Assessment of Protective Effects of Pheniramine Maleate on Reperfusion Injury in Lung After Distant Organ Ischemia

Direct kidney injury or lower extremity ischemia induced indirect kidney injury: Which one is more harmful for kidneys?

OBJECTIVES

The aim of this study was to investigate and compare the severity of kidney damage following lower limb ischemia-reperfusion and direct kidney ischemia-reperfusion.

METHODS

Thirty Sprague Dawley male rats were randomly divided into three groups; lower extremity ischemia-reperfusion group (Group 2), renal ischemia-reperfusion group (Group 3) and control (anesthesia and median laparotomy only) (Group 1). In group 3, 1-h ischemia was performed on the kidney and in group 2, 1-h ischemia was performed on the left lower extremity. This procedure was followed by reperfusion for 24 h. Renal tissues were removed after the reperfusion period and the groups were evaluated for glutathioneperoxidase activity, malondialdehyde and GSH levels, and furthermore, their histolopathological scores were calculated.

RESULTS

Renal malondialdehyde levels were significantly higher in Group 2 and Group 3 than they were in the Control group. There was no significant difference in renal malondialdehyde levels between Group 2 and Group 3. Kidney glutathione (GSH) levels were statistically lower in Group 2 and Group 3 than in the Control group. No statistically significant difference was found between Group 2 and Group 3 regarding their GSH levels. In histological evaluation, there was no statistically significant difference between Group 2 and Group 3 in terms of kidney damage score.

CONCLUSIONS

This study has identified that lower extremity ischemia induces remote kidney damage with similar features to kidney injury, occurring after direct kidney ischemia-reperfusion.

The Effect of Cerium Oxide on Lung Tissue in Lower Extremity Ischemia Reperfusion Injury in Sevoflurane Administered Rats

Introduction

We aimed to investigate the effects of cerium oxide, applied before the sevoflurane anesthesia, on lung tissue in rats with lower extremity ischemia-reperfusion (IR).

Materials and Methods

A total of 30 rats were randomly divided into five groups as; control (C), IR, cerium oxide-IR (CO-IR), IR-sevoflurane (IRS), and cerium oxide-IR-sevoflurane (CO-IRS). In the CO-IR group, 30 minutes after the injection of cerium oxide (0.5 mg/kg, intraperitoneal (i.p)), an atraumatic microvascular clamp was placed on the infrarenal abdominal aorta for 120 minutes. Then, the clamp was removed and reperfused for 120 minutes. Sevoflurane was applied in 100% oxygen at a rate of 2.3% at 4 L/min during IR. The blood samples were taken for biochemical analysis and the lung tissue samples were taken for histological analysis.

Results

Neutrophil infiltration/aggregation was significantly higher in the IR group than in the C and CO-IRS groups. The alveolar wall thickness and total lung injury scores were significantly higher in the IR group than in the C, IRS, CO-IR and CO-IRS groups.

Discussion

We determined that the administration of 0.5 mg/kg dose of cerium oxide with sevoflurane reduces the oxidative stress and corrects IR-related damage in lung tissue. Our results show that the administration of cerium oxide before IR and the administration of sevoflurane during IR have a protective effect in rats.

How important is the damage to the liver after lower limb ischemia-reperfusion? An experimental study in a rat model

Background

The aim of this study was to compare the effect of lower extremity ischemia reperfusion on the liver and the effect of ischemiareperfusion on the liver itself in a rat model.

Methods

Thirty Sprague-Dawley male rats were randomly divided into three groups including 10 in each group: sham (Group 1), lower limb ischemia-reperfusion (Group 2), and liver ischemia-reperfusion (Group 3). In Group 2, one hour of left lower limb ischemia was performed. In Group 3, one hour of ischemia in the liver was performed, followed by 24 hours of reperfusion. After reperfusion, the liver tissues were removed, and the groups were evaluated biochemically and histologically.

Results

The liver malondialdehyde levels were significantly higher in Groups 2 and 3 than in the sham group (p<0.001). In Group 2, the malondialdehyde levels were significantly higher than in Group 3 (p=0.019). The glutathione levels in the liver were significantly lower in Groups 2 and 3 than in the sham group (p<0.001). However, the glutathione levels were significantly higher in Group 2 than in Group 3 (p=0.005). In the histological evaluation, although the liver damage score was higher in Group 3 than in Group 2 (p=0.015), there was no significant difference between the two groups in TUNEL(+) cell number (p>0.05).

Conclusion

Reperfusion injury in the liver after lower limb ischemiareperfusion is as important as ischemia-reperfusion injury which is specifically induced in the liver. This should be taken into account, particularly in reperfusion surgeries following vascular trauma or in cases of leg tourniquets to stop bleeding after lower limb vascular trauma.

Which Distant Organ is Most Affected by Lower Extremity Ischemia-Reperfusion?

BACKGROUND

It has been experimentally shown that reperfusion injury occurs in many remote organs after ischemia-reperfusion (I/R) of the lower extremity. However, which distant organ is affected more after I/R of the lower extremity has not been investigated. In this study, we investigate which remote organ is predominantly affected after lower extremity I/R.

METHODS

Twenty male Sprague-Dawley rats were randomly divided into 2 groups: sham (group 1) and lower extremity I/R (group 2). In group 2, 1 hr of ischemia of the left lower extremity was followed by 24 hr of reperfusion of the limb. After reperfusion, the lung, liver, kidney, heart, and small intestine tissues were harvested in both groups.

RESULTS

In the I/R group, the malondialdehyde levels were significantly higher in the heart and small intestine tissues than those in other tissues (P < 0.05). In addition, in the I/R group, the glutathione and glutathione peroxidase activities were also higher in the heart tissues than those in other tissues (P < 0.05). However, these results were not significant because the malondialdehyde, glutathione, and glutathione peroxidase levels of the heart tissues in the control group were higher than those of the other tissues. Therefore, no statistically significant difference was found between the tissues in terms of the histological damage score we created and the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling-positive cell numbers.

CONCLUSIONS

There was no difference in the severity of reperfusion injury between the tissues we examined after lower extremity I/R. This suggests that every distal organ should be carefully monitored after lower extremity I/R.