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The Possible Pathophysiological Outcomes and Mechanisms of Tourniquet-Induced Ischemia-Reperfusion Injury during Total Knee Arthroplasty. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:8087598. [PMID: 30524661 PMCID: PMC6247434 DOI: 10.1155/2018/8087598] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 10/04/2018] [Indexed: 12/22/2022]
Abstract
Ischemia and reperfusion (I/R) injury induced by tourniquet (TQ) application leads to the release of both oxygen free radicals and inflammatory cytokines. The skeletal muscle I/R may contribute to local skeletal muscle and remote organ damage affecting outcomes after total knee arthroplasty (TKA). The aim of the study is to summarize the current findings associated with I/R injury following TKA using a thigh TQ, which include cellular alterations and protective therapeutic interventions. The PubMed database was searched using the keywords "ischemia reperfusion injury," "oxidative stress," "tourniquet," and "knee arthroplasty." The search was limited to research articles published in the English language. Twenty-eight clinical studies were included in this qualitative review. Skeletal muscle I/R reduces protein synthesis, increases protein degradation, and upregulates genes in cell stress pathways. The I/R of the lower extremity elevates local and systemic oxidative stress as well as inflammatory reactions and impairs renal function. Propofol reduces oxidative injury in this I/R model. Ischemic preconditioning (IPC) and vitamin C may prevent oxygen free radical production. However, a high dose of N-acetylcysteine possibly induces kidney injury. In summary, TQ-related I/R during TKA leads to muscle protein metabolism alteration, endothelial dysfunction, oxidative stress, inflammatory response, and renal function disturbance. Propofol, IPC, and vitamin C show protective effects on oxidative and inflammatory markers. However, a relationship between biochemical parameters and postoperative clinical outcomes has not been validated.
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Wu Y, Zhang MH, Xue Y, Zhang T, Wu N, Guo W, Du X, Xu YL. Effect of microRNA-26a on vascular endothelial cell injury caused by lower extremity ischemia-reperfusion injury through the AMPK pathway by targeting PFKFB3. J Cell Physiol 2018; 234:2916-2928. [PMID: 30132885 DOI: 10.1002/jcp.27108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/28/2018] [Indexed: 12/23/2022]
Abstract
Vascular endothelial cell (VEC) dysfunction plays an important role in the ischemia-reperfusion injury (IRI)-related diseases, and microRNAs (miRNAs) are key factors during this process. We conducted this study to investigate whether miRNA-26a (miR-26a) has effect on the IRI-induced VEC injury via the AMPK pathway by targeting 6-phosphofructo-2-kinase-fructose-2,6-biphosphatase 3 (PFKFB3). IRI rat models were successfully constructed by an abdominal incision. Additionally, the cultured VECs were further treated with miR-26a mimic or inhibitor, and si-PFKFB3. Both the reverse-transcription quantitative polymerase chain reaction and the western blot assay method were carried out to examine the expressions of PFKFB3, endothelial nitric oxide synthase (eNOS), and 5'-adenosine monophosphate-activated protein kinase (AMPK) α1, as well as the extent of the AMPK α1 phosphorylation levels in vascular tissues. Circulating endothelial cell (CEC), von Willebrand factor (VWF), thrombomodulin (TM), superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO), and endothelin (ET) were all measured. In the rat model of an IRI, a poorly expressed miR-26a and contrarily highly expressed PFKFB3 were identified in vascular tissues. In response to an overexpression of miR-26a or to the PFKFB3 gene silencing, decreased CEC number, TM, VWF, MDA, and ET contents, increased AMPK α1, and eNOS levels, as well as the extent of AMPK α1 phosphorylation coordinate with both increased SOD and NO contents based on the restoration of the AMPK pathway. Overexpression of the miR-26a or si-PFKFB3 provides an elevation in cell proliferation. Our study suggests that the miR-26a RNA alleviates lower extremity IRI-induced VEC injury in rats through the activation of the AMPK pathway by inhibiting PFKFB3.
