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Palmier M, Cornet E, Renet S, Dumesnil A, Perzo N, Cohen Q, Richard V, Plissonnier D. A Supraceliac Aortic Cross Clamping Model to Explore Remote Lung Injury and the Endothelial Glycocalyx. Ann Vasc Surg 2022:S0890-5096(22)00906-2. [PMID: 36572096 DOI: 10.1016/j.avsg.2022.12.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/11/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND We hypothesized that supraceliac aortic cross clamping could induce lung injury mediated by an inflammatory ischemia-reperfusion (IR) trigger. We aimed to characterize glycocalyx (GCX), a component of endothelial membrane, participating to remote lung injury. METHODS Rats underwent supraceliac aortic cross clamping for 40 min and were sacrificed at 0, 3, 6, and 24 hr of reperfusion (n = 10/group). Each group was compared to sham (n = 6/group). GCX products (syndecan-1 [Sdc-1] and heparan sulfate [HS]), tumor necrosis factor-alpha (TNF-α), and interleukin-1β (IL-1β) were measured in plasma (enzyme-linked immunosorbent assay[ELISA]). Lungs were harvested for measurements of TNF-α, IL-1β (polymerase chain reaction) and Sdc-1 (western blotting [WB]). Histologic lung injury scoring and pulmonary gravimetry were analyzed in a blinded manner. RESULTS Plasmatic Sdc-1, HS, TNF-α, and IL-1β reached peak levels at 3 hr. Levels were significantly higher in clamping groups than sham at 6 hr for Sdc-1, at 0 and 3 hr for HS, at 3 and 6 hr for TNF-α, and at 3 hr for IL-1β. Lung TNF-α and Interleukin-1β reached peak levels at 6 hr. Levels were significantly higher than sham at 6 and 24 hr for TNF-α and at 6 hr for IL-1β. Lung Sdc-1 was lowest at 3 hr. Sdc-1 was not significantly different compared to sham at the different reperfusion times. At 3 hr, it was 0.27 ± 0.03 vs. 0.33 ± 0.02 (sham) (P = 0.09). Histopathologic scores at 6 and 24 hr were higher in clamping groups than sham. At 6 and 24 hr, it was higher for hemorrhage, polynuclear neutrophil (PNN) infiltration and intravascular leukocytes. Pulmonary edema was higher by gravimetry at 0 and 6 hr. CONCLUSIONS Supra celiac aortic clamping causes early lung injury in relation with a systemic inflammatory response associated with altered GCX structure.
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Affiliation(s)
- Mickael Palmier
- Department of Vascular Surgery, Rouen University Hospital, Rouen, France; Rouen University Hospital, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - Emlyn Cornet
- Department of Anatomopathology, Rouen University Hospital, Rouen, France
| | - Sylvanie Renet
- Rouen University Hospital, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - Anais Dumesnil
- Rouen University Hospital, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - Nicolas Perzo
- Rouen University Hospital, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - Quentin Cohen
- Department of Vascular Surgery, Rouen University Hospital, Rouen, France; Rouen University Hospital, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - Vincent Richard
- Rouen University Hospital, INSERM U1096, FHU REMOD-VHF, Rouen, France
| | - Didier Plissonnier
- Department of Vascular Surgery, Rouen University Hospital, Rouen, France; Rouen University Hospital, INSERM U1096, FHU REMOD-VHF, Rouen, France.
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Vlastos D, Zeinah M, Ninkovic-Hall G, Vlachos S, Salem A, Asonitis A, Chavan H, Kalampalikis L, Al Shammari A, Alvarez Gallesio JM, Pons A, Andreadou I, Ikonomidis I. The effects of ischaemic conditioning on lung ischaemia-reperfusion injury. Respir Res 2022; 23:351. [PMID: 36527070 PMCID: PMC9756694 DOI: 10.1186/s12931-022-02288-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Ischaemia-reperfusion injury (IRI) encompasses the deleterious effects on cellular function and survival that result from the restoration of organ perfusion. Despite their unique tolerance to ischaemia and hypoxia, afforded by their dual (pulmonary and bronchial) circulation as well as direct oxygen diffusion from the airways, lungs are particularly susceptible to IRI (LIRI). LIRI may be observed in a variety of clinical settings, including lung transplantation, lung resections, cardiopulmonary bypass during cardiac surgery, aortic cross-clamping for abdominal aortic aneurysm repair, as well as tourniquet application for orthopaedic operations. It is a diagnosis of exclusion, manifesting clinically as acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Ischaemic conditioning (IC) signifies the original paradigm of treating IRI. It entails the application of short, non-lethal ischemia and reperfusion manoeuvres to an organ, tissue, or arterial territory, which activates mechanisms that reduce IRI. Interestingly, there is accumulating experimental and preliminary clinical evidence that IC may ameliorate LIRI in various pathophysiological contexts. Considering the detrimental effects of LIRI, ranging from ALI following lung resections to primary graft dysfunction (PGD) after lung transplantation, the association of these entities with adverse outcomes, as well as the paucity of protective or therapeutic interventions, IC holds promise as a safe and effective strategy to protect the lung. This article aims to provide a narrative review of the existing experimental and clinical evidence regarding the effects of IC on LIRI and prompt further investigation to refine its clinical application.
