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Tveita T, Sieck GC. Physiological Impact of Hypothermia: The Good, the Bad and the Ugly. Physiology (Bethesda) 2021; 37:69-87. [PMID: 34632808 DOI: 10.1152/physiol.00025.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Hypothermia is defined as a core body temperature of < 35°C, and as body temperature is reduced the impact on physiological processes can be beneficial or detrimental. The beneficial effect of hypothermia enables circulation of cooled experimental animals to be interrupted for 1-2 h without creating harmful effects, while tolerance of circulation arrest in normothermia is between 4 and 5 min. This striking difference has attracted so many investigators, experimental as well as clinical, to this field, and this discovery was fundamental for introducing therapeutic hypothermia in modern clinical medicine in the 1950's. Together with the introduction of cardiopulmonary bypass, therapeutic hypothermia has been the cornerstone in the development of modern cardiac surgery. Therapeutic hypothermia also has an undisputed role as a protective agent in organ transplantation and as a therapeutic adjuvant for cerebral protection in neonatal encephalopathy. However, the introduction of therapeutic hypothermia for organ protection during neurosurgical procedures or as a scavenger after brain and spinal trauma has been less successful. In general, the best neuroprotection seems to be obtained by avoiding hyperthermia in injured patients. Accidental hypothermia occurs when endogenous temperature control mechanisms are incapable of maintaining core body temperature within physiologic limits and core temperature becomes dependent on ambient temperature. During hypothermia spontaneous circulation is considerably reduced and with deep and/or prolonged cooling, circulatory failure may occur, which may limit safe survival of the cooled patient. Challenges that limit safe rewarming of accidental hypothermia patients include cardiac arrhythmias, uncontrolled bleeding, and "rewarming shock".
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Affiliation(s)
- Torkjel Tveita
- Anesthesia and Critical Care Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Division of Surgical Medicine and Intensive Care, University Hospital of North Norway, Tromsø, Norway
| | - Gary C Sieck
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States
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Yokoyama I, Negita M, Liu DG, Nagasaka T, Kobayashi T, Hayakawa A, Hayashi S, Nakao A. Prevention of free-radical induced apoptosis by induction of human recombinant Cu, Zn-SOD in pig endothelial cells. Transpl Int 2002. [DOI: 10.1111/j.1432-2277.2002.tb00156.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Nakagawa K, Koo DDH, Davies DR, Gray DWR, McLaren AJ, Welsh KI, Morris PJ, Fuggle SV. Lecithinized superoxide dismutase reduces cold ischemia-induced chronic allograft dysfunction. Kidney Int 2002; 61:1160-9. [PMID: 11849471 DOI: 10.1046/j.1523-1755.2002.00217.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Chronic renal allograft failure (CAF) is influenced by both allo-dependent and independent factors and is a major cause of graft loss in clinical renal transplantation. We evaluated a novel membrane-bound free radical scavenger, lecithinized superoxide dismutase (lec-SOD), to determine its potential in limiting the harmful effects of ischemia/reperfusion injury on CAF. METHODS Fisher rat kidneys were stored for either 1 hour or 18 hours in cold Marshall's preservation solution either with or without lec-SOD and transplanted into Lewis recipients. RESULTS Within 3 days of transplantation, an early inflammatory response involving granulocytes and macrophages was detected in renal allografts exposed to 18 hours cold ischemia that was significantly reduced by preservation with lec-SOD. By 24 weeks post-transplantation, elevated proteinuria and detection of apoptotic cells was observed in kidneys exposed to 18 hours of cold ischemia, that was attenuated by preservation with lec-SOD (P < 0.05). However, up-regulated expression of intracellular adhesion molecule-1 (ICAM-1) and major histocompatibility complex (MHC) Class II together with a T lymphocyte infiltration were observed at 24 weeks that was not prevented by preservation with lec-SOD. CONCLUSIONS These results demonstrate that ischemia/reperfusion injury, apoptotic cell death and allo-immune responses may be exacerbated by cold ischemia and accelerate the development of CAF. Preservation with lec-SOD may protect against the early damage induced by cold ischemia and reperfusion injury.
