawton
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University-Shreveport Health Sciences Center, Shreveport, Louisiana, U.S.A
| | | | | | | |
Collapse
|
29
|
Effect of ischemia post-conditioning on skeletal muscle oxidative injury, mTOR, Bax, Bcl-2 proteins expression, and HIF-1α/β-actin mRNA, IL-6/β-actin mRNA and caveolin-3/β-actin mRNA expression in ischemia-reperfusion rabbits. Mol Biol Rep 2012; 40:507-14. [PMID: 23108993 DOI: 10.1007/s11033-012-2087-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 10/03/2012] [Indexed: 01/21/2023]
Abstract
This study is designed to investigate the effect of ischemia post-conditioning on IR-induced skeletal muscle injury in limbs of experimental rabbits. Rabbits are randomized to one of the following three groups: sham control, ischemic reperfusion, ischemic postconditioning. The lipid peroxidation level, antioxidant enzymes activities, skeletal muscle mammalian target of rapamycin (mTOR), Bax, Bcl-2 proteins expression and Bcl-2/Bax, and HIF-1α/β-actin mRNA, interleukin-6 (IL-6)/β-actin mRNA and caveolin-3/β-actin mRNA expression were tested in the current study. The results suggested that ischemic postconditioning might decrease lipid peroxidation level, lactic dehydrogenase (LDH), creatine kinase (CK) activities, Bcl-2 proteins expression and Bcl-2/Bax, HIF-1α/β-actin mRNA expression and increase skeletal muscle antioxidant enzymes activities, Bax protein expression and IL-6/β-actin mRNA and caveolin-3/β-actin mRNA expression. These indicated that protective effect of ischemic postconditioning against IR-induced skeletal muscle injury involve into a complex molecular mechanism. Our research results may offer a theoretical guidance for therapy of related clinical diseases.
Collapse
|
30
|
Chang KP, Lai CS. Micro-RNA profiling as biomarkers in flap ischemia-reperfusion injury. Microsurgery 2012; 32:642-8. [PMID: 23097335 DOI: 10.1002/micr.22046] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 08/02/2012] [Accepted: 08/09/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND Ischemia-reperfusion injury (IRI) is usually the key and often plays an irreversible role to induce flap compromise in microvascular tissue transfers. This article aims to profile the expression of micro-RNAs (miRs) in free flap surgeries following IRI. METHODS The miRs expression profiling was initially surveyed in rat epigastric flap vessels using Agilent 350-Microarrayed miRs after IRI, and then quantified by real-time reverse transcription polymerase chain reaction in flap vessels and tissues (n = 5) at three intervals: before induction of ischemia (normoxia without IRI, sham), 2 and 72 hours after reperfusion following 2 hours of ischemia. Furthermore, for seven patients with free anterolateral thigh flap reconstruction, the miRs expression patterns in these flaps before induction of ischemia (normoxia), at 2 and 72 hours after reperfusion following an ischemic interval were investigated. RESULTS Four miRs (miR-96, miR-193-3p, miR-210, and miR-21) of 350 tested rat miRs were found to be positively significant. In rat flap vessels, the upregulation of these miRs at 72-hour reperfusion was statistically significant. These patterns were not noted in rat flap tissues, except for miR-96. However, there seemed to be no significant difference in human flap vessels between normoxia and 2-hour reperfusion following ischemia. In human flap tissue, significant upregulation of miR-193-3p, miR-210, and miR-21 was detected at 72-hour perfusion. CONCLUSIONS Our findings show some changes of four upregulated miRs in our model of IRI. We suggest that further investigation is needed to determine the role of miRs in IRI of microsurgical reconstruction.
