Laboratory of Drug Safety Management, Faculty of Pharmaceutical Science, Josai University, Saitama, Japan.
J Trauma Acute Care Surg. 2012 Jun;72(6):1548-54. doi: 10.1097/TA.0b013e31824a76b5.
Nitrite is an intrinsic signaling molecule with potential therapeutic implications in mammalian ischemia/reperfusion (I/R) injury of the heart, liver, and kidney. Although limb muscle compression and subsequent reperfusion are the causative factors in developing crush syndrome (CS), there has been no report evaluating the therapeutic effects of nitrite on CS. We therefore tested whether nitrite could be a therapeutic agent for the treatment of CS.
To create a CS model, anesthetized rats were subjected to bilateral hind limb compression with rubber tourniquets for 5 hours, followed by reperfusion for 0 hour to 6 hours while monitoring blood pressure. Saline for the CS group or sodium nitrite (NaNO(2)-100, 200, and 500 μmol/kg) for the nitrite-treated CS groups was intravenously administered immediately before reperfusion. Blood and tissue samples were collected for biochemical analysis.
Tissue nitrite levels in injured muscles were significantly reduced in the CS group compared with the sham group during I/R injury. Nitrite administration to CS rats restored nitric oxide bioavailability by enhancing nitrite levels of the muscle, resulting in a reduction of rhabdomyolysis markers such as potassium, lactate dehydrogenase, and creatine phosphokinase. Nitrite treatment also reduced plasma levels of interleukin-6 and myeloperoxidase activities in muscle and lung tissues, finally resulting in a dose-dependent improvement of survival rate from 24% (CS group) to 36% (NaNO(2)-100 group) and 64% (NaNO(2)-200 and 500 groups).
These results indicate that nitrite reduces I/R-induced muscle damage through its cytoprotective action and contributes to improved survival rate in a rat CS model.
亚硝酸盐是一种内源性信号分子,在心、肝和肾的哺乳动物缺血/再灌注(I/R)损伤中具有潜在的治疗意义。尽管肢体肌肉压迫和随后的再灌注是导致挤压综合征(CS)的原因,但尚无报告评估亚硝酸盐对 CS 的治疗效果。因此,我们测试了亚硝酸盐是否可以成为治疗 CS 的治疗剂。
为了创建 CS 模型,麻醉大鼠的双侧后肢用橡胶止血带压迫 5 小时,然后再灌注 0 小时至 6 小时,同时监测血压。CS 组给予生理盐水,亚硝酸盐处理的 CS 组(NaNO(2)-100、200 和 500μmol/kg)在再灌注前立即静脉注射。采集血液和组织样本进行生化分析。
与假手术组相比,CS 组在 I/R 损伤期间受伤肌肉中的组织亚硝酸盐水平显着降低。CS 大鼠给予亚硝酸盐可通过增强肌肉中亚硝酸盐水平来提高一氧化氮的生物利用度,从而减少肌溶解标志物,如钾、乳酸脱氢酶和肌酸磷酸激酶。亚硝酸盐处理还降低了肌肉和肺组织中白细胞介素-6 和髓过氧化物酶活性的血浆水平,最终导致存活率从 24%(CS 组)提高到 36%(NaNO(2)-100 组)和 64%(NaNO(2)-200 和 500 组),呈剂量依赖性。
这些结果表明,亚硝酸盐通过其细胞保护作用减轻 I/R 诱导的肌肉损伤,并有助于提高大鼠 CS 模型的存活率。