Stefanutti Giorgio, Pierro Agostino, Vinardi Simona, Spitz Lewis, Eaton Simon
Department of Paediatric Surgery, Institute of Child Health, London WC1N 1EH, United Kingdom.
Shock. 2005 Aug;24(2):159-64. doi: 10.1097/01.shk.0000168871.60531.6f.
Multisystem organ failure represents a major cause of mortality in intestinal ischemia and reperfusion (I/R), and oxidative stress plays a key role in its pathogenesis. Hypothermia is beneficial in I/R injury, but its effects on systemic oxidative stress have not been elucidated. The aim of this study was to evaluate the effects of moderate hypothermia on systemic oxidative stress after intestinal I/R injury. Anaesthetized adult rats (n = 10 per group) underwent 60 min of intestinal ischemia followed by 120 min of reperfusion or sham operation at normothermia (36 degrees C-38 degrees C) or moderate hypothermia (30 degrees C-32 degrees C). At sacrifice, ileum, liver, lungs, and kidneys were removed to determine the concentration of malondialdehyde (a marker of lipid peroxidation), reduced and oxidized glutathione (a major endogenous antioxidant), and glutathione redox state. Plasma malondialdehyde and nitrate plus nitrite (reflecting nitric oxide production) were also analyzed. A marked elevation of malondialdehyde was observed after I/R at normothermia in plasma, ileum, and lungs; however, hypothermia during I/R prevented this increase. I/R at normothermia caused a profound decrease in reduced glutathione and glutathione redox state in the ileum, but this was not observed in I/R at hypothermia. Interestingly, hypothermia increased glutathione content of control intestine. Nitric oxide production was increased only in normothermic I/R animals. Moderate hypothermia attenuates systemic oxidative stress associated with experimental intestinal I/R in an animal model by decreasing lipid peroxidation in plasma, ileum, lungs, and kidneys, by preventing the depletion of gut glutathione, and by reducing systemic nitric oxide production. However, whether these effects persist after rewarming is unknown.
多系统器官衰竭是肠道缺血再灌注(I/R)导致死亡的主要原因,氧化应激在其发病机制中起关键作用。低温对I/R损伤有益,但其对全身氧化应激的影响尚未阐明。本研究旨在评估中度低温对肠道I/R损伤后全身氧化应激的影响。将成年麻醉大鼠(每组n = 10)在正常体温(36℃-38℃)或中度低温(30℃-32℃)下进行60分钟的肠道缺血,随后进行120分钟的再灌注或假手术。处死时,取出回肠、肝脏、肺和肾脏,以测定丙二醛(脂质过氧化的标志物)、还原型和氧化型谷胱甘肽(一种主要的内源性抗氧化剂)的浓度以及谷胱甘肽氧化还原状态。还分析了血浆丙二醛和硝酸盐加亚硝酸盐(反映一氧化氮生成)。在正常体温下I/R后,血浆、回肠和肺中的丙二醛显著升高;然而,I/R期间的低温可防止这种升高。正常体温下的I/R导致回肠中还原型谷胱甘肽和谷胱甘肽氧化还原状态显著降低,但在低温下的I/R中未观察到这种情况。有趣的是,低温增加了对照肠道的谷胱甘肽含量。仅在正常体温I/R动物中一氧化氮生成增加。中度低温通过降低血浆、回肠、肺和肾脏中的脂质过氧化,防止肠道谷胱甘肽耗竭以及减少全身一氧化氮生成,减轻动物模型中与实验性肠道I/R相关的全身氧化应激。然而,复温后这些影响是否持续尚不清楚。