On the perfluorocarbon emulsions of second generation

Prolongation of the intestinal viability using oxygenated perfluorocarbon in an experimental model of acute intestinal ischemia

OBJECTIVES

Liquid perfluorocarbons (PFCs) are well known for their capability to carry respiratory gases. The aim of this study was to evaluate the effectiveness of oxygenated F-Decalin on the intestinal viability, in an experimental model of acute intestinal ischemia.

MATERIAL AND METHODS

Thirty-six rabbits were subjected to 8h intestinal ischemia by ligation of the superior mesenteric artery (subgroups 1), the mesenteric vein (subgroups 2) or both vessels (subgroups 3). The animals were divided into three groups: (a) Control (ischemia alone), (b) PFC-O2 (ischemia plus infusion of oxygenated F-Decalin) and (c) PFC (ischemia plus infusion of not-oxygenated F-Decalin). Intestinal biopsies from four different sites and blood samples for serum enzymes measurements were taken at 2, 4, 6 and 8 h. All tissue sections were examined blindly under light microscope. Sections from the specimens were taken at 4 and 8 h, and examined blindly under the electron microscope. Statistical analysis was performed by non-parametric Kruskal Wallis test.

RESULTS

Using light microscope, the observed intestinal damages to the sections from Control and PFC groups were severe at 4 h and destructive after 8 h. On the contrary, minimal injuries were observed in the biopsies from PFC-O2 group at 4 and even after 8 h of ischemia. These findings were confirmed by the electron microscope study and correlated to the serum enzymes measurements.

CONCLUSIONS

These results suggest that intestinal viability could be prolonged after acute ischemia using oxygenated perfluorocarbons and this could be a promising pretreatment modality for a variety of mesenteric ischemic forms.

Second-generation perfluorocarbon emulsion blood substitutes

A novel series of perfluorocarbon (PFC) emulsions, based on perfluorodecalin (C10F18) and stabilised with up to 2.5% (w/v) of lecithin have been produced for evaluation as injectable, temporary respiratory gas-carrying blood substitutes. Some formulations contained 1.0% (w/v) of perfluorodimorpholinopropane (C11F22N2O2) to retard droplet growth through molecular diffusion (Ostwald Ripening). Other emulsions contained novel, amphiphilic fluorinated surfactants, such as, for example, the monocarbamate, C8F17C2H4NHC(O)(CH2CH2O)2Me (designated compound P6), at 0.1% (w/v) to enhance stability. Emulsions were prepared by homogenisation, were steam sterilisable and were stable for > 300 days (25 degrees C). Injection of rats (7.5 ml kg-1 b.w.) with emulsions produced significant (P < 0.05), transient increases in liver and spleen weights. One emulsion inhibited phorbol 12-myristate 13-acetate (PMA)-stimulated, Luminol-enhanced, chemiluminescence of human polymorphonuclear leucocytes (PMNL) in vitro, suggesting possible applications in ischaemic tissues for suppressing PMNL-mediated inflammation. The P6 fluoro-surfactant inhibited spontaneous platelet aggregation in hirudin-anticoagulated human blood in vitro, suggesting possible applications as an anti-thrombotic agent.

Fluorocarbon emulsions

Perfluorocarbon emulsions have been the topic of intense investigation for many years and presently there are still no absolute indications for their use in clinical practice. The relatively disappointing results of the early clinical studies, as a consequence of using low concentrations of a relatively underdeveloped emulsion, have been responsible for a largely negative impression and it is now essential that the newer second generation emulsions should be judged individually with regard to their efficacy and toxicity under different circumstances. Technological advancement in the fields of chemistry and detergent/emulsifier research will continue and new formulations are being developed which which will require to be tested in models in the laboratory. In the future, this class of drugs will continue to be the topic of intense investigation and their mechanisms of action, which are undoubtedly more complex than the simple carriage of dissolved gases in solution, will be clarified. However, whether fluorocarbon emulsions will ever be used as a 'blood substitute' as was originally anticipated is doubtful.