Collapse
Affiliation(s)
- Kao-Ping Chang
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | | |
Collapse
|
31
|
Monitoring molecular changes induced by ischemia/reperfusion in human free muscle flap tissue samples. Ann Plast Surg 2012; 68:202-8. [PMID: 21508818 DOI: 10.1097/sap.0b013e3181f77ba5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Our current knowledge of the pathophysiological sequelae of ischemia or reperfusion (I/R) injury in free tissue transfer in reconstructive surgery is based on data obtained in animal experiments. In this study, we investigated the histologic and molecular changes after 11 free microsurgical muscle transfers in human muscle tissue. METHODS Biopsies of free muscle flap tissue were taken immediately before clipping of the pedicle and 5 days after ischemia and successful microanastomosis and restoration of the blood flow. Samples were analyzed histologically for edema formation and by immunohistochemistry for infiltration of inflammatory cells and angiogenesis. Expression levels of the inflammatory marker proteins interleukin-1β and tumor necrosis factor α and of complement component 3 as a major mediator of I/R injury were analyzed by real-time polymerase chain reaction. A TUNEL (terminal desoxynucleotidyl transferase-mediated-dUTP-nick-end-labeling) assay was used to assess apoptosis levels within the human muscle tissue. RESULTS I/R injury leads to a significant up-regulation of inflammatory parameters, infiltration of inflammatory cells, and angiogenesis. Increased complement component 3 deposition and apoptosis of cells were accompanied by interstitial edema as indication for a pronounced postischemic inflammatory reaction within the muscle tissue after free tissue transfer. CONCLUSIONS Our findings of molecular changes induced by I/R injury in human striated muscle tissue validate data obtained in animal models of I/R injury. The parameters and inflammatory patterns defined in this study will allow for the monitoring of the success of novel pharmaceutical strategies in the future and will help to transfer data obtained in animal work to the in vivo setting in human beings.
Collapse
|
32
|
Huang L. The impact of lidocaine on secondary ischemia injury of skin flaps. Transplant Proc 2012; 43:2550-3. [PMID: 21911121 DOI: 10.1016/j.transproceed.2011.04.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 03/19/2011] [Accepted: 04/21/2011] [Indexed: 11/16/2022]
Abstract
PURPOSE Lidocaine is used to reduce the undesirable effects of ischemia because of its anti-inflammatory effects. Herein we investigated the effects of lidocaine on secondary ischemia in a skin flap model. MATERIALS AND METHODS In this epigastric skin flap protocol in animals, we followed 2 hours of primary global ischemia with a reperfusion period of 6 hours and then either secondary arterial or venous ischemia for another 6 hours during which we tested the usefulness of lidocaine. Lidocaine was injected via the intraperitoneal route 5 minutes before the second period of ischemia. The animals were allocated into secondary arterial ischemia or secondary venous ischemia groups which were subdivided according to the delivered agents. Neutrophil cell counts at the margins of the flaps were recorded 12 hours after the end of the second period of ischemia. Flap viability was assessed 1 week after the surgical procedure. Surviving flap area was recorded as the percentage of the whole area. The Least Significant Difference test was used to detect a significant difference among groups, and the Pearson test to evaluate the relationship between neutrophil counts and flap survival rate. RESULTS There were significant differences among groups both with respect to neutrophil count and flap survival. There was a relationship between the neutrophil counts and the flap survivals. CONCLUSION Intraperitoneally injected lidocaine was an effective procedure to reduce flap necrosis as a cause of secondary ischemia in skin flaps, an effect of the ischemia-reperfusion injury.
Collapse
Affiliation(s)
- L Huang
- Department of Plastic and Reconstructive Surgery, Anzheng Hospital, Capital University of Medical Science, Beijing, China.