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Affiliation(s)
- Dimitrios Vlastos
- grid.415914.c0000 0004 0399 9999Department of Vascular Surgery, Countess of Chester Hospital, Chester, UK ,grid.411449.d0000 0004 0622 4662Second Department of Cardiology, Attikon University Hospital, Athens, Greece ,Present Address: Liverpool, UK
| | - Mohamed Zeinah
- grid.415992.20000 0004 0398 7066Department of Cardiac Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK ,grid.7269.a0000 0004 0621 1570Ain Shams University, Cairo, Egypt
| | - George Ninkovic-Hall
- grid.415970.e0000 0004 0417 2395Department of Vascular Surgery, Royal Liverpool University Hospital, Liverpool, UK
| | - Stefanos Vlachos
- grid.411449.d0000 0004 0622 4662Second Department of Cardiology, Attikon University Hospital, Athens, Greece
| | - Agni Salem
- grid.415992.20000 0004 0398 7066Department of Cardiac Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Athanasios Asonitis
- grid.413157.50000 0004 0590 2070Department of Cardiothoracic Surgery, NHS Golden Jubilee National Hospital, Glascow, UK
| | - Hemangi Chavan
- grid.421662.50000 0000 9216 5443Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Lazaros Kalampalikis
- grid.414012.20000 0004 0622 6596Department of Minimally Invasive Cardiac Surgery, Metropolitan General Hospital, Athens, Greece
| | - Abdullah Al Shammari
- grid.421662.50000 0000 9216 5443Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - José María Alvarez Gallesio
- grid.421662.50000 0000 9216 5443Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Aina Pons
- grid.421662.50000 0000 9216 5443Department of Thoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Ioanna Andreadou
- grid.5216.00000 0001 2155 0800School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Ignatios Ikonomidis
- grid.411449.d0000 0004 0622 4662Second Department of Cardiology, Attikon University Hospital, Athens, Greece
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Umer A, Ługowska-Umer H, Schönborn-Kellenberger O, Korolkiewicz PK, Sein-Anand Ł, Kuziemski K, Korolkiewicz RP. Tachykinin Antagonists Reverse Ischemia/Reperfusion Gastrointestinal Motility Impairment in Rats. J Surg Res 2020; 255:510-516. [PMID: 32629333 DOI: 10.1016/j.jss.2020.05.092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/26/2020] [Accepted: 05/24/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Supraceliac aortic clamping and unclamping produces ischemia-reperfusion (I/R) injury of the splanchnic organs. The protective effects of tachykinin receptor antagonists, SR140333 (NK1 receptor), SR48968 (NK2 receptor), and SB222200 (NK3 receptor), against I/R-induced inhibition of intestinal motility were tested in rats. MATERIAL AND METHODS The intestinal transit of Evans blue was measured in untreated rats and animals subjected to skin incision, I/R (1 h superior mesenteric artery occlusion followed by 24 h reperfusion) or sham operation. Surgical procedures were conducted under diethyl ether anesthesia. RESULTS The gastrointestinal transit has not been markedly affected in rats, which were anesthetized or subjected to skin incision in comparison with untreated animals. In contrast, a sham operation and I/R have significantly reduced the intestinal motility. Pretreatment with NK1-3 blockers (SR140333 [3-30 μg/kg]; SR48968 [3-100 μg/kg]; and SB222200 [10-100 μg/kg]) reversed dose dependently the effects of I/R to the level observed after sham operation only. A combination of NK1+NK2+NK3 inhibitors exerted an additive effect compared with NK1 and NK2 antagonists used as single agents. Similarly, combined NK1+NK2 were more effective than NK2 alone. Sham operation and I/R have shifted the in vitro carbachol concentration-response curves to the right in comparison with untreated animals, a phenomenon partially reversed by NK1-NK3 pretreatment. CONCLUSIONS Single-agent and combined treatment with NK1-3 antagonists markedly attenuated the gastrointestinal dysmotility evoked by I/R injury. The pretreatment with NK3 blocker proved to be the most active in this experimental setting.
