Universidade de São Paulo - Faculdade de Medicina - Divisão de Cirurgia Pediátrica - São Paulo (SP), Brazil.
Acta Cir Bras. 2023 Jun 1;38:e381323. doi: 10.1590/acb381323. eCollection 2023.
Acute mesenteric ischemia (AMI) is a condition in pediatric surgery that ranges from intestine necrosis to death. Ischemic postconditioning (IPoC) methods were developed to reduce the damage caused by revascularization. This study aimed to evaluate the efficacy of these methods in an experimental weaning rat model.
Thirty-two 21-day-old Wistar rats were allocated into four groups according to the surgical procedure performed: control, ischemia-reperfusion injury (IRI), local (LIPoC) and remote IPoC (RIPoC). At euthanasia, fragments of the intestine, liver, lungs, and kidneys were submitted to histological, histomorphometric, and molecular analyses.
In the duodenum, intestines, and kidneys histological alterations promoted by IRI were reversed by remote postconditioning method. In the distal ileum, the histomorphometric alterations could be reversed by the postconditioning methods with more evident effects promoted by the remote method. The molecular analysis found that the levels of expression of Bax (proapoptotic) and Bcl-XL (antiapoptotic) genes in the intestine were increased by IRI. These alterations were equally reversed by the postconditioning methods, with more evident effects of the remote method.
IPoC methods positively reduced the damage caused by IRI in weaning rats.
急性肠系膜缺血(AMI)是小儿外科中的一种病症,其严重程度可由肠坏死发展至死亡。缺血后处理(IPoC)方法的出现旨在减轻再灌注损伤造成的损害。本研究旨在评估这些方法在实验性离乳大鼠模型中的效果。
根据所进行的手术程序,将 32 只 21 天大的 Wistar 大鼠分为 4 组:对照组、缺血再灌注损伤(IRI)组、局部(LIPoC)组和远程 IPoC(RIPoC)组。安乐死后,肠、肝、肺和肾的组织片段进行了组织学、组织形态计量学和分子分析。
在十二指肠、肠和肾脏中,IRI 引起的组织学改变通过远程后处理方法得到逆转。在回肠远端,后处理方法可以逆转组织形态计量学改变,且远程方法的效果更为明显。分子分析发现,IRI 增加了肠中 Bax(促凋亡)和 Bcl-XL(抗凋亡)基因的表达水平。这些改变同样通过后处理方法得到逆转,且远程方法的效果更为明显。
IPoC 方法可积极减轻离乳大鼠 IRI 造成的损害。