| |
Collapse
|
33
|
Avci G, Kadioglu H, Sehirli AO, Bozkurt S, Guclu O, Arslan E, Muratli SK. Curcumin Protects Against Ischemia/Reperfusion Injury in Rat Skeletal Muscle. J Surg Res 2012; 172:e39-46. [DOI: 10.1016/j.jss.2011.08.021] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 07/28/2011] [Accepted: 08/10/2011] [Indexed: 10/17/2022]
|
34
|
Negative pressure wound therapy reduces the ischaemia/reperfusion-associated inflammatory response in free muscle flaps. J Plast Reconstr Aesthet Surg 2011; 65:640-9. [PMID: 22137686 DOI: 10.1016/j.bjps.2011.11.037] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Revised: 09/25/2011] [Accepted: 11/10/2011] [Indexed: 12/22/2022]
Abstract
BACKGROUND We recently established negative pressure wound therapy (NPWT) as a safe postoperative care concept for free muscle flaps; however, the molecular effects of NPWT on free muscle flaps remain elusive. Here we investigated the effects of NPWT on pathological changes associated with ischaemia/reperfusion injury in free flap tissue. METHODS From July 2008 to September 2010, 30 patients receiving skin-grafted free muscle transfer for defect coverage were randomly assigned to two treatment groups: In one group the skin-grafted free flap was covered by a vacuum dressing (NPWT); in the second group, flaps were covered by conventional petroleum gauze dressings (conv). Biopsies were taken intra-operatively prior to clipping of the pedicle and on postoperative day 5. Samples were analysed by immunohistochemistry for infiltration of inflammatory cells, real-time polymerase chain reaction (RT-PCR) for the analysis of expression levels of interleukin-1β (IL-1β) and tumour necrosis factor (TNF)-alpha as markers of inflammation. Histological samples were also examined for interstitial oedema formation, and apoptosis was detected by a terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) assay. RESULTS NPWT leads to a significantly reduced tissue infiltration of CD68 + macrophages and reduced expression of the inflammatory cytokines IL-1β and TNFα. None of these parameters was significantly elevated in the pre-ischaemic biopsies. Furthermore, NPWT reduced the interstitial oedema formation and the number of apoptotic cells in free flap tissue. CONCLUSION NPWT of skin-grafted free muscle flaps leads to a reduced inflammatory response following ischaemia/reperfusion, resulting in reduced oedema formation improving the microcirculation and ultimately reduced tissue damage. We thereby deliver new insight into the effects of NPWT.
Collapse
|
35
|
Benlier E, Eskiocak S, Puyan FO, Kandulu H, Unal Y, Top H, Aygit AC. Fucoidin, a neutrophil rolling inhibitor, reduces damage in a rat electrical burn injury model. Burns 2011; 37:1216-21. [DOI: 10.1016/j.burns.2011.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 04/12/2011] [Accepted: 04/15/2011] [Indexed: 11/15/2022]
|
36
|
Fucoidan: A Versatile Biopolymer for Biomedical Applications. ACTIVE IMPLANTS AND SCAFFOLDS FOR TISSUE REGENERATION 2011. [DOI: 10.1007/8415_2011_67] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
|
37
|
Freitas FAS, Piccinato CE, Cherri J, Marchesan WG. Effects of pentoxyfilline and heparin on reperfusion injury island skin flaps in rats exposed to tobacco. J Surg Res 2010; 164:139-45. [PMID: 20739032 DOI: 10.1016/j.jss.2010.05.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2008] [Indexed: 10/19/2022]
Abstract
BACKGROUND Ischemia-reperfusion injury is believed to be a major cause of transferred skin flap failure. Cigarette smoking is known to be associated with endogenous antioxidant depletion, hypercoagulability, and cutaneous vasoconstriction. This investigation was carried out to study possible effects of pentoxyfilline or heparin on rat skin reperfusion injury under tobacco exposure. MATERIALS AND METHODS Thirty-six rats were randomized into two major groups: 18 were exposed to cigarette smoke during a 4 wk period prior to surgery; the remaining 18 underwent a sham smoking procedure. Each group was further divided into three equal subgroups: heparin, pentoxyfilline, and saline solution. One identical skin flap was raised in each animal. The vasculature of the flap was clamped for 3 h and reperfused for 5 min. A venous blood sample was obtained from the flap after reperfusion for serum malondialdehyde (MDA) and myeloperoxidase (MPO) analysis. Flap survival was assessed 7 d after the procedure. RESULTS The lipid peroxidation levels and flap necrosis were significantly higher in the cigarette-smoking group skin flaps. There was also a decrease of MPO activity in this group compared with the non-smoking group. Heparin-treated rats had significantly lower MDA levels and showed the most viable percent area among smoking rats. CONCLUSIONS These data suggest that heparin had a significant beneficial effect both on flap survival and on the lipid peroxidation reduction after smoke exposure in the rat axial-pattern skin flap subjected to ischemia and reperfusion injury. Pharmacologic therapy may represent an alternative way to counteract tobacco effects in flap surgery in emergency situations.
