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Korkmaz-Icöz S, Sun X, Li S, Brlecic P, Loganathan S, Ruppert M, Sayour AA, Radovits T, Karck M, Szabó G. Conditioned Medium from Mesenchymal Stem Cells Alleviates Endothelial Dysfunction of Vascular Grafts Submitted to Ischemia/Reperfusion Injury in 15-Month-Old Rats. Cells 2021; 10:1231. [PMID: 34067928 PMCID: PMC8155879 DOI: 10.3390/cells10051231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 01/09/2023] Open
Abstract
In patients undergoing coronary artery bypass grafting (CABG), ischemia/reperfusion injury (IRI) is the main contributor to organ dysfunction. Aging-induced vascular damage may be further aggravated during CABG. Favorable effects of conditioned medium (CM) from mesenchymal stem cells (MSCs) have been suggested against IRI. We hypothesized that adding CM to saline protects vascular grafts from IRI in rats. We found that CM contains 28 factors involved in apoptosis, inflammation, and oxidative stress. Thoracic aortic rings from 15-month-old rats were explanted and immediately mounted in organ bath chambers (aged group) or underwent 24 h of cold ischemic preservation in saline-supplemented either with vehicle (aged-IR group) or CM (aged-IR+CM group), prior to mounting. Three-month-old rats were used as referent young animals. Aging was associated with an increase in intima-to-media thickness, an increase in collagen content, higher caspase-12 mRNA levels, and immunoreactivity compared to young rats. Impaired endothelium-dependent vasorelaxation to acetylcholine in the aged-IR group compared to the aged-aorta was improved by CM (aged 61 ± 2% vs. aged-IR 38 ± 2% vs. aged-IR+CM 50 ± 3%, p < 0.05). In the aged-IR group, the already high mRNA levels of caspase-12 were decreased by CM. CM alleviates endothelial dysfunction following IRI in 15-month-old rats. The protective effect may be related to the inhibition of caspase-12 expression.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
| | - Xiaoxin Sun
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
| | - Shiliang Li
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
| | - Paige Brlecic
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
| | - Sivakkanan Loganathan
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
- Department of Cardiac Surgery, University Hospital Halle (Saale), 06120 Halle, Germany
| | - Mihály Ruppert
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary;
| | - Alex Ali Sayour
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary;
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary;
| | - Matthias Karck
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
| | - Gábor Szabó
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
- Department of Cardiac Surgery, University Hospital Halle (Saale), 06120 Halle, Germany
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Abstract
Reconstruction of head and neck patients using free tissue transfer is perhaps the most challenging of areas in the human body. Although complications are inevitable in a percentage of patients, it is good postoperative care and monitoring that determines the success or failure of the reconstruction and also permits early salvage of a failing free flap. Teamwork and cooperation among members of the reconstructive team are critical. Here we review the significance of clinical care and monitoring of reconstructed head and neck patients in the intraoperative and postoperative periods. We also review different techniques and strategies for flap monitoring and anticoagulation used for free tissue transfers.
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