Effect of Ischemic Postconditioning and Atorvastatin in the Prevention of Remote Lung Reperfusion Injury

Carlos Henrique Marques Dos Santos,Giovanna Serra Da Cruz Vendas,Ian De Oliveira Chaves,Murillo Henrique Martins De Almeida,Henrique Budib Dorsa Pontes,Euler De Azevedo Neto,Baldomero Antonio Kato Da Silva,Letícia Do Espírito Santo Dias,João Victor Cunha Miranda,Doroty Mesquita Dourado,João Victor Durães Gomes Oliva,Trícia Luna Sampaio

doi:10.21470/1678-9741-2017-0022

Carlos Henrique Marques Dos Santos, Giovanna Serra Da Cruz Vendas + Show 10 more

Open Access

https://doi.org/10.21470/1678-9741-2017-0022

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Abstract

ObjectiveThe aim of the present study was to evaluate the ability of ischemic postconditioning, atorvastatin and both associated to prevent or minimize reperfusion injury in the lung of rats subjected to ischemia and reperfusion by abdominal aortic clamping.MethodsWe used 41 Wistar norvegic rats, which were distributed into 5 groups: ischemia and reperfusion (I/R), ischemic postcondictioning (IPC), postconditioning + atorvastatin (IPC+A), atorvastatin (A) and SHAM. It was performed a medium laparotomy, dissection and isolation of the infra-renal abdominal aorta; except for the SHAM group, all the others were submitted to the aortic clamping for 70 minutes (ischemia) and posterior clamp removal (reperfusion, 70 minutes). In the IPC and IPC+A groups, postconditioning was performed between the ischemia and reperfusion phases by four cycles of reperfusion and ischemia lasting 30 seconds each. In the IPC+A and A groups, preceding the surgical procedure, administration of 3.4 mg/day of atorvastatin was performed for seven days by gavage. After the surgical procedure, the right caudal lobe was removed from the lung for histological study, using tissue injury score ranging from grade 1 (normal tissue) to grade 4 (intense lesion).ResultsThe mean lung injury was 3.6 in the I/R group, 1.6 in the IPC group, 1.2 in the IPC+A group, 1.2 in the A group, and 1 in the SHAM group (P<0.01).ConclusionIschemic postconditioning and atorvastatin were able to minimize lung reperfusion injury, alone or in combination.

Highlights

Reperfusion is a fundamental step in the treatment of ischemia
We used 41 Wistar norvegic rats, which were distributed into 5 groups: ischemia and reperfusion (I/R), ischemic postcondictioning (IPC), postconditioning + atorvastatin (IPC+A), atorvastatin (A) and SHAM
The lung can be the target of the ischemia and reperfusion (IR) lesion directly, as in pulmonary edema after transplantation or in the resolution of thromboembolism, or be reached at a distance, as in cases of shock or reperfusion injury in the intestine or lower limbs, as occurs in the aortic clamping, used in aneurysm surgeries[2]

Summary

Introduction

Clinical and experimental evidence shows that the main events leading to cell and tissue dysfunction are related to reperfusion[1]. The ischemia and reperfusion (IR) injury constitutes a pathophysiological event common to several diseases of daily clinical practice. The lung can be the target of the IR lesion directly, as in pulmonary edema after transplantation or in the resolution of thromboembolism, or be reached at a distance, as in cases of shock or reperfusion injury in the intestine or lower limbs, as occurs in the aortic clamping, used in aneurysm surgeries[2]. It was believed that the lung was more resistant to ischemic lesions than other organs. The lung can be considered the only organ that can suffer ischemia without hypoxia[3]

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Discussion

Conclusion