Collapse
Affiliation(s)
- Frederico A S Freitas
- Department of Surgery and Anatomy, Division of Plastic Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | | | | | | |
Collapse
|
38
|
Gideroglu K, Yilmaz F, Aksoy F, Bugdayci G, Saglam I, Yimaz F. Montelukast Protects Axial Pattern Rat Skin Flaps Against Ischemia/Reperfusion Injury. J Surg Res 2009; 157:181-6. [DOI: 10.1016/j.jss.2008.07.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Revised: 07/09/2008] [Accepted: 07/16/2008] [Indexed: 10/21/2022]
|
39
|
Eskitascioglu T, Karaci S, Canoz O, Kılıc E, Gunay GK. The impact of lidocaine on flap survival following reperfusion injury. J Surg Res 2009; 167:323-8. [PMID: 19766238 DOI: 10.1016/j.jss.2009.05.046] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Revised: 05/15/2009] [Accepted: 05/27/2009] [Indexed: 12/29/2022]
Abstract
BACKGROUND Inflammatory events triggered by the mediators released from free oxygen radicals and infiltrated leukocytes play a direct role in formation of the ischemia-reperfusion (IR) injury. The aim of this study was to investigate the impact of lidocaine on IR injury due to its anti-inflammatory properties. MATERIALS AND METHODS Following delivery of lidocaine to the ischemic flaps in two different doses prior to the reperfusion, flap survival, malondialdehyde (MDA) level, myeloperoxidase (MPO) level, neutrophil count, and measurement of vascular diameters were studied. Twelve hours after reperfusion, tissue specimens were collected for measurement of MDA level, MPO level, neutrophil count, and vascular diameters. Flap survival was evaluated on the fifth day. RESULTS Flap survival rate was 15.54% ± 8.23% in the control group, whereas the groups treated wtih lidocaine showed remarkable elevations in survival rates as follows: 70.83% ± 33.53% and 67.42% ± 30.81%, respectively. MDA levels in sham and lidocaine treatment groups were significantly lower than those observed in control group. CONCLUSION Lidocaine inhibited the increase in MDA level associated with IR injury while showing no influence over increases in number of neutrophils and tissue MPO level, and it elevated the flap survival rate.
Collapse
Affiliation(s)
- Teoman Eskitascioglu
- Department of Plastic, Reconstructive and Aesthetic Surgery, Erciyes University, Faculty of Medicine, Kayseri, Turkey.
| | | | | | | | | |
Collapse
|
40
|
van den Heuvel MG, Buurman WA, Bast A, van der Hulst RR. Review: ischaemia–reperfusion injury in flap surgery. J Plast Reconstr Aesthet Surg 2009; 62:721-6. [DOI: 10.1016/j.bjps.2009.01.060] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2008] [Revised: 01/03/2009] [Accepted: 01/30/2009] [Indexed: 11/25/2022]
|
41
|
Turker Ozyigit M, Turkaslan T, Ertugrul O, Ertugrul BM, Cevikbas U, Ozsoy Z. Protective effects of carvedilol on ischemia–reperfusion injury in rat epigastric island skin flaps. EUROPEAN JOURNAL OF PLASTIC SURGERY 2007. [DOI: 10.1007/s00238-007-0147-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
42
|
Aydogan H, Gurlek A, Parlakpinar H, Askar I, Bay-Karabulut A, Aydogan N, Fariz A, Acet A. Beneficial effects of caffeic acid phenethyl ester (CAPE) on the ischaemia-reperfusion injury in rat skin flaps. J Plast Reconstr Aesthet Surg 2007; 60:563-8. [PMID: 17399667 DOI: 10.1016/j.bjps.2006.01.030] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2004] [Revised: 01/23/2006] [Accepted: 01/24/2006] [Indexed: 11/25/2022]
Abstract
