Chan R K, Ibrahim S I, Verna N, Carroll M, Moore F D, Hechtman H B
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Br J Surg. 2003 Dec;90(12):1470-8. doi: 10.1002/bjs.4408.
Reperfusion injury is a common clinical problem that lacks effective therapy. Two decades of research implicating oxygen free radicals and neutrophils has not led to a single successful clinical trial.
The aim was to review new clinical and preclinical data pertaining to the alleviation of reperfusion injury. A review of the literature was undertaken by searching the MEDLINE database for the period 1966-2003 without language restrictions.
Evidence now points to complement and immune complexes as critical players in mediating reperfusion injury. Ischaemia is postulated to induce a phenotypical cellular change through the surface expression of a neoantigen. Preformed circulating natural IgM antibodies are then trapped and complement is activated. Final events leading to reperfusion injury include formation of the membrane attack complex and mast cell degranulation.
再灌注损伤是一个缺乏有效治疗方法的常见临床问题。二十年来，涉及氧自由基和中性粒细胞的研究并未带来一项成功的临床试验。
目的是回顾与减轻再灌注损伤相关的新临床和临床前数据。通过检索1966年至2003年期间的MEDLINE数据库进行文献综述，无语言限制。
现在有证据表明补体和免疫复合物是介导再灌注损伤的关键因素。据推测，缺血通过新抗原的表面表达诱导细胞表型改变。预先形成的循环天然IgM抗体随后被捕获，补体被激活。导致再灌注损伤的最终事件包括膜攻击复合物的形成和肥大细胞脱颗粒。
