Crinnion J N, Homer-Vanniasinkam S, Hatton R, Parkin S M, Gough M J
Vascular Surgical Unit, General Infirmary at Leeds, UK.
Cardiovasc Surg. 1994 Dec;2(6):749-53.
This study investigated the effect of neutrophil depletion and neutrophil elastase inhibition on the severity of skeletal muscle reperfusion injury. In a rodent model, indices (experimental/normal limb) of gastrocnemius muscle viability (histochemical staining), oedema (wet:dry weight ratio) and myeloperoxidase content (neutrophil recruitment) were assessed in normal (no ischaemia), ischaemic (6-h unilateral hindlimb ischaemia), control (6-h ischaemia and 4-h reperfusion), neutrophil-depleted rats (given antineutrophil serum) and rats receiving the neutrophil elastase inhibitor Elafin. Neutrophil recruitment muscle infarction and oedema did not occur in normal limbs, or in those subjected to ischaemia without reperfusion. In contrast increased muscle myeloperoxidase levels (P < 0.001), muscle infarction (P < 0.01) and oedema (P < 0.001) all occurred in the reperfused limbs of control animals compared with those of normal and ischaemic rats. Antineutrophil serum and Elafin both reduced neutrophil recruitment during reperfusion (P < 0.001 and P < 0.01 respectively) and muscle viability was preserved. Reperfusion oedema still occurred however, suggesting that altered endothelial permeability is mediated by factors other than neutrophils.
本研究调查了中性粒细胞减少和中性粒细胞弹性蛋白酶抑制对骨骼肌再灌注损伤严重程度的影响。在一个啮齿动物模型中，评估了正常（无缺血）、缺血（单侧后肢缺血6小时）、对照（缺血6小时和再灌注4小时）、中性粒细胞减少的大鼠（给予抗中性粒细胞血清）和接受中性粒细胞弹性蛋白酶抑制剂Elafin的大鼠的腓肠肌活力（组织化学染色）、水肿（湿重与干重之比）和髓过氧化物酶含量（中性粒细胞募集）等指标（实验肢体/正常肢体）。正常肢体或仅经历缺血而无再灌注的肢体未发生中性粒细胞募集、肌肉梗死和水肿。相比之下，与正常和缺血大鼠相比，对照动物再灌注肢体的肌肉髓过氧化物酶水平升高（P<0.001）、肌肉梗死（P<0.01）和水肿（P<0.001）均出现。抗中性粒细胞血清和Elafin均降低了再灌注期间的中性粒细胞募集（分别为P<0.001和P<0.01），并保留了肌肉活力。然而，再灌注水肿仍然发生，这表明内皮通透性改变是由中性粒细胞以外的因素介导的。