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Affiliation(s)
- Artur Umer
- Department of Thoracic Surgery, Medical University of Gdansk, Smoluchowskiego, Gdańsk, Poland
| | - Hanna Ługowska-Umer
- Department of Dermatology, Venerology, Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | - Łukasz Sein-Anand
- Department of Clinical Toxicology, Medical University of Gdańsk, Gdańsk, Poland
| | - Krzysztof Kuziemski
- Department of Allergology and Pneumonology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Tyvold SS, Dahl T, Dragsund S, Gunnes S, Lyng O, Damås JK, Aadahl P, Solligård E. Bronchial microdialysis monitoring of inflammatory response in open abdominal aortic aneurysm repair; an observational study. Physiol Rep 2017; 5:5/14/e13348. [PMID: 28743822 PMCID: PMC5532484 DOI: 10.14814/phy2.13348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/10/2017] [Accepted: 06/16/2017] [Indexed: 11/24/2022] Open
Abstract
Aortic surgery results in ischemia-reperfusion injury that induces an inflammatory response and frequent complications. The magnitude of the inflammatory response in blood and bronchi may be associated with the risk of immediate complications. The purpose of the study was to evaluate bronchial microdialysis as a continuous monitoring of cytokines in bronchial epithelial lining fluid (ELF) and to determine whether bronchial ELF cytokine levels reflect the ischemia-reperfusion injury and risk for complications during open abdominal aortic aneurysm (AAA) repair. We measured cytokines in venous blood using microdialysis and in serum for comparison. Sixteen patients scheduled for elective open AAA repair were included in a prospective observational study. Microdialysis catheters were introduced into a bronchi and a cubital vein. Eighteen cytokines were measured using a Bio-Plex Magnetic Human Cytokine Panel. Samples were collected before and during cross-clamping of the aorta as well as from 0 to 60 min and from 60 to 120 min of reperfusion. The ELF levels of several cytokines changed significantly during reperfusion. In particular, IL-6 increased more than 10-fold and IL-13 more than 5-fold during ischemia and reperfusion. Also, the venous levels of several inflammatory and anti-inflammatory cytokines increased and exhibited their highest concentration during reperfusion. Both bronchial and venous cytokine levels correlated with duration of the procedure, intensive care days, and preoperative kidney disease. Three patients suffered organ failure as a direct consequence of the procedure, and in these patients the bronchial ELF concentrations of 17 of 18 cytokines differed significantly from patients without such complications. Bronchial microdialysis is suited for continuous monitoring of inflammation during open AAA repair. The bronchial ELF cytokine levels may be useful in predicting immediate complications such as organ failure in patients undergoing vascular surgery.
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Affiliation(s)
- Stig S Tyvold
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torbjørn Dahl
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Surgery, St. Olavs Hospital, Trondheim, Norway
| | - Stein Dragsund
- Clinic of Anesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway
| | - Sigurd Gunnes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim, Norway
| | - Oddveig Lyng
- Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan K Damås
- Centre of Molecular Inflammation Research, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Mid-Norway Sepsis Research Group, NTNU and St. Olavs Hospital, Trondheim, Norway
| | - Petter Aadahl
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim, Norway
| | - Erik Solligård
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Anesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway.,Mid-Norway Sepsis Research Group, NTNU and St. Olavs Hospital, Trondheim, Norway
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Erling Junior N, Montero EFDS, Sannomiya P, Poli-de-Figueiredo LF. Local and remote ischemic preconditioning protect against intestinal ischemic/reperfusion injury after supraceliac aortic clamping. Clinics (Sao Paulo) 2013; 68:1548-54. [PMID: 24473514 PMCID: PMC3840383 DOI: 10.6061/clinics/2013(12)12] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Accepted: 06/20/2013] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES This study tests the hypothesis that local or remote ischemic preconditioning may protect the intestinal mucosa against ischemia and reperfusion injuries resulting from temporary supraceliac aortic clamping. METHODS Twenty-eight Wistar rats were divided into four groups: the sham surgery group, the supraceliac aortic occlusion group, the local ischemic preconditioning prior to supraceliac aortic occlusion group, and the remote ischemic preconditioning prior to supraceliac aortic occlusion group. Tissue samples from the small bowel were used for quantitative morphometric analysis of mucosal injury, and blood samples were collected for laboratory analyses. RESULTS Supraceliac aortic occlusion decreased intestinal mucosal length by reducing villous height and elevated serum lactic dehydrogenase and lactate levels. Both local and remote ischemic preconditioning mitigated these histopathological and laboratory changes. CONCLUSIONS Both local and remote ischemic preconditioning protect intestinal mucosa against ischemia and reperfusion injury following supraceliac aortic clamping.