BACKGROUND Reperfusion injury is a phenomenon that occurs when tissues are subjected to ischaemia for a variable period of time, after which they are reperfused. Many factors have been implicated in the cause of reperfusion injury including free radicals and neutrophils. Caffeic acid (3,4-dihydroxycinnamic acid) phenethyl ester (CAPE) is an active component of propolis from honeybee; it has anti-inflammatory and immunomodulatory properties, and protective effects against ischaemia-reperfusion (I/R) injury. We investigated the effects of CAPE on the survival of skin flaps in the rat. MATERIALS AND METHODS Eighteen Wistar rats were used, and randomly divided into three groups (n=6 rats each group): the control group (Group 1), ethanol group (Group 2), and CAPE group (Group 3). A caudally based rectangular flap, 3x10 cm in size, was elevated on the back of the rat, according to the method described by Khouri and colleagues. The flap was sutured back into its original place. In the control group, saline 0.2 ml/day was given intraperitoneally (i.p.). Five percent ethanol 0.2 ml/day was administered i.p. in the ethanol group, and CAPE 50 micromol/kg/day i.p. in the CAPE group. To observe the effects of CAPE, levels of malondialdehyde (MDA), nitric oxide (NO), glutathione (GSH), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) were measured from extracted skin tissue. Flap viability was evaluated seven days after the initial operation, measuring necrotic areas of flaps and total flap areas. RESULTS MDA and NO levels were significantly decreased in CAPE group; and however, GSH, GSH-Px, and SOD enzyme activities were significantly increased in CAPE group. We believed that the CAPE had beneficial effects to improve the survival of skin flaps since it has antioxidative and anti-inflammatory properties, and protective effects against I/R injury.
Collapse
Affiliation(s)
- Hakan Aydogan
- Department of Plastic and Reconstructive Surgery, Inonu University, Medical Faculty, T. Ozal Medical Center, TR 44069 Malatya, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Beheshtian A, Demehri S, Kiumehr S, Salmasi AH, Nezami BG, Ghazinezami B, Rahimpour S, Amanpour S, Rabbani S, Mohagheghi MA, Dehpour AR. ATP-sensitive potassium channels mediate the anti-ischemic properties of ischemic and pharmacologic preconditioning in rat random-pattern skin flap. Ann Plast Surg 2006; 57:94-9. [PMID: 16799317 DOI: 10.1097/01.sap.0000214872.13634.d4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ischemic preconditioning (IPC) and pharmacologic preconditioning by morphine and adenosine may significantly decrease the amount of necrosis in rat random pattern skin flaps. We examined the role of ATP-sensitive potassium channels (K(ATP) channels) in mediating these protective phenomenon by using glibenclamide a nonspecific blocker of these channels. We also investigated whether administration of diazoxide an opener of the K(ATP) channels could mimic the same protective effect. Ninety male Sprague-Dawley rats were randomly divided into either control or treatment groups (n = 6 each). Bipedicled dorsal skin flaps (2 x 8 cm) were elevated at the midline. In pharmacologic preconditioning groups, 1 mL of morphine (5 mg/flap), adenosine (0.5 mg/flap), or different doses of diazoxide (0.5, 1, 5, and 15 mg/flap) were administered locally in the cranial half of the flap, respectively. One milliliter of saline was locally injected in the control group. In the IPC group, 1 hour after local saline injection the cranial pedicle was clamped for 20 minutes, and then 40 minutes' reperfusion was performed. In another experiment, 0.3 mg/kg of glibenclamide was injected intraperitoneally 30 minutes before local administration of saline or drug in ischemic or pharmacologic preconditioning groups. Regardless of the group, all flaps were cut at the cranial side 2 hours after elevation and were sutured back. Flap survival area was evaluated on the seventh postoperative day. IPC and pharmacologic preconditioning with morphine, adenosine, and diazoxide (in higher doses; 1, 5, and 15 mg/flap) improved survival area compared with the control group. Glibenclamide abolished their protective effect. K(ATP) channels may have a key role in anti-ischemic properties of IPC and pharmacologic preconditioning.
