Determinants of mortality and treatment outcome following surgical interventions for acute mesenteric ischemia

During ischemia, the cell structures are progressively damaged, but restoration of the blood flow, paradoxically, intensifies the lesions caused by the ischemia. The mechanisms of ischemia injury and reperfusion (I/R) have not been completely defined and many studies have been realized in an attempt to find an ideal therapy for mesenteric I/R. The occlusion and reperfusion of the splanchnic arteries provokes local and systemic alterations principally derived from the release of cytotoxic substances and the interaction between neutrophils and endothelial cells. Substances involved in the process are discussed in the present review, like oxygen-derived free radicals, nitric oxide, transcription factors, complement system, serotonin and pancreatic proteases. The mechanisms of apoptosis, alterations in other organs, therapeutic and evaluation methods are also discussed.

https://www.scielo.br/pdf/acb/v20n4/24991.pdf

Pathophysiology of mesenteric ischemia/reperfusion: a review.

Liver disease encompasses a wide variety of liver conditions, including liver failure, liver cirrhosis and a spectrum of acute and chronic hepatitis, such as alcoholic, fatty, drug, viral and chronic hepatitis. Liver injury is a primary causative factor in liver disease; generally, these factors include direct liver damage and immune-mediated liver injury. Neutrophils (also known as neutrophilic granulocytes or polymorphonuclear leukocytes (PMNs)) are the most abundant circulating white blood cell type in humans, and PMNs are a major innate immune cell subset. Inappropriate activation and homing of neutrophils to the microvasculature contributes to the pathological manifestations of many types of liver disease. This review summarizes novel concepts of neutrophil-mediated liver injury that are based on current clinical and animal model studies.

/pdf/the-role-of-neutrophils-in-the-development-of-liver-diseases-223u3q0sii.pdf

The role of neutrophils in the development of liver diseases

Ischemia-reperfusion injury (IRI) is a common occurrence following myocardial infarction, transplantation, stroke, and trauma that can lead to multiple organ failure, which remains the foremost cause of death in critically ill patients. Current therapeutic strategies for IRI are mainly palliative, and there is an urgent requirement for a therapeutic that could prevent or reverse tissue damage caused by IRI. Neutrophils are the primary responders following ischemia and reperfusion and represent important components in the protracted inflammatory response and severity associated with IRI. Experimental studies demonstrate neutrophil infiltration at the site of ischemia and show that inducing neutropenia can protect organs from IRI. In this review, we highlight the mechanisms involved in neutrophil recruitment, activation, and adherence and how this contributes to disease severity in IRI. Inhibiting neutrophil mobilization, tissue recruitment, and ultimately neutrophil-associated activation of local and systemic inflammatory responses may have therapeutic potential in the amelioration of local and remote tissue damage following IRI.

https://espace.library.uq.edu.au/view/UQ:319067/UQ319067OA.pdf

Neutrophils--a key component of ischemia-reperfusion injury.

Ischemia/reperfusion injury (IRI) permeates a variety of diseases and is a ubiquitous concern in every transplantation proceeding, from whole organs to modest grafts. Given its significance, efforts to evade the damaging effects of both ischemia and reperfusion are abundant in the literature and they consist of several strategies, such as applying pre-ischemic conditioning protocols, improving protection from preservation solutions, thus providing extended cold ischemia time and so on. In this review, we describe many of the latest pharmacological approaches that have been proven effective against IRI, while also revisiting well-established concepts and presenting recent pathophysiological findings in this ever-expanding field. A plethora of promising protocols has emerged in the last few years. They have been showing exciting results regarding protection against IRI by employing drugs that engage several strategies, such as modulating cell-surviving pathways, evading oxidative damage, physically protecting cell membrane integrity, and enhancing cell energetics.

https://www.mdpi.com/1422-0067/20/20/5034/pdf

Ischemia/Reperfusion Injury Revisited: An Overview of the Latest Pharmacological Strategies.

O oxido nitrico e um mediador gasoso responsavel por uma variedade de fenomenos fisiologicos. A l-arginina e a precursora da sintese do oxido nitrico, na presenca de oxido nitrico-sintase. Este artigo reve as funcoes das oxido nitrico-sintases e como o oxido nitrico atua na permeabilidade vascular e na sindrome de isquemia e reperfusao, assim como possiveis metodos para sua mensuracao.

