Engglis

Abstract

The mortality rate of acute mesenteric ischemia (AMI) is high due to the delay in diagnosis. Determination of potent biomarker for early AMI is the key in reducing the mortality. As a proinflammatory cytokine, the level of TNF-α might be affected during the ischemia and reperfusion, with the prediction duration of 60-120 min. High TNF-α level may stimulate the upregulation of IL-10 as an inhibitor of TNF-α. This provides a new opportunity for early diagnosis of AMI by measuring the ratio between those two cytokines. The purpose of this study was to investigate the effect of duration of the mesenteric artery to the ratio of TNF-α/IL-10 in a AMI rat model. This was an experimental study using Wistar rat. We performed mesenteric artery in 28 male rats to produce an AMI model, with ligation duration of 0, 30, 60, 90, 120, 150, and 180 minutes. At the end of ligation, blood samples were taken for measurement of TNF-α and IL-10 level using ELISA. For the microscopic examination of tissue necrosis, intestinal organ samples were taken and made into paraffin blocks and stained using Haematoxylin-Eosin. TNF-α increased in minute 120 compared to other treatment groups (p<0.05). IL-10 increased in minute 180 compared to control group (p<0.05). Microscopic examination showed that the duration of ligation affects the structure and morphology of intestinal mucosa characterized by discoloration of organs along with increasing the ligation duration. Ligation of the superior mesenteric artery was found to be significantly increased the TNF-α level and to be compensated by increasing IL-10. It is assumed that when the IL-10 level, that has protective effect as an inhibitor, higher than TNF-α level as a proinflammatory cytokine on duration 150 minutes, it means no more inflammatory or cells is dead. Therefore TNF-α/IL-10 ratio can be used as a biomarker candidate of prognosic factor management of AMI.