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Affiliation(s)
- Ken Nakagawa
- Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, United Kingdom
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Rauen U, de Groot H. Mammalian cell injury induced by hypothermia- the emerging role for reactive oxygen species. Biol Chem 2002; 383:477-88. [PMID: 12033437 DOI: 10.1515/bc.2002.050] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hypothermia is a well-known strategem to protect biological material against injurious or degradative processes and is widely used in experimental and especially in clinical applications. However, hypothermia has also proved to be strongly injurious to a variety of cell types. Hypothermic injury to mammalian cells has long been attributed predominantly to disturbances of cellular ion homeostasis, especially of sodium homeostasis. For many years, reactive oxygen species have hardly been considered in the pathogenesis of hypothermic injury to mammalian cells. In recent years, however, increasing evidence for a role of reactive oxygen species in hypothermic injury to these cells has accumulated. Today there seems to be little doubt that reactive oxygen species decisively contribute to hypothermic injury in diverse mammalian cells. In some cell types, such as liver and kidney cells, they even appear to play the central role in hypothermic injury, outruling by far a contribution of the cellular ion homeostasis. In these cells, the cellular chelatable, redox-active iron pool appears to be decisively involved in the pathogenesis of hypothermic injury and of cold-induced apoptosis that occurs upon rewarming of the cells after a (sublethal) period of cold incubation.
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Affiliation(s)
- Ursula Rauen
- Institut für Physiologische Chemie, Universitätsklinikum, Essen, Germany
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Koo DD, Welsh KI, West NE, Channon KM, Penington AJ, Roake JA, Morris PJ, Fuggle SV. Endothelial cell protection against ischemia/reperfusion injury by lecithinized superoxide dismutase. Kidney Int 2001; 60:786-96. [PMID: 11473663 DOI: 10.1046/j.1523-1755.2001.060002786.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Organs used for transplantation may experience long periods of cold ischemic preservation and consequently oxygen free radical-mediated damage following reperfusion. Lecithinized superoxide dismutase (lec-SOD) is a novel free radical scavenger that has been shown to bind with high affinity to cell membranes. The aim of this study was to determine whether lec-SOD bound to endothelial cells under organ preservation conditions to mediate direct antioxidant activity at the endothelial cell surface and thus offer protection against the harmful effects of ischemia/reperfusion injury. METHODS An in vitro study was performed on large vessel endothelial cells (HUVEC) and a human microvascular endothelial cell line HMEC-1, to investigate the potential therapeutic benefits of incorporating lec-SOD into organ preservation solution. A cold hypoxia/reoxygenation system was developed to examine lec-SOD binding affinity to endothelial cells, protection against hypoxia/reoxygenation-induced cell death, and neutrophil adhesion. RESULTS Lec-SOD bound to endothelial cells with higher affinity than unmodified recombinant human superoxide dismutase (rhSOD) and significantly protected both HUVEC and HMEC-1 from cell death following 27 hours of cold hypoxia (P < 0.01). Furthermore, neutrophil adhesion to the endothelium stimulated by hypoxia and reoxygenation was significantly inhibited by treatment with lec-SOD but not by lecithin or rhSOD (P < 0.01). Analysis by flow cytometry demonstrated that E-selectin and ICAM-1 were up-regulated by hypoxia/reoxygenation that was inhibited in part by lec-SOD. CONCLUSIONS The results from this study suggest that incorporation of lec-SOD into organ preservation solutions provides effective protection to endothelial cells against cold ischemia and reperfusion injury following transplantation.
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Affiliation(s)
- D D Koo
- Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
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D.H. Koo D, Fuggle SV. Impact of ischemia/reperfusion injury and early inflammatory responses in kidney transplantation. Transplant Rev (Orlando) 2000. [DOI: 10.1053/trre.2000.16754] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Yokoyama I, Negita M, Hayakawa A, Hayashi S, Kobayashi T, Ogawa H, Takagi H. Free radicals and apoptosis of the endothelial cells. Transplant Proc 2000; 32:26. [PMID: 10700953 DOI: 10.1016/s0041-1345(99)00861-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- I Yokoyama
- Nagoya University, School of Medicine, Department of Surgery II, Japan
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Hayashi S, Namii Y, Guan-Lin M, Dai-Kaku L, Kobayashi T, Nagasaka T, Yokoyama I, Hamada H, Takagi H. Effect of adenovirus-mediated gene transfer with CTLA4-Ig gene in organ transplantation. Transplant Proc 1999; 31:1944-5. [PMID: 10455927 DOI: 10.1016/s0041-1345(99)00220-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- S Hayashi
- Department of Surgery II, Nagoya University School of Medicine, Japan
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Affiliation(s)
- T Kurokawa
- Department of Surgery II, Nagoya University School of Medicine, Japan
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Bilbao G, Contreras JL, Mikheeva G, Krasnykh V, Eckhoff DE, Thomas FT, Thomas J, Curiel DT. Genetic cytoprotection of human endothelial cells during preservation time with an adenoviral vector encoding the anti-apoptotic human Bcl-2 gene. Transplant Proc 1999; 31:1012-5. [PMID: 10083450 DOI: 10.1016/s0041-1345(98)01880-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- G Bilbao
- Gene Therapy Program, University of Alabama at Birmingham, USA
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Yokoyama I, Negita M, Hayakawa A, Hayashi S, Kobayashi T, Namii Y, Nagasaka T, Takagi H. Cytosolic calcium dynamics and free radical-induced apoptosis of the endothelial cells. Transplant Proc 1999; 31:808-9. [PMID: 10083349 DOI: 10.1016/s0041-1345(98)01780-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- I Yokoyama
- Department of Surgery II, Nagoya University, School of Medicine, Japan.
