Ferencz Andrea, Szántó Zalán, Borsiczky Balázs, Kiss Katalin, Kalmár-Nagy Károly, Szeberényi József, Horváth Péter Ors, Róth Erzsébet
Department of Experimental Surgery, Department of Surgery, Department of Medical Biology, University of Pécs, Faculty of Medicine, Pécs, Hungary.
Surgery. 2002 Nov;132(5):877-84. doi: 10.1067/msy.2002.129910.
One determining factor in intestinal transplantation is the extreme sensitivity of the small bowel to ischemia-reperfusion injury. This study investigated the effect of ischemic preconditioning prior to autotransplantation.
Total orthotopic intestinal autotransplantation was performed in 40 mongrel dogs. In 4 groups (GI-GIV), grafts were stored for 3 hours in cold Euro Collins (GI,GIII) and University of Wisconsin (GII,GIV) solutions. In GIII and GIV, before preservation, preconditioning was induced by 4 cycles (5-min ischemia + 10-min reperfusion). Bowel samples were collected after laparotomy (control), at the end of preservation and reperfusion periods. We determined oxidative stress markers (reduced glutathione [GSH], superoxide dismutase [SOD]), production of oxygen free radicals, activity of nuclear factor-kappaB (NF-kappaB), and DNA damage.
In the non-preconditioned groups, GSH concentration increased slightly, while SOD activity decreased significantly during reperfusion. In the preconditioned groups, GSH increased markedly, and better preservation of SOD was observed. The number of oxygen free radicals increased during reperfusion mainly in non-preconditioned groups. Activation of NF-kappaB peaked by 1 hour, and decreased 3 hours after preconditioning. We observed DNA-damaged cells in all groups.
Our findings confirm that preconditioning prior to preservation can moderate the severity of oxidative stress and activate the endogenous cellular adaptation in bowel tissue.
肠道移植的一个决定性因素是小肠对缺血再灌注损伤极为敏感。本研究调查了自体移植前缺血预处理的效果。
对40只杂种犬进行全原位肠道自体移植。在4组（GI - GIV）中，移植物分别置于冷的尤尔·柯林斯液（GI、GIII）和威斯康星大学液（GII、GIV）中保存3小时。在GIII和GIV组中，保存前通过4个周期（5分钟缺血 + 10分钟再灌注）进行预处理。剖腹术后（对照）、保存期末和再灌注期末采集肠组织样本。我们测定了氧化应激标志物（还原型谷胱甘肽[GSH]、超氧化物歧化酶[SOD]）、氧自由基生成、核因子κB（NF - κB）活性和DNA损伤情况。
在未预处理组中，再灌注期间GSH浓度略有升高，而SOD活性显著降低。在预处理组中，GSH显著升高，且观察到SOD保存较好。再灌注期间氧自由基数量增加，主要见于未预处理组。NF - κB的激活在1小时达到峰值，预处理后3小时下降。我们在所有组中均观察到DNA受损细胞。
我们的研究结果证实，保存前进行预处理可减轻氧化应激的严重程度，并激活肠组织内源性细胞适应性。