/pdf/oxido-nitrico-revisao-5b34geqroy.pdf

Óxido nítrico: revisão

Purpose : To evaluate hemodynamic and systemic changes during and after splanchnic ischemia and reperfusion (I/R). Methods : Ratswere divided into two groups: a) control: animals submitted to surgery, but not to I/R, treated with saline (5 ml/kg/h) for 150 min; b)group I/R: animals continuously infused with saline, and submitted to occlusion of the celiac trunk, superior mesenteric artery (SMA),and inferior mesenteric artery for 30 min, followed by a 120-min reperfusion. Mean arterial blood pressure (MABP), venous pressure,aortic and SMA blood flow, heart rate, esophageal temperature and hematocrit were evaluated. Results : During reperfusion in I/Rgroups, there was a progressive decrease in MABP, aortic blood flow, SMA blood flow, heart rate and esophageal temperature; veinpressure and hematocrit remained unchanged during the experiment. Conclusion : The model of ischemia used causes systemic changes,which are evidenced by hypotension, decrease in mesenteric blood flow, heart rate and esophageal temperature.

/pdf/systemic-evaluation-on-ischemia-and-reperfusion-injury-of-z0n6ljvt81.pdf

Systemic evaluation on ischemia and reperfusion injury of splanchnic organs in rats

PURPOSE: To assess the influence of experimental chronic alcoholism in the morphology and biomechanics of the aorta, in a rat model METHODS: Forty-four Wistar rats were randomly divided into two groups of 22 animals each: in the alcoholism group, the rats received water mixed to increasing concentrations of ethyl alcohol; and control group: the rats received pure water for 180 days The animals were then killed by an overdose of pentobarbital and the abdominal aortas were excised for histological (hematoxylin-eosin, Masson, Calleja, and Picrosirius red stain), histomorphometrical, and biomechanical analysis RESULTS: Histology and histomorphometry did not show differences in aorta morphology of both groups Biomechanical analysis showed a significantly greater yield point elongation in the alcoholic rat group (p<005) CONCLUSION: Chronic alcoholism did not cause morphological alterations in the aortic wall but increased elongation, without modifying any other mechanical properties

https://www.scielo.br/pdf/acb/v20n3/a04v20n3.pdf

Morphological and biomechanical study of abdominal aorta of rats submitted to experimental chronic alcoholism

Purpose: To assess the influence of experimental chronic alcoholism in the morphology and biomechanics of the aorta, in a rat model. Methods: Forty-four Wistar rats were randomly divided into two groups of 22 animals each: in the alcoholism group, the rats received water mixed to increasing concentrations of ethyl alcohol; and control group: the rats received pure water for 180 days. The animals were then killed by an overdose of pentobarbital and the abdominal aortas were excised for histological (hematoxylin-eosin, Masson, Calleja, and Picrosirius red stain), histomorphometrical, and biomechanical analysis. Results: Histology and histomorphometry did not show differences in aorta morphology of both groups. Biomechanical analysis showed a significantly greater yield point elongation in the alcoholic rat group (p<0.05). Conclusion: Chronic alcoholism did not cause morphological alterations in the aortic wall but increased elongation, without modifying any other mechanical properties.

/pdf/morphological-and-biomechanical-study-of-abdominal-aorta-of-22v8dakv0z.pdf

Morphological and biomechanical study of abdominal aorta of rats submitted to experimental chronic alcoholism 1 Avaliação morfológica e biomecânica da aorta abdominal de ratos submetidos ao alcoolismo crônico experimental

Nereide Freire Cerqueira

Papers

Pathophysiology of mesenteric ischemia/reperfusion: a review.

Óxido nítrico: revisão

Systemic evaluation on ischemia and reperfusion injury of splanchnic organs in rats

Morphological and biomechanical study of abdominal aorta of rats submitted to experimental chronic alcoholism

Morphological and biomechanical study of abdominal aorta of rats submitted to experimental chronic alcoholism 1 Avaliação morfológica e biomecânica da aorta abdominal de ratos submetidos ao alcoolismo crônico experimental