Members Members Residents Job Board
Join Today Renew Your Membership Make A Donation
2006 Abstracts: The Effect Of L-Arginine And Aprotinin On Intestinal Ischemia-Reperfusion Injury
Back to 2006 Program and Abstracts
The Effect Of L-Arginine And Aprotinin On Intestinal Ischemia-Reperfusion Injury
Constantine P. Spanos, Christos Papakonstandinou, Panagiota Papakonstandinou, Panagiotis Spanos; Surgery, Aristotelian University, Thessaloniki, Greece

BACKGROUND: Intestinal ischemia-reperfusion (I/R) results in local mucosal injury, systemic injury and organ dysfunction. These injuries are characterized by altered microvascular and epithelial permeability and villous damage. Activation of neutrophils, platelets and endothelial factors are known to be involved in this process. Cytokines and oxygen-derived free radicals are believed to be important pathogenic mediators. Capillary no-reflow is also known to play a role in I/R. The aim of our study was to examine the role of L-arginine and aprotinin on intestinal I/R. METHODS: Pigs weighing 20-25 kg were used. Ischemia was established by clamping the superior mesenteric artery (SMA) at its origin and was sustained for 2 hours. Duration of reperfusion was 2 hours. Animals were divided into four groups: A, the control group, which was submitted to I/R injury only, B, in which L-arginine was administered at a rate of 5 mg/kg/min during ischemia and continuing throughout reperfusion, C, in which aprotinin was administered with an initial bolus dose of 20000U/kg during ischemia followed by a continuous dose at 50U/h throughout reperfusion and D in which both substances were administered. In all groups TNF-α, IL-1 and IL-6 levels were measured using ELISA at baseline, 1 hour and 2 hours of ischemia, and 30 min 1 hour and 2 hours of reperfusion. SMA blood flow was measured with an electromagnetic probe at baseline, 10 min, and 2 hours of reperfusion. Histologic changes of the intestinal mucosa were examined and graded on a 5-point scale. RESULTS: In the control group, levels of TNF-α, IL-1, and IL-6 were significantly increased during reperfusion (p<0.05) as compared to baseline. Administration of L-arginine and aprotinin led to suppression of the release of TNF-α, IL-1 and IL-6 during reperfusion in a statistically significant manner (all p<0.05). A synergistic or additive effect of L-arginine and aprotinin was not observed. SMA blood flow in the control group was decreased (p>0.05) during reperfusion as compared to baseline. In animals treated with L-arginine and aprotinin, SMA blood flow during reperfusion was significantly increased (p<0.05) as compared to the control group. Histologic examination of the intestinal mucosa was characterized by villous flattening and necrosis in the control group. In the treated animals, less severe histological changes were noted. CONCLUSIONS: Administration of L-arginine and aprotinin may lead to amelioration of intestinal I/R injury. We did not note a synergistic or additive effect of these two substances. These findings warrant further studies in clinical settings for future treatment efforts.


Back to 2006 Program and Abstracts


Society for Surgery of the Alimentary Tract

Facebook Twitter YouTube

Email SSAT Email SSAT
500 Cummings Center, Suite 4400, Beverly, MA 01915 500 Cummings Center
Suite 4400
Beverly, MA 01915
+1 978-927-8330 +1 978-927-8330
+1 978-524-0498 +1 978-524-0498
Links
About
Membership
Publications
Newsletters
Annual Meeting
Join SSAT
Job Board
Make a Pledge
Event Calendar
Awards