Collapse
Affiliation(s)
- Azadeh Beheshtian
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Iran
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Gurlek A, Celik M, Parlakpinar H, Aydogan H, Bay-Karabulut A. The protective effect of melatonin on ischemia-reperfusion injury in the groin (inferior epigastric) flap model in rats. J Pineal Res 2006; 40:312-7. [PMID: 16635018 DOI: 10.1111/j.1600-079x.2006.00319.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Inadequate blood perfusion and ischemia-reperfusion (I/R) injury in the surgical skin flap are believed to be the major factors that cause harmful changes within the tissue and vasculature, resulting in flap necrosis. Reactive oxygen radical species (ROS), in part, are believed to play an important role in this injury. Melatonin, in many physiological conditions, has been shown to have direct and indirect antioxidative effects and free-radical-scavenging properties. Therefore, it may have a beneficial effect on I/R-induced flap injury. In this study, the possible protective effects of melatonin were investigated in I/R injury of rat epigastric (axial pattern) flaps. Ischemia was achieved for 12 h by occlusion of inferior epigastric artery. Melatonin or vehicle was administered 1 h before flap elevation and was continued for 6 days after ischemia. I/R injury elevated malondialdehyde (MDA), an end product of lipid peroxidation, and nitric oxide (NO) levels while the glutathione (GSH) content was reduced. Myeloperoxidase (MPO) activity, which is known to be related to tissue neutrophil accumulation, was found to be statistically higher in the I/R group when compared with the sham group. Administration of melatonin significantly decreased MDA, NO and MPO levels and elevated the GSH content. Moreover, melatonin reduced the flap necrosis area, which was determined using a planimetric method. In conclusion, melatonin, a potent scavenger of free radicals, plays a major role in preventing the inferior epigastric arterial I/R-induced flap necrosis, based on planimetric flap survival and biochemical results. The beneficial effects of melatonin in I/R injury implies the involvement of free radicals in flap damage.
Collapse
Affiliation(s)
- Ali Gurlek
- Division of Plastic-Reconstructive and Aesthetic Surgery, Department of Medicine, Inonu University, Malatya, Turkey.
| | | | | | | | | |
Collapse
|
45
|
Yoshida WB, Campos EBPD. Ischemia and reperfusion in skin flaps: effects of mannitol and vitamin C in reducing necrosis area in a rat experimental model. Acta Cir Bras 2005; 20:358-63. [PMID: 16186959 DOI: 10.1590/s0102-86502005000500004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PURPOSE: The aim of the present study was to develop an experimental model of ischemia-reperfusion injury in rat skin flap and to verify the effect of mannitol and vitamin C on reducing necrosis area. METHODS: A 6-x 3-cm groin skin flap was raised and submitted to 8 hours of ischemia by clamping the vascular pedicle and to 7 days of reperfusion. The animals were divided in four groups: S1 and S2 (10 animals each) and C and T (14 animals each). In groups S1 and S2 skin flaps were not submitted to ischemia and animals received lactated Ringer's solution (S1) and antioxidant solution (S2 ). In groups C and T, flaps were subjected to 8 hours of warm ischemia and animals received Lactated Ringer's solution (Group C) and antioxidant solution immediately before reperfusion, (Group T). Flap survival was evaluated on the seventh day using a paper template technique and computer-assistant imaging analysis of necrotic and normal areas. RESULTS: Statistical analysis showed no area differences between groups C and T. CONCLUSION: The experimental model provided consistent necrotic area in control groups and drugs used were not effective in improving skin flap survival.