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Hayashi S, Emi N, Okada H, Yokoyama I, Takagi H. Feasibility of double-expression retroviral vector using complement regulatory factor gene. J Surg Res 1998; 78:64-7. [PMID: 9733620 DOI: 10.1006/jsre.1998.5388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The donor source of vascular endothelial cells for hybrid blood vessels seeded with genetically engineered endothelial cells is generally considered to be autologous. The purpose of this study was to determine whether porcine endothelial cells transduced with double-expression retroviral vector using complement-resistant gene could be substituted for autologous endothelial cells. Decay-accelerating factor (DAF) and tissue plasminogen activator (tPA) cDNA were inserted into retroviral vector with homologous restriction factor 20 cDNA as a complement regulatory factor gene. Porcine aortic endothelial cells were transduced with these double-expression retroviral vectors, followed by the complement-dependent selection. Porcine endothelial cells transduced withdouble-expression retroviral vectors showed a high gene expression of both DAF and tPA. Complement-dependent cytotoxicity and adherence of U937 were significantly inhibited by the transduction of double-expression vectors with complement regulatory factor gene. Double-expression retroviral vector using complement regulatory factor gene was efficacious in substituting porcine endothelial cells for the autologous endothelial cells.
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Affiliation(s)
- S Hayashi
- Department of Surgery II, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466, Japan
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Pahlavani MA, Van Remmen H. New directions for studying the role of free radicals in aging. AGE 1997; 20:151-163. [PMID: 23604307 PMCID: PMC3455893 DOI: 10.1007/s11357-997-0014-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Oxidative damage caused by free radicals in vivo is believed to play an important role in the etiology of aging and age-associated degenerative diseases. The most direct evidence supporting this theory is the recent finding that the transgenic Drosophila that overexpress the antioxidant enzymes catalase and superoxide dismutase exhibit an increase in life span. Although the increase in life span in Drosophila by these enzymes is certainly important, the next logical direction is to demonstrate whether increased antioxidant protection occurs similarly in mammals. Several transgenic mouse models that overexpress antioxidant enzymes are currently available. However, one major shortcoming in using these transgenic mice is the difficulty of producing antioxidant overexpression in more than a few tissues. Despite the potential shortcomings of using transgenic mice, these animals provide a unique system in which individual components of a complex system, such as the antioxidant defense system, can be modulated and examined independently. Transgenic mice are therefore potentially powerful tools to study the role of various components of the antioxidant system in the aging process. A parallel direction in the study of free radical roles in aging is to investigate the modulation of transcription factors by oxidative stress. Among these, the transcription factors, NF-κB and AP-1 are implicated in oxidative stress. The activities of these oxidative stress-response transcription factors are regulated by upstream signaling molecules, which involve a cascade of phosphorylation and dephosphorylation events leading to their activation. In this article, we review recent studies that use molecular approaches to investigate the biological role of oxidant stress. Each of these studies potentially provide new insights into the roles of free radicals and free radical damage in the aging process.
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Affiliation(s)
- Mohammad A. Pahlavani
- />Geriatric Research, Education and Clinical Center, Audie L. Murphy Memorial Veterans Hospital, San Antonio, Texas 78284
- />Department of Physiology, University of Texas Health Science Center, San Antonio, Texas 78284
| | - Holly Van Remmen
- />Geriatric Research, Education and Clinical Center, Audie L. Murphy Memorial Veterans Hospital, San Antonio, Texas 78284
- />Department of Physiology, University of Texas Health Science Center, San Antonio, Texas 78284
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Yokoyama I, Negita M, Hayakawa A, Takebe A, Hayashi S, Kobayashi T, Katayama A, Namii Y, Nagasaka T, Koike C, Kojima T, Takagi H. Apoptosis in pig endothelial cells after reperfusion and its prevention by genetic induction of human Cu, Zn-SOD cDNA. Transplant Proc 1997; 29:1364. [PMID: 9123341 DOI: 10.1016/s0041-1345(96)00597-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- I Yokoyama
- Nagoya University School of Medicine, Department of Surgery II, Japan
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Negita M, Hayashi S, Koike C, Emi N, Yokoyama I, Uchida K, Takagi H. Protective effect of human superoxide dismutase cDNA transfection in the prevention of cold preservation injury. Transplant Proc 1997; 29:1363. [PMID: 9123340 DOI: 10.1016/s0041-1345(96)00596-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M Negita
- Department of Surgery II, Nagoya University School of Medicine, Japan
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