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El-Shoura EAM, Abdelzaher LA, Ahmed AAN, Abdel-Wahab BA, Sharkawi SMZ, Mohamed SA, Salem EA. Reno-protective effect of nicorandil and pentoxifylline against potassium dichromate-induced acute renal injury via modulation p38MAPK/Nrf2/HO-1 and Notch1/TLR4/NF-κB signaling pathways. J Trace Elem Med Biol 2024; 85:127474. [PMID: 38788404 DOI: 10.1016/j.jtemb.2024.127474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 04/09/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Occupational and environmental exposure to chromium compounds such as potassium dichromate (PDC) (K2Cr2O7) has emerged as a potential aetiologic cause for renal disease through apoptotic, and inflammatory reactions. The known potent antioxidants such as nicorandil (NIC) and/or pentoxifylline (PTX) were studied for their possible nephroprotective effect in PDC-treated rats. METHODS Forty male Wistar rats were divided into five groups; control, PDC group, NIC+PDC, PTX+PDC group, and combination+PDC group. Nephrotoxicity was evaluated histopathologically and biochemically. Invasive blood pressure, renal function parameters urea, creatinine, uric acid and albumin, glomerular filtration rate markers Cys-C, Kim-1 and NGAL, inflammatory markers IL-1β, IL-6, TNF-α, TGF-β, COX-II, p38MAPK, NF-κB and TLR4, oxidative stress SOD, GSH, MDA, MPO, HO-1 and Nrf2 and apoptotic mediators Notch1 and PCNA were evaluated. Besides, renal cortical histopathology was assayed as well. RESULTS PDC led to a considerable increase in indicators for kidney injury, renal function parameters, invasive blood pressure, oxidative stress, and inflammatory markers. They were markedly reduced by coadministration of PDC with either/or NIC and PTX. The NIC and PTX combination regimen showed a more significant improvement than either medication used alone. Our results demonstrated the nephroprotective effect of NIC, PTX, and their combined regimen on PDC-induced kidney injury through suppression of oxidative stress, apoptosis, and inflammatory response. CONCLUSION Renal recovery from PDC injury was achieved through enhanced MAPK/Nrf2/HO-1 and suppressed Notch1/TLR4/NF-κB signaling pathways. This study highlights the role of NIC and PTX as effective interventions to ameliorate nephrotoxicity in patients undergoing PDC toxicity.
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Affiliation(s)
- Ehab A M El-Shoura
- Department of Clinical Pharmacy, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut 71524, Egypt; Department of Pharmacy Practice, Faculty of Pharmacy, Horus University, New Damietta, Egypt.
| | - Lobna A Abdelzaher
- Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed A N Ahmed
- Department of Pharmacology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Basel A Abdel-Wahab
- Department of Pharmacology, College of Pharmacy, Najran University, P.O. Box 1988, Najran, Saudi Arabia
| | - Souty M Z Sharkawi
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | | | - Esraa A Salem
- Department of Medical Physiology, Faculty of Medicine, Menoufia University, Shebeen ElKom 32511, Egypt
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Atorvastatin Attenuates Radiotherapy-Induced Intestinal Damage through Activation of Autophagy and Antioxidant Effects. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:7957255. [PMID: 36092168 PMCID: PMC9459441 DOI: 10.1155/2022/7957255] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 07/06/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022]
Abstract
Abdominal or pelvic radiotherapy (RT) often results in small intestinal injury, such as apoptosis of epithelial cells and shortening of the villi. Atorvastatin, a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, has many biological effects including cholesterol reduction, protection from cell damage, and autophagy activation. To reduce the extent of radiotherapy- (RT-) induced enteritis, we investigated the protective effects of atorvastatin against RT-induced damage of the intestinal tract. In this study, C57BL/6 mice were randomly distributed into the following groups (n = 8 per group): (1) control group: mice were fed water only, (2) atorvastatin group (Ator): mice were administered atorvastatin, (3) irradiation group (IR): mice received abdominal RT, (4) Ator+IR group: mice received abdominal RT following atorvastatin administration, and (5) Ator+IR+3-MA group: abdominal RT following atorvastatin and 3-methyladenine (an autophagy inhibitor) administration. Based on the assessment of modified Chiu's injury score and villus/crypt ratio, we found that atorvastatin administration significantly reduced intestinal mucosal damage induced by RT. Atorvastatin treatment reduced apoptosis (cleaved caspase-3 and cleaved poly (ADP-ribose) polymerase), DNA damage (γH2AX and 53BP1), oxidative stress (OS, 4-hydroxynonenal), inflammatory molecules (phospho-NF-κB p65 and TGF-β), fibrosis (collagen I and collagen III), barrier leakage (claudin-2 and fluorescein isothiocyanate-dextran), disintegrity (fatty acid-binding protein 2), and dysfunction (lipopolysaccharide) caused by RT in small intestinal tissue. In addition, atorvastatin upregulated the expression of autophagy-active molecules (LC3B), antioxidants (heme oxygenase 1 and thioredoxin 1), and tight junction proteins (occludin and zonula occludens 1). However, the biological functions of atorvastatin in decreasing RT-induced enteritis were reversed after the administration of 3-MA; the function of antioxidant molecules and activity of thioredoxin reductase were independent of autophagy activation. Our results indicate that atorvastatin can effectively relieve RT-induced enteritis through autophagy activation and associated biological functions, including maintaining integrity and function and decreasing apoptosis, DNA damage, inflammation, OS, and fibrosis. It also acts via its antioxidative capabilities.
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Aydogdu I, Karaca E, Coban G, Cay A, Guler EM, Kocyigit A, Uzun E, Aydoğdu YE, Metin H, Miçooğullari U, Ilbey YO, Keskin MZ. An investigation of the effects of amniotic fluid on experimental ischemia/reperfusion damage in rat testes. J Pediatr Urol 2021; 17:761.e1-761.e6. [PMID: 34518124 DOI: 10.1016/j.jpurol.2021.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/18/2021] [Accepted: 08/06/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Various agents have been tested as preventive treatments for ischemia/reperfusion (IR) damage. In this study, we have investigated for the first time in the literature the efficacy of injection of amniomax (AMX) into testicular parenchyma, which is a commercial medium of rat amniotic fluid, in preventing testicular IR damage related to testicular torsion. OBJECTIVE This study aims to evaluate whether or not amniomax has an effect on experimental IR damage in rat testes using biochemical and histopathological methods based on data in the literature. Even if testicular torsion is repaired surgically in early term injury because of de IR damage still occurs. Is it possible to reduce the ischemia reperfusion injury with amniotic fluid and increase the success of treatment? STUDY DESIGN 40 male Wistar albino rats were included. Four groups were formed with 10 rats in each group: Sham, Ischemia/Reperfusion (IR), injection 1 min before detorsion (AMX-BD), injection 1 min after detorsion (AMX-AD). Total Oxidant Status (TOS) and Oxidative Stress Index (OSI) were computed for oxidative stress, and Total Antioxidant Status (TAS) levels were computed for the antioxidant system, for both serum and tissue. Necrosis and microcalcification levels were assessed in the evaluation of testicular histology. P < 0.05 was considered statistically significant. RESULTS AMX-AD group has low necrosis degree than IR, Mean serum and tissue levels of TAS, TOS, and OSI parameters were respectively determined as; for TAS: 0.64 ± 0.11 and 0.96 ± 0.25 mmol Trolox Equivalent/L; for TOS: 6.71 ± 0.87 and 9.40 ± 1.03 μmol H2O2 equivalent/L; for OSI: 11.94 ± 3.74 and 10.70 ± 4.23 arbitrary unit. DISCUSSION Our study has investigated for the first time in the literature the efficacy of amniotic fluid in preventing testicular IR damage, and used amniomax (AMX) for this purpose. The limitation of our study may be the small number of rat in the groups. CONCLUSION We think an injection after detorsion is more favorable considering that the AMX-AD group demonstrated significantly lower levels of TOS in serum and tissue and OSI in serum, and significantly higher serum levels of TAS compared to the AMX-BD group, as well as the fact that the morphological protection effect was only observed for injections performed immediately after detorsion.
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Affiliation(s)
- Ibrahim Aydogdu
- Bezmialem Vakif University, School of Medicine, Department of Pediatric Surgery, Istanbul, Turkey.
| | - Erkin Karaca
- Izmir Saglik Bilimleri University, Tepecik Training and Research Hospital, Department of Urology, Izmir, Turkey.
| | - Ganime Coban
- Bezmialem Vakif University, School of Medicine, Department of Pathology, Istanbul, Turkey.
| | - Ali Cay
- Bezmialem Vakif University, School of Medicine, Department of Pediatric Surgery, Istanbul, Turkey.
| | - Eray Metin Guler
- Bezmialem Vakif University, Medical Laboratory Techniques Program, Istanbul, Turkey.
| | - Abdurrahim Kocyigit
- Bezmialem Vakif University, School of Medicine, Department of Biochemistry, Istanbul, Turkey.
| | - Ersan Uzun
- Istanbul Medeniyet University, School of Medicine, Department of Pediatric Surgery, Istanbul, Turkey.
| | | | - Hüseyin Metin
- Bezmialem Vakif University, Scgool of Medicine, Emergency Medicine, Istanbul, Turkey.
| | - Uygar Miçooğullari
- Izmir Saglik Bilimleri University, Tepecik Training and Research Hospital, Department of Urology, Izmir, Turkey.
| | - Yusuf Ozlem Ilbey
- Izmir Saglik Bilimleri University, Tepecik Training and Research Hospital, Department of Urology, Izmir, Turkey.
| | - Mehmet Zeynel Keskin
- Izmir Saglik Bilimleri University, Tepecik Training and Research Hospital, Department of Urology, Izmir, Turkey.
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de Jesus-Silva SG, de Moraes Silva MA, Carbonel AAF, Grillo Filho GFR, Grigório TS, Simões MDJ, Cardoso RS, Fagundes DJ. Heparin Attenuates Visceral Apoptosis in a Swine Model of Hemorrhagic Shock and Reperfusion Injury. Ann Vasc Surg 2020; 67:449-460. [PMID: 32179141 DOI: 10.1016/j.avsg.2020.01.106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 01/09/2020] [Accepted: 01/30/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The use of unfractionated heparin in hypovolemic shock, aortic clamping, and visceral reperfusion is still not established, despite evidence of inhibition of early cell damage. This study investigated the potential protective effect of unfractionated heparin on hepatic and renal apoptosis in a porcine ischemia and reperfusion model. METHODS Twenty-one male swine (Sus scrofa) were divided into 3 groups: sham (n = 5), heparin (n = 8), and nonheparin (n = 8). The heparin and nonheparin groups underwent hypovolemic shock for 30 min, supraceliac aortic clamping for 1 h and reperfusion for 3 h. Unfractionated heparin 200 mg/kg was administered to the heparin group during aortic clamping. Hemodynamic and laboratory parameters were monitored, including aminotransferase and serum urea. Histological lesion scores were applied to hematoxylin and eosin-stained liver and kidney sections. Apoptosis quantification was performed by caspase-3 immunohistochemistry. RESULTS The proposed model caused a severe cardiocirculatory disturbance in the heparin and nonheparin groups, observed by the carotid-femoral pressure gradient and lactic acidosis. There was no significant difference in hemodynamic and laboratory parameters between these two groups. The mean values of liver and renal histological lesion scores did not present any significant differences. Caspase-3 immunoexpression was lower in the heparin than the nonheparin group for both liver and kidney. CONCLUSIONS Attenuation of liver and kidney cell apoptosis in pigs undergoing systemic heparinization suggests a potential use for heparin in modulating cell death under critical hemodynamic conditions.
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Affiliation(s)
| | | | | | | | - Thyago Silva Grigório
- Division of Vascular and Endovascular Surgery, Hospital de Clinicas de Itajubá, HCI, Itajubá, Brazil
| | - Manuel de Jesus Simões
- Department of Morphology and Genetics, Paulista School of Medicine/Federal University of São Paulo, EPM/UNIFESP, São Paulo, Brazil
| | - Rodolfo Souza Cardoso
- Division of Vascular and Endovascular Surgery, Hospital de Clinicas de Itajubá, HCI, Itajubá, Brazil
| | - Djalma José Fagundes
- Department of Surgical Technique and Experimental Surgery, EPM/UNIFESP, São Paulo, Brazil
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Yildirim M, Kaplan M, Duzenli T, Tanoglu A, Kucukodaci Z, Onal Tastan Y, Cakir Guney B, Serindag Z. Pentoxifylline has favorable preventive effects on experimental chronic pancreatitis model. Scand J Gastroenterol 2020; 55:236-241. [PMID: 31942828 DOI: 10.1080/00365521.2020.1712471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: To investigate the protective efficacy of pentoxifylline through biochemical parameters and histopathological scores in a caerulein- and alcohol-induced experimental model of chronic pancreatitis in rats.Methods: A model of chronic pancreatitis with caerulein and alcohol was created in female rats of the genus Sprague Dawley. Pentoxifylline was administered in doses of 25 mg/kg (low dose) and 50 mg/kg (high dose) as a protective agent. Each group contained 8 animals. The groups were: group 1 (control group); caerulein + alcohol, group 2 (low-dose pentoxifylline group); caerulein + alcohol + pentoxifylline 25 mg/kg, group 3 (high-dose pentoxifylline group); caerulein + alcohol + pentoxifylline 50 mg/kg, group 4 (placebo); caerulein + alcohol + saline, group 5 (sham group); only saline injection.Rats were sacrificed 12 h after the last injection, and TNF-α, TGF-β, MDA, and GPx concentrations were measured in blood samples. The histopathologic examination was conducted by a pathologist who was unaware of the groups.Results: The biochemical results of the treatment groups (group 2 and group 3) were statistically significantly lower compared with the control group (group 1) (p < .05). The difference between the low-dose treatment group (group 2) and high-dose treatment group (group 3) was significant in terms of biochemical parameters (p < .05). The difference between group 2 and the control group was not significant in terms of histopathologic scores (p > .05), whereas the difference between the group 3 and the control group was statistically significant (p < .05).Conclusions: As a result, pentoxifylline, which has anti-inflammatory and antioxidant properties, was shown to have protective efficacy in an experimentally generated model of chronic pancreatitis.