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Affiliation(s)
- Ye Wu
- Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, China
| | - Min-Hong Zhang
- Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, China
| | - Yan Xue
- Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, China.,Department of Cardiovascular Surgery, General Hospital of Armed Police Forces, Beijing, China
| | - Tao Zhang
- Department of Vascular Surgery, Peking University People's Hospital, Beijing, China
| | - Na Wu
- Department of Central Laboratory, Institute of Clinical Molecular Biology, Peking University People's Hospital, Beijing, China
| | - Wei Guo
- Department of Cardiovascular Surgery, Chinese PLA Rocket Force General Hospital, Beijing, China
| | - Xin Du
- Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, China
| | - Yong-Le Xu
- Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, China
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Lohsiriwat V, Scholefield JH, Wilson VG, Dashwood MR. Endothelin-1 and its receptors on haemorrhoidal tissue: a potential site for therapeutic intervention. Br J Pharmacol 2017; 174:569-579. [PMID: 28095606 DOI: 10.1111/bph.13719] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/15/2016] [Accepted: 07/10/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND AND PURPOSE Haemorrhoids is a common anorectal condition affecting millions worldwide. We have studied the effect of endothelin-1 (ET-1) and the role of endothelin ETA and ETB receptors in haemorrhoid tissue. EXPERIMENTAL APPROACH Protein expression of ET-1, ETA and ETB receptors were compared between haemorrhoids and normal rectal submucosa using Western blot analysis, with the localization of proteins determined by autoradiography and immunohistochemistry. Effects of ET-1 and sarafotoxin 6a on human colonic and rectal arteries and veins was assessed by wire myography and the involvement of receptor subtypes established by selective antagonists. KEY RESULTS Dense binding of [125 I]-ET-1 to haemorrhoidal sections was reduced by selective receptor antagonists. A higher density of ETB than ETA receptors was found in haemorrhoidal, than in control rectal tissue and confirmed by Western blot analysis. ETA and ETB receptors were localized to smooth muscle of haemorrhoidal arteries and veins, with ETB receptors on the endothelium. Human colonic and rectal arteries and veins were similarly sensitive to ET-1 and affected by the ETA selective antagonist, but sarafotoxin S6a-induced contractions were more pronounced in veins and antagonized by a selective ETB receptor antagonist. CONCLUSIONS AND IMPLICATIONS ETA and ETB receptors are present in human haemorrhoids with ETB receptors predominating. ETA receptors are activated by ET-1 to mediate a contraction in arteries and veins, but the latter are selectively activated by sarafotoxin S6a - a response that involves ETB receptors at low concentrations. Selective ETB agonists may have therapeutic potential to reduce congestion of the haemorrhoidal venous sinusoids.
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Affiliation(s)
- Varut Lohsiriwat
- Division of Gastrointestinal Surgery, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - John H Scholefield
- Division of Gastrointestinal Surgery, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Vincent G Wilson
- School of Life Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Michael R Dashwood
- Royal Free Hospital Campus, University College Medical School, London, UK
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Roberts LA, Nosaka K, Coombes JS, Peake JM. Cold water immersion enhances recovery of submaximal muscle function after resistance exercise. Am J Physiol Regul Integr Comp Physiol 2014; 307:R998-R1008. [PMID: 25121612 DOI: 10.1152/ajpregu.00180.2014] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We investigated the effect of cold water immersion (CWI) on the recovery of muscle function and physiological responses after high-intensity resistance exercise. Using a randomized, cross-over design, 10 physically active men performed high-intensity resistance exercise followed by one of two recovery interventions: 1) 10 min of CWI at 10°C or 2) 10 min of active recovery (low-intensity cycling). After the recovery interventions, maximal muscle function was assessed after 2 and 4 h by measuring jump height and isometric squat strength. Submaximal muscle function was assessed after 6 h by measuring the average load lifted during 6 sets of 10 squats at 80% of 1 repetition maximum. Intramuscular temperature (1 cm) was also recorded, and venous blood samples were analyzed for markers of metabolism, vasoconstriction, and muscle damage. CWI did not enhance recovery of maximal muscle function. However, during the final three sets of the submaximal muscle function test, participants lifted a greater load (P < 0.05, Cohen's effect size: 1.3, 38%) after CWI compared with active recovery. During CWI, muscle temperature decreased ∼7°C below postexercise values and remained below preexercise values for another 35 min. Venous blood O2 saturation decreased below preexercise values for 1.5 h after CWI. Serum endothelin-1 concentration did not change after CWI, whereas it decreased after active recovery. Plasma myoglobin concentration was lower, whereas plasma IL-6 concentration was higher after CWI compared with active recovery. These results suggest that CWI after resistance exercise allows athletes to complete more work during subsequent training sessions, which could enhance long-term training adaptations.