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Affiliation(s)
- Nilon Erling Junior
- Vascular Surgery, Department of Surgery, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto AlegreRS, Brazil
| | | | - Paulina Sannomiya
- Institute of Heart, Faculdade de Medicina da Universidade de São Paulo, São PauloSP, Brazil
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Karhausen J, Stafford-Smith M. The role of nonocclusive sources of acute gut injury in cardiac surgery. J Cardiothorac Vasc Anesth 2013; 28:379-91. [PMID: 24119676 DOI: 10.1053/j.jvca.2013.04.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Indexed: 12/16/2022]
Affiliation(s)
- Jörn Karhausen
- Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
| | - Mark Stafford-Smith
- Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
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Lung Injury and Acute Respiratory Distress Syndrome After Cardiac Surgery. Ann Thorac Surg 2013; 95:1122-9. [DOI: 10.1016/j.athoracsur.2012.10.024] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 08/10/2012] [Accepted: 10/04/2012] [Indexed: 12/26/2022]
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Shih HC, Huang MS, Lee CH. Magnolol attenuates the lung injury in hypertonic saline treatment from mesenteric ischemia reperfusion through diminishing iNOS. J Surg Res 2011; 175:305-11. [PMID: 21704335 DOI: 10.1016/j.jss.2011.04.063] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 04/12/2011] [Accepted: 04/27/2011] [Indexed: 12/29/2022]
Abstract
BACKGROUND Hypertonic saline (HTS) administration can decrease the inflammation following ischemia reperfusion. Magnolol is a potent antioxidant. The present study investigated whether combined treatment of magnolol and HTS could provide further protection in mesenteric ischemia reperfusion injury. METHODS Male C3H/HeOuJ mice were randomly segregated into the following groups: sham-operated (sham), vehicle treatment and mesenteric ischemia reperfusion (MSIR) (vehicle-treated), magnolol treatment and MSIR (magnolol-treated), HTS treatment and MSIR (HTS-treated), as well as co-administration of magnolol plus HTS and MSIR (combined-treated). In MSIR, mice were subjected to mesenteric ischemia for 60 min followed by reperfusion for 30 min. Lung injury was evaluated by lung edema (water ratio) and myeloperoxide (MPO) activity; RNA expression of inducible nitric oxide synthetase (iNOS), TNF-α, and IL-6 were assayed by real time RT-PCR. The formation of peroxynitrite in plasma was assayed by the peroxynitrite-dependent oxidation of dihydrorhodamine 123 (DHR 123) to rhodamine. RESULTS Compared with those in the sham-treated group, lung edema and MPO activity, expressions of iNOS, TNF-α and IL-6, and plasma peroxynitrite were significantly increased in the vehicle-treated group. Significant attenuations of these parameters were found in the magnolol-treated or HTS-treated animals. Combined treatment of magnolol and HTS further suppressed the lung edema, iNOS, and TNF-α expressions, and plasma peroxynitrite, compared with the results of a single treatment of magnolol or HTS. CONCLUSIONS Compared with single-agent use, co-administration of magnolol and HTS further decreases iNOS expression and plasma peroxynitrite as well as the degree of lung injury from MISR. These results may provide another treatment measure for post-injury immunomodulation.
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Affiliation(s)
- Hsin-Chin Shih
- Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan.
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What's New in Shock, November 2010? Shock 2010. [DOI: 10.1097/shk.0b013e3181f54a98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Nosál'ová V, Sotníková R. Assessment of ischemic vascular damage. ACTA ACUST UNITED AC 2010; Chapter 21:Unit 21.4. [PMID: 20967746 DOI: 10.1002/0471140856.tx2104s44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This protocol describes a model convenient for acute experiments in anesthetized rats, performed by selective occlusion of the superior mesenteric artery. Such a model provides a means for assessing the role played by various pathophysiological mechanisms in the development of intestinal ischemic injury. It is especially suitable for studying different treatments, mainly pharmacological ones, to help cope with this problem in clinical practice. In the form of support protocols, this unit includes functional vascular and chemiluminescence studies, determination of vascular permeability and myeloperoxidase activity, transit time, and mortality.
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Affiliation(s)
- Viera Nosál'ová
- Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Bratislava, Slovak Republic
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