Effect of vitamin E on reperfusion injuries during reconstructive vascular operations on lower limbs

Abstract

Introduction: The challenge against reperfusion injury and tissue oxidative stress, especially in vascular surgical interventions has an essential importance to reach the optimal clinical result. Numerous experimental attempts have proved the positive antioxidant effect of vitamin E in both chronic and acute phase models. In our study we monitored the effect of continuous preoperative treatment with vitamin E, on oxidative stress and tissue inflammation reactions developed after reconstructive operations.Patients and methods: 32 patients have been involved in a randomized, prospective study, all suffering from AFS occlusion proved by angiography, and all undergone supragenual reconstruction. Duration of ischemia and amount of tissues under vascular clamping were almost the same in all patients. In the group treated with E-vitamin, we administered 1 × 200 mg of vitamin E p/o from the preoperative day till the 7th post operative day. Patients of the second group did not receive vitamin E.Materials and methods: Peripheral blood samples were collected immediately before operation and at the end of the second reperfusion hour (early reperfusion period). Late reperfusion period has been monitored by analyzing blood samples taken at 24th hour and 7th day next to the operative ischemia. Among oxidative stress parameters, direct measurement of reactive oxygen intermediator (ROI) and determination of antioxidant state (GSH, Total-SH group, SOD) have been performed. Malondialdehyde was chosen as marker for lipidperoxidation. Inflammation reactions were monitored up on expression of adhesion molecules (CD11a and CD18). We also controlled the oscillation of myeloperoxidase (MPO) activity.Results: Our study has proved that preoperative (from the preoperative day till the 7th post operative day) administration of 200 mg vitamin E could reduce the level of oxidative stress developed after ischemic-reperfusion insult (lipidproxidation, antioxidant enzymes). According to our results, the prooxidant-antioxidant imbalance also diminished in the group with E-vitamin treatment. We proved that elective administration of vitamin E could decrease the WBC activity (MPO activity, free radicals production, expression of adhesion molecules) and its consequential local inflammation process, during early reperfusion.

Significance of Preoperative Total Lymphocyte Count as a Prognostic Criterion in Adult Cardiac Surgery

“…Gennari et al ( 33 ) and Dionigi et al ( 34 ) revealed that the lymphocytopenia that occurred after major surgery, stemmed from neuroendocrine stress and led to cortisol production, which ultimately caused lymphocytopenia in the peripheral blood. Additionally, decreased lymphocytes observed after myocardial infarction (MI), have been linked to injuries connected with ischemia-reperfusion (IR) ( 35 ). The current data demonstrated that in patients undergoing cardiac surgery with CPB, the total lymphocyte count conveys powerful prognostic information ( 10 ).…”

Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps

“…Many medical treatment options such as recombinant human BCL2 protein, ethyl pyruvate, laser therapy, hydrogen sulfide, PJ 34, poloxamer 188, ketamine, recombinant human VEGF165 protein, activated protein C, adenosine A, bortezomib, MRS2693, hypertonic saline solution, cariporide, grape seed proanthocyanin extract, Wisconsin solution, ultrasound, erythropoietin, resveratrol, vitamin E, 12 amino acid peptides have been experimentally studied and all of them were reported to have positive effects at some degree. [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] However, studies on all these agents remained experimental and these agents failed to find a place in clinical use.…”

Protecting the BBB endothelium against cigarette smoke-induced oxidative stress using popular antioxidants: Are they really beneficial?

“…For example, vitamin C prevents histamine release and increases the detoxification of histamine (Johnston, Martin, and Cai, 1992), thus acting as an anti-inflammatory agent as well as a potent antioxidant. Vitamin E on the other hand has been shown to be cardioprotective against tobacco smoke-induced peroxidative damage (Al-Malki and Moselhy, 2013; Gumustekin, Taysi, Alp, Aktas, Oztasan, Akcay, Suleyman, Akar, Dane, and Gul, 2010; Koul, Singh, and Sandhