Different Ischemic Preconditioning Regimens Affecting Preservation Injury of Intestines

Abstract

Decreasing ischemia-reperfusion injury in intestinal transplantation is of paramount importance for improving graft recovery and function. This study explores the ability of two ischemic preconditioning (IPC) regimens to reduce preservation injury. Sprague-Dawley rats were divided into 3 groups (n = 11 each). In the controls (group C), intestinal grafts were harvested and preserved. IPC was performed either through 4 cycles of mesenteric ischemia of 4 min each followed by 10 min of reperfusion (group BIPC) or 2 ischemic cycles of 12 min each followed by 10 min of reperfusion (group LIPC). Grafts were stored in histidine-tryptophan-ketoglutarate, and samples were taken 0, 3, 6, 9, 12, 18, and 24 h after preservation. Preservation injury was scored using the Park/Chiu scale. Goblet cells (GC), enteroendocrine cells (EEC) and serotonin-producing EEC (SPEEC) were studied for evaluation of the graft conditions. Group C had the most advanced preservation injury followed by group BIPC. GC count was lowest in group C, followed by BIPC. Comparison between groups BIPC and LIPC showed superior parameters (preservation injury, GC, EEC, and SPEEC) in LIPC. In conclusion, an IPC regimen of 2 ischemic cycles of 12 min each followed by 10 min of reperfusion distinctly decreased the preservation injury of intestinal grafts compared with non-manipulated grafts.

The relationship between morphology and disaccharidase activity in ischemia- reperfusion injured intestine.

“…Recently we have confiromed this fact in our study of GC changes during cold storage of intestines. With a lengthening time of preservation, graft mucosal alteration increased at a rate which correlated with the decrease in GC numbers (Varga et al, 2011). In the present study, the tendency in GC development during intestinal IR injury was similar to HII.…”

“…In the present study, the tendency in GC development during intestinal IR injury was similar to HII. The reduction in GC is in close connection with disintegration due to epithelial lifting along the villous sides, denudation of the villi, and loss of villous tissue (Tóth et al, 2011). Ikeda et al (2002) clearly demonstrated that GC resist being detached along with the enterocytes from the villi subjected to short-term injury.…”

“…Primarily, ischemia causes blockage of the ATP supply and initiation of catabolic processes. One of the first changes in this phase is the release of the tight junction and thus also disruption of the continuity of surface epithelial cell (Varga et al, 2011). The majority of the catabolic reactions are catalysed by enzymes activated through calcium cations, and so ischemia leads also to releasing of calcium cations.…”

“…Their endogenous activity allows them to support epithelial restitution and facilitate migration of cells, and also through specific intestinal trefoil factor peptides they are able to block apoptosis (Taupin & Podolsky, 2003;Kjellev, 2009). Our previous studies (Tóth et al, 2007;Varga et al, 2009Varga et al, , 2011 described in detail the morphological changes at the level of particular cell populations in the intestines during IT (graft harvest, preservation, implementation and reperfusion) have been described in detail (Varga et al, 2009). Knowledge of concurrently arising functional changes could bring useful information.…”

Alterations of epithelial layer after ischemic preconditioning of small intestine in rats

“…Ischemic preconditionig (IPC) was introduced by Murry et al (1986) in the canine heart model and intestine model of IPC was first described by Hotter et al (1996) ten year afterwards. Positive effects if IPC was documented in many experimental studies (Wang and Li 2003;Wu et al 2004;Aban et al 2005;Varga et al 2011). Evidence of Aksöyek et al (2002) suggests that IPC reduces bacterial translocation, iNOS activation and intestinal injury in intestinal IR.…”