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Affiliation(s)
- Llion A Roberts
- School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia; Centre of Excellence for Applied Sport Science Research, Queensland Academy of Sport, Brisbane, Queensland, Australia
| | - Kazunori Nosaka
- School of Exercise and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; and
| | - Jeff S Coombes
- School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia
| | - Jonathan M Peake
- Centre of Excellence for Applied Sport Science Research, Queensland Academy of Sport, Brisbane, Queensland, Australia; School of Biomedical Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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Gene Expression of the Endothelin-1 in Vasospastic Flap Pedicle – an Experimental Study on a Porcine Model. ACTA VET BRNO 2010. [DOI: 10.2754/avb201079030453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this study was to evaluate the amount of Endothelin-1 (ET-1) gene expression in the vasospastic vessel of the flap pedicle to prove or disprove the role of ET-1 gene expression in pathogenesis of mechanically induced vasospasm. The vasospasm was induced by the tension on the pedicle of the pedicled caudal superficial epigastric flap on 8 pigs. Laser Doppler was used for peripheral blood flow measurement. Specimens from the vasospastic vessel (group of specimens B) and from the flap border with no vasospasm (control group A) were taken 2 h after the stimulus initiation. Detection of ET-1 mRNA by Quantitative Real-Time RT-PCR was performed. β-actin was selected as an acceptable reference gene. Relative gene expression data were given as the n-fold change in transcription of target genes normalized to the endogenous control. Relative gene expressions and time indicators of vasospasm were compared in both groups. No significant difference of the ET-1 gene expressions was found between groups A and B (p = 0.505). No correlation between the duration of vasospasm and ET-1 gene expression was found as well (p = 0.299). In conclusion, the expression of the ET-1 gene in the mechanically induced vasospastic vessel of the pedicled flap was not significantly increased. In this study, the causality of the vasospasm pathogenesis and gene expression of ET-1 was not proven.
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Hughes SF, Hendricks BD, Edwards DR, Maclean KM, Bastawrous SS, Middleton JF. Total hip and knee replacement surgery results in changes in leukocyte and endothelial markers. J Inflamm (Lond) 2010; 7:2. [PMID: 20148137 PMCID: PMC2820000 DOI: 10.1186/1476-9255-7-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2009] [Accepted: 01/19/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is estimated that over 8 million people in the United Kingdom suffer from osteoarthritis. These patients may require orthopaedic surgical intervention to help alleviate their clinical condition. Investigations presented here was to test the hypothesis that total hip replacement (THR) and total knee replacement (TKR) orthopaedic surgery result in changes to leukocyte and endothelial markers thus increasing inflammatory reactions postoperatively. METHODS During this 'pilot study', ten test subjects were all scheduled for THR or TKR elective surgery due to osteoarthritis. Leukocyte concentrations were measured using an automated full blood count analyser. Leukocyte CD11b (Mac-1) and CD62L cell surface expression, intracellular production of H(2)O(2 )and elastase were measured as markers of leukocyte function. Von Willebrand factor (vWF) and soluble intercellular adhesion molecule-1 (sICAM-1) were measured as markers of endothelial activation. RESULTS The results obtained during this study demonstrate that THR and TKR orthopaedic surgery result in similar changes of leukocyte and endothelial markers, suggestive of increased inflammatory reactions postoperatively. Specifically, THR and TKR surgery resulted in a leukocytosis, this