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Affiliation(s)
- Muhammed Yildirim
- Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Kaplan
- Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Tolga Duzenli
- Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Alpaslan Tanoglu
- Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Zafer Kucukodaci
- Department of Pathology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Yesim Onal Tastan
- Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Basak Cakir Guney
- Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Zeliha Serindag
- Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
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Roshankhah S, Salahshoor M, Jalili C, Abdolmaleki A. Pentoxifylline modulation hepatotoxicity and apoptosis induced by nitrosamine in rats. BIOMEDICAL AND BIOTECHNOLOGY RESEARCH JOURNAL (BBRJ) 2020. [DOI: 10.4103/bbrj.bbrj_54_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Luo Y, Duan X, Bian L, Chen Z, Kuang L, Li Y. Ischemic Preconditioning Preventing Downregulation of miR-182 Protects Intestine Against Ischemia/Reperfusion Injury by Inhibiting Apoptosis. Arch Med Res 2019; 50:241-248. [DOI: 10.1016/j.arcmed.2019.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/24/2019] [Accepted: 08/29/2019] [Indexed: 01/16/2023]
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Jalili C, Moradi D, Roshankhah S, Salahshoor MR. Effect of pentoxifylline on kidney damage induced by nitrosamine in male rats. Res Pharm Sci 2019; 14:64-73. [PMID: 30936934 PMCID: PMC6407339 DOI: 10.4103/1735-5362.251854] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Nitrosamines are well-known carcinogenic agents. Humans are exposed to nitrosamines in various ways, the most important of which is the diet. Pentoxifylline is a xanthine derivative, which is used as a drug that inhibits inflammatory factors, reduces blood viscosity, improves peripheral blood flow, and increases oxygenation of tissue. This study was designed to evaluate the effects of pentoxifylline against damage induced by nitrosamine to the kidneys of rats. In this study, 48 male rats were randomly assigned to 8 groups: control normal group and nitrosamine control treated group (40 mg/kg); pentoxifylline groups (25, 50, 100 mg/kg) and nitrosamine + pentoxifylline treated groups (25, 50, 100 mg/kg). Treatments were administered either intraperitoneally (nitrosamine) or orally (pentoxifylline) on a daily basis for 28 days. The normalized kidney weight, glomeruli characteristics, thiobarbituric acid reactive species, antioxidant capacity, kidney function indicators, and serum nitrite oxide levels were investigated. Nitrosamine administration increased kidney malondialdehyde (MDA) level, kidney weight, blood urea nitrogen (BUN), creatinine, and nitrite oxide levels and decreased significantly glomeruli number and tissue ferric reducing/antioxidant power (FRAP) level compared to the control normal group (P < 0.05). The pentoxifylline and pentoxifylline + nitrosamine treatments reduced BUN, kidney MDA level, creatinine, glomerular diameter, and nitrite oxide levels significantly at all doses and increased the glomeruli number, kidney weight, and tissue FRAP level compared to the nitrosamine control group (P < 0.05). It seems that pentoxifylline administration improved kidney injury induced by nitrosamine in rats.
