Birk-Sørensen L, Kerrigan C L, Jensen G S
Department of Surgery, Royal Victoria Hospital, Montreal, Canada.
Scand J Plast Reconstr Surg Hand Surg. 1998 Dec;32(4):365-71. doi: 10.1080/02844319850158444.
The inflammatory recruitment of leucocytes is a main cause of tissue damage in ischaemia/reperfusion (I/R) injury. Under appropriate flow conditions, E-selectin and L-selectin participate in the initial deceleration of neutrophils (PMNs) on inflamed endothelial cells before transmigration of PMNs into the surrounding tissue. Previous work from our lab showed increased survival of I/R injured myocutaneous flaps after treatment with anti-E/L-selectin. In this study, we have evaluated a combined antibody to E-selectin and L-selectin (EL-246) in porcine pure skin flaps exposed to I/R injury. Buttock skin flaps were exposed to eight hours of ischaemia and 20 hours of reperfusion. EL-246 or saline was given intra-arterially into the flaps. Estimated surviving area was not improved in the treated group. The lack of effect of EL-246 supports our suspicion that different mechanisms are involved in I/R injury in myocutaneous flaps compared with pure skin flaps. As a certain shear stress must be present for the selectins to exert their effect, a possible explanation for the diverse results in muscle and skin might be different reflow patterns.
白细胞的炎性募集是缺血/再灌注（I/R）损伤中组织损伤的主要原因。在适当的血流条件下，E-选择素和L-选择素在中性粒细胞（PMNs）迁移到周围组织之前，参与中性粒细胞在炎症内皮细胞上的初始减速过程。我们实验室之前的研究表明，用抗E/L-选择素治疗后，I/R损伤的肌皮瓣存活率增加。在本研究中，我们评估了一种针对E-选择素和L-选择素的联合抗体（EL-246）对暴露于I/R损伤的猪纯皮瓣的影响。将臀部皮瓣进行8小时缺血和20小时再灌注处理。将EL-246或生理盐水动脉内注入皮瓣。治疗组的估计存活面积没有改善。EL-246无效支持了我们的怀疑，即与纯皮瓣相比，肌皮瓣的I/R损伤涉及不同的机制。由于选择素发挥作用必须存在一定的剪切应力，肌肉和皮肤结果不同的一个可能解释是再灌注模式不同。