being demonstrated by an increase in the total leukocyte concentration following surgery. Evidence of leukocyte activation was demonstrated by a decrease in CD62L expression and an increase in CD11b expression by neutrophils and monocytes respectively. An increase in the intracellular H(2)O(2 )production by neutrophils and monocytes and in the leukocyte elastase concentrations was also evident of leukocyte activation following orthopaedic surgery. With respect to endothelial activation, increases in vWF and sICAM-1 concentrations were demonstrated following surgery. CONCLUSION In general it appeared that most of the leukocyte and endothelial markers measured during these studies peaked between days 1-3 postoperatively. It is proposed that by allowing orthopaedic surgeons access to alternative laboratory markers such as CD11b, H(2)O(2 )and elastase, CD62L, vWF and sICAM-1, an accurate assessment of the extent of inflammation due to surgery per se could be made. Ultimately, the leukocyte and endothelial markers assessed during this investigation may have a role in monitoring potential infectious complications that can occur during the postoperative period.
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Affiliation(s)
- Stephen F Hughes
- Department of Biological Sciences, University of Chester, UK
- Leopold Muller Arthritis Research Centre, RJAH Orthopaedic Hospital, Medical School, Keele University, UK
| | | | | | | | | | - Jim F Middleton
- Leopold Muller Arthritis Research Centre, RJAH Orthopaedic Hospital, Medical School, Keele University, UK
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Spirig R, Potapova I, Shaw-Boden J, Tsui J, Rieben R, Shaw SG. TLR2 and TLR4 agonists induce production of the vasoactive peptide endothelin-1 by human dendritic cells. Mol Immunol 2009; 46:3178-82. [DOI: 10.1016/j.molimm.2009.05.179] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Accepted: 05/30/2009] [Indexed: 12/12/2022]
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Recommended Practices for the Use of the Pneumatic Tourniquet in the Perioperative Practice Setting. AORN J 2007; 86:640-655. [DOI: 10.1016/j.aorn.2007.09.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Enhanced lipid peroxidation in tourniquet-release mice. Clin Chim Acta 2006; 371:79-84. [PMID: 16624265 DOI: 10.1016/j.cca.2006.02.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2005] [Revised: 02/17/2006] [Accepted: 02/17/2006] [Indexed: 11/24/2022]
Abstract
BACKGROUND The pathogenesis of ischemia-reperfusion involves generation of reactive oxygen and resulting lipid peroxidation. However, investigation that ischemia-reperfusion following tourniquet release enhances lipid peroxidation is insufficient. METHODS Tourniquet was applied to a unilateral hind limb of mice for 3h followed by 5-, 15-, 30- and 60-min release. To examine superoxide production immunohistochemically in ischemia-reperfusion muscles, a primary antibody directed to 4-hydroxy-nonenal (HNE) was used. Furthermore, we analyzed 7alpha- and 7beta-hydroperoxycholest-5-en-3beta-ol, 7alpha- and 7beta-hydroxycholesterol, and 7-ketocholesterol by HPLC in the gastrocnemius muscles, kidneys, liver, heart and lungs of mice after 1-h reperfusion. RESULTS Increased HNE immunoreactivitiy was observed in the tourniquet-applied side of gastrocnemius muscles of hind limb particularly after 5-min reperfusion. All the oxysterols were significantly higher in the gastrocnemius muscles of the tourniquet-applied side than of the contralateral muscles. Oxysterols were elevated in the kidneys and the liver. Together with the presence of high blood urea nitrogen, these data indicate that the kidney is vulnerable to ischemia-reperfusion. CONCLUSIONS The enhanced oxidative stress due to ischemia-reperfusion appears to increase HNE in muscle and oxysterols by peroxidation not only in the gastrocnemius muscles but also in the kidneys and liver.
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