Glycine preserves function and decreases necrosis in skeletal muscle undergoing ischemia and reperfusion injury

Abstract

Background. Glycine (GLY) is a neutral amino acid that has been shown to be cytoprotective in the kidneys of dogs and rabbits undergoing ischemia-reperfusion injury. To investigate whether GLY exhibits a protective effect on skeletal muscle subjected to ischemia and reperfusion injury, we used a well-described gracilis muscle model in canines. Methods. Twelve adult mongrel dogs were subjected to 6 hours of ischemia in 1 randomly selected side. The dogs were randomized into 2 groups: group 1 (6 animals) underwent 15 minutes of perfusion with 2.2% GLY, and group 2 (6 animals) underwent 15 minutes of perfusion with normal saline solution (NS) only. Both groups had normothermic reperfusion for 1 hour along with the corresponding perfusate. Muscle biopsy specimens were taken, frozen in liquid nitrogen, and stored at −70°C. Muscle injury was evaluated at 48 hours by measuring weight gain (edema), maximal contractile force, and percent of muscle necrosis. Adenosine triphosphate (ATP) and phosphocreatine (Pcr) (an energy store for ATP synthesis) levels were determined by using high performance liquid chromatography. Results. In group 1, the average weight gain was 57% ± 11.27% while in group 2 it was 100% ± 12.48%. Maximal muscle contractile force was 712.5 ± 68 g for group 1 and 511 ± 27.91 g for group 2. The amount of muscle necrosis was 30 ± 3.7% in group 1, as opposed to 63 ± 10% in group 2. The ATP content was 0.07 ± 0.03 nmol/mg wet tissue weight (post-ischemia with NS) and 0.21 ± 0.08 nmol/mg wet tissue weight (post-ischemia with GLY). Pcr content was 0.19 ± 0.04 mmol/mg wet tissue weight (post-ischemia with NS) and 0.27 ± 0.04 μmol/mg wet tissue (post-ischemia and infused with GLY) (P < .05). Conclusions. These data show that GLY preserves muscle function, decreases edema and the amount of muscle necrosis and preserves energy stores in this canine model. Because GLY can be safely given systemically in human beings in higher concentrations than that given in our model, as it is given in parenteral nutrition, its mechanism of action should be further investigated for its potential use in the clinical setting of ischemia and reperfusion injury. (Surgery 2001;129:231-5.)