Abstract
The aim of this study was to investigate whether the hind limbs or intestinal tract is the most important initiator of the inflammatory response secondary aortic clamping and hind limb ischemia/reperfusion injury. Blood samples of Wistar rats obtained from posterior cava vein, portal vein, and heart cavity during either laparotomy (control group, n=8) or laparotomy + 2 h of aortic clamping and bilateral hind limb ischemia (ischemia group, n=8), or 2 h after ischemia and 2 h of reperfusion (ischemia-reperfusion group, n=8) were assayed for interleukin 6 (IL-6) and C-reactive protein (CRP). Serum IL-6 at the heart (223.6+/-197.9 [10-832] pg/mL) was higher (p<0.001) than at both portal (133.08+/-108.52 [4-372] pg/mL) and posterior cava veins (127.58+/-109.15 [8-388] pg/mL). CRP was not significant different among groups. The splanchnic region is also a source of inflammatory response secondary to ischemia and reperfusion of the hind limbs.
Highlights
The prevalence of abdominal aortic aneurysm (AAA) is estimated at 3% of the male population above 50, and is the cause of 2% of deaths in men over the age of 65 years1-4
The findings in the present study suggest that the inflammatory response mediated by interleukin 6 (IL-6) in this animal model of aortic clamping and hind limbs ischemia arise from both the splanchnic region and the hind limbs
Patients subjected to open AAA surgical repair have endothelial activation and accumulation of activated neutrophils in muscles as a result of ischemia/reperfusion injury . 27,28 This evidence suggests that the inferior members are the source of inflammation in ischemia/reperfusion injury
Summary
The prevalence of abdominal aortic aneurysm (AAA) is estimated at 3% of the male population above 50, and is the cause of 2% of deaths in men over the age of 65 years. When AAA is operated on an emergency basis (due to rupture), the mortality rate is at least 50% In this case, multiple organ failure (MOF) is the main cause of death. The initial inflammatory response to injury is presumed to be beneficial for restoring the patient’s homeostasis If it is either exaggerated or perpetuated, the patient may enter a state of malignant systemic inflammation that may progress to MOF9. CRP serum levels seem to have direct correlation with acute inflammation, it has not been studied in experimental models of ischemia/reperfusion injury. It would be plausible to investigate which region or organ is responsible for the initiation and/or perpetuation of SIRS in the AAA surgical repair Would it be the inferior limbs, the splanchnic region or both? A second objective was to compare the effect of ischemia and ischemia associated with reperfusion on both the production of inflammatory mediators and gut mucosal
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