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Affiliation(s)
- Cyrus Jalili
- Medical Biology Research Center, Department of Anatomical Sciences, Medical School, Kermanshah University of Medical Sciences, Kermanshah, I.R. Iran
| | - Delnia Moradi
- Department of Anatomical Sciences, Medical School, Kermanshah University of Medical Sciences, Kermanshah, I.R. Iran
| | - Shiva Roshankhah
- Department of Anatomical Sciences, Medical School, Kermanshah University of Medical Sciences, Kermanshah, I.R. Iran
| | - Mohammad Reza Salahshoor
- Department of Anatomical Sciences, Medical School, Kermanshah University of Medical Sciences, Kermanshah, I.R. Iran
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Oliveira TRRD, Oliveira GFD, Simões RS, Feitosa SM, Tikazawa EH, Monteiro HP, Fagundes DJ, Taha MO. The expression of endothelial and inducible nitric oxide synthase and apoptosis in intestinal ischemia and reperfusion injury under the action of ischemic preconditioning and pentoxifylline. Acta Cir Bras 2017; 32:935-948. [PMID: 29236798 DOI: 10.1590/s0102-865020170110000005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 10/08/2017] [Indexed: 01/15/2023] Open
Abstract
PURPOSE To investigate the expression of nitric oxide synthase (NOS) and apoptosis associated with ischemic preconditioning (IPC) and pentoxifylline (PTX) in intestinal ischemia (I) and reperfusion (R) injury. METHODS Thirty male rats were assigned to 5 groups: (CG), no clamping of the superior mesenteric artery (90 minutes); (IR-SS) saline + ischemia (30 minutes) + reperfusion (60 minutes); (IR-PTX) PTX + ischemia (30 minutes) + reperfusion (60 minutes); (IPC-IR-SS) 5 minutes of ischemia + 5 minutes of reperfusion (IPC) + saline + I(30 minutes)+R(60 minutes); and (IPC-IR-PTX) IPC + PTX + I(30 minutes)+ R(60 minutes). RESULTS The application of IPC and PTX showed a significantly lower immunohistochemistry reaction for active caspase-3 (P<0.05) compared to IR+SS. The number of cells immunoreactive to BCL-2 was higher in the IR-PTX group (P>0.05). The NOS-2 expression (qRTPCR) in the IR-PTX group (P<0.05) was higher than the values for the IPC+IR-SS and IPC-IR-PTX groups. The NOS-3 expression was significantly upper in the IPC-IR-PTX group than in the CG (P<0.05), the IR-SS (P<0.05) and the IR-PTX (P<0.05) groups. CONCLUSIONS The BCL-2 and active caspase-3 showed beneficial effects on PTX and IPC. The expression of NOS-2 and NOS-3 in the IPC and IPC-PTX groups showed no synergistic effect.
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Affiliation(s)
- Teresinha Regina Ribeiro de Oliveira
- PhD, Associate Professor, School of Health Sciences, Universidade Federal da Grande Dourados (UFGD), Brazil. Acquisition, analysis and interpretation of data; technical procedures; statistical analysis; manuscript preparation and writing
| | - Geraldo Ferreira de Oliveira
- PhD, Associate Professor, School of Health Sciences, UFGD, Dourados-MS, Brazil. Acquisition of data, technical procedures, manuscript writing
| | - Ricardo Santos Simões
- PhD, Department of Morfology and Genetic, Universidade de São Paulo (UNIFESP), Brazil. Immunohistochemical examinations, analysis of data
| | - Suellen Maurim Feitosa
- PhD, Department Gynecology, UNIFESP, Sao Paulo-SP, Brazil. Acquisition, analysis and interpretation of data; technical procedures
| | - Eduardo Hiroshi Tikazawa
- MD, Department Public Health, School of Medicine, Universidade Estadual de Campinas (UNICAMP), Brazil. Acquisition of data, technical procedures, manuscript preparation
| | - Hugo Pequeno Monteiro
- PhD, Full Professor, Department of Biochemistry, UNIFESP, Sao Paulo-SP, Brazil. Analysis and interpretation of data, manuscript preparation, critical revision
| | - Djalma José Fagundes
- PhD, Full Professor, Division of Surgical Techniques and Experimental Surgery, Department of Surgery, UNIFESP, Sao Paulo-SP, Brazil. Analysis and interpretation of data, manuscript preparation, critical revision
| | - Murched Omar Taha
- PhD, Associate Professor, Division of Surgical Techniques and Experimental Surgery, Department of Surgery, UNIFESP, Sao Paulo-SP, Brazil. Conception and design of the study, critical revision, final approval
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