Collapse
|
46
|
Kiumehr S, Demehri S, Rabbani S, Amanpour S, Mohagheghi MA, Dehpour AR. Preconditioning of the rat random-pattern skin flap: modulation by opioids. ACTA ACUST UNITED AC 2005; 58:58-64. [PMID: 15629168 DOI: 10.1016/j.bjps.2004.06.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2003] [Accepted: 06/03/2004] [Indexed: 10/26/2022]
Abstract
Opioid receptors have been implicated in protecting several organ systems from ischaemic events. The authors have studied the effects of opioid receptors on random-pattern skin flap survival. Sixty-nine male Sprague-Dawley rats were used. Bipedicled dorsal skin flaps (2 x 8 cm) were elevated at the midline. Different doses of morphine (0.01, 0.1, 1 and 5 mg/flap) were administered locally in the cranial half of the flap and systemically through intraperitoneal injections (5 and 10 mg/kg). In another experiment, 0.4 mg/flap of naloxone was injected followed by 5 mg/flap injection of morphine to determine whether the effect of morphine is receptor mediated. The role of the opioid receptors in the ischaemic preconditioning (IPC) phenomenon was investigated by administration of naloxone (0.4 mg/flap) 1 h before clamping the cranial pedicle for 20 min followed by 40 min of reperfusion. Appropriate control groups were included. The cranial pedicle was cut 2 h after saline or drug administration in all groups and flap survival area was evaluated on the seventh postoperative day. Local administration of morphine in higher doses (1 and 5 mg/flap) significantly reduced the amount of flap necrosis when compared to that of the control cohort (P < 0.05). Naloxone abolished this protective effect of morphine. Furthermore naloxone significantly decreased the anti-ischaemic effect of the IPC. Systemic administrations of morphine had no significant effect on flap survival area in compare with the control group.
Collapse
Affiliation(s)
- S Kiumehr
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, P.O. Box 13145-784, Tehran, Iran
| | | | | | | | | | | |
Collapse
|
47
|
Cetin C, Ozyilmaz M, Bayçu C, Köse AA, Karabağli Y. Effects of rolling inhibition on smoke inhalation injury. Burns 2003; 29:307-14. [PMID: 12781607 DOI: 10.1016/s0305-4179(03)00005-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Inhalation of chemical and particulate products of smoke is one of the principal determinant of mortality following burn injury. Inflammatory responses have been implicated in the pathogenesis of lung injury after smoke inhalation. In the current study, we tested the inhibitory effect of Fucoidin on the neutrophil rolling stage of inflammatory response and determined the degree of pulmonary injury. Fifteen rats were divided into three groups: sham group (N: 5) of rats inhaled room air; control group (N: 5) inhaled smoke, and experimental group inhaled smoke and received Fucoidin. All the rats were sacrificed 24h after smoke inhalation. The trachea and lungs were removed totally; samples for histopathological and biochemical (myeloperoxidase (MPO)) analysis were taken from each lung and trachea. Morphologic studies using light and electron microscopes showed a decrease in lung parenchymal and tracheoepithelial injury in the experiment group of rats. Also, biochemical analysis of tissue MPO was significantly lower in test group than in control group. These results suggest that the inhibition of neutrophil rolling leads to a reduction of neutrophil invasion to pulmonary parenchyma and trachea, which may be beneficial for attenuating neutrophil mediated inhalation injury.
Collapse
Affiliation(s)
- Cengiz Cetin
- Department of Plastic and Reconstructive Surgery, Medical School, Osmangazi University, 26480 Meşelik Eskişehir, Turkey
| | | | | | | | | |
Collapse
|
48
|
Abstract
Intensivists frequently collaborate with plastic and reconstructive surgeons in treating patients with major wounds, following significant reconstructive procedures, and following free-tissue transfers. Pressure ulcers are a significant source of morbidity and mortality in the intensive care unit; prevention, early recognition, and multidisciplinary treatment are critical components for successful management. Necrotizing fasciitis is an aggressive, soft-tissue infection that requires rapid diagnosis, early surgical intervention frequent operative debridements, and soft-tissue reconstruction Catastrophic abdominal injuries and infections can be treated with an open abdominal approach and require the expertise of a plastic surgeon to reconstruct the abdominal wall. The success of free-tissue transfers and complex reconstructive procedures requires a thorough understanding of the factors that improve flap survival.
Collapse
Affiliation(s)
- Gerard J Fulda
- Department of Surgery, Christiana Care Health Services, 4755 Ogletown-Stanton Road, Newark, DE 19718, USA.
| | | | | |
Collapse
|