Kang Nan, Hai Yong, Liang Fang, Gao Chun-Jin, Liu Xue-Hua
Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China.
Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China.
Mol Med Rep. 2014 Jun;9(6):2124-30. doi: 10.3892/mmr.2014.2064. Epub 2014 Mar 24.
Hyperbaric oxygen (HBO) therapy is an effective therapy for ischemia/reperfusion (I/R) injury of the brain, small intestine, testes and liver. However, the detailed molecular mechanisms underlying the effect of HBO therapy remain undetermined. In the current study, the hypothesis that preconditioning rats with HBO protects grafted skin flaps against subsequent I/R injury was investigated. In addition, the molecular mechanisms underlying HBO therapy were characterized by analyzing the roles of the following important inflammatory factors: High mobility group protein 1 (HMGB1) and nuclear factor-κ B (NF-κB). A total of 40 rats were randomly divided into the following five groups: (i) Sham surgery (SH); (ii) ischemia followed by reperfusion 3 days following surgery (I/R3d); (iii) ischemia followed by reperfusion 5 days following surgery (I/R5d); (iv) HBO preconditioning (HBO-PC) and ischemia followed by reperfusion 3 days following surgery (HBO-PC+3d); and (v) HBO-PC and ischemia followed by reperfusion 5 days following surgery (HBO-PC+5d). For the surgical procedure, all pedicled skin flaps were first measured and elevated (9x6 cm). The feeding vessels of the skin flaps were subsequently clamped for 3 h and released to restore blood flow. The rats in the HBO-PC+3d and HBO-PC+5d groups received 1 h HBO for 3 and 5 consecutive days, respectively, prior to surgery. Following surgery, the rats were euthanized, and grafted tissues were collected for western blotting and immunohistochemistry. HBO-PC increased blood perfusion in epigastric skin flaps and attenuated I/R injury following skin flap graft. Additionally, the elevated expression of HMGB1 and NF-κB proteins during I/R injury was attenuated by HBO-PC treatment. HBO-PC may therefore be applied to reduce I/R injury and improve the survival rate of grafted skin flaps. The molecular mechanisms underlying the effect of HBO therapy are associated with the attenuation of inflammatory responses.
高压氧（HBO）疗法是治疗脑、小肠、睾丸和肝脏缺血/再灌注（I/R）损伤的一种有效疗法。然而，HBO疗法作用的详细分子机制仍未明确。在本研究中，我们探讨了用HBO预处理大鼠以保护移植皮瓣免受随后I/R损伤的假说。此外，通过分析以下重要炎症因子：高迁移率族蛋白1（HMGB1）和核因子-κB（NF-κB）的作用，对HBO疗法的分子机制进行了表征。总共40只大鼠被随机分为以下五组：（i）假手术组（SH）；（ii）术后3天缺血再灌注组（I/R3d）；（iii）术后5天缺血再灌注组（I/R5d）；（iv）HBO预处理组（HBO-PC）及术后3天缺血再灌注组（HBO-PC+3d）；（v）HBO-PC及术后5天缺血再灌注组（HBO-PC+5d）。手术过程中，首先测量并掀起所有带蒂皮瓣（9×6 cm）。随后夹闭皮瓣的供血血管3小时，然后松开以恢复血流。HBO-PC+3d组和HBO-PC+5d组的大鼠在手术前分别连续3天和5天接受1小时的HBO治疗。手术后，对大鼠实施安乐死，并收集移植组织用于蛋白质印迹法和免疫组织化学分析。HBO预处理增加了上腹部皮瓣的血液灌注，并减轻了皮瓣移植后的I/R损伤。此外，HBO预处理可减轻I/R损伤期间HMGB1和NF-κB蛋白表达的升高。因此，HBO预处理可用于减轻I/R损伤并提高移植皮瓣的存活率。HBO疗法作用的分子机制与炎症反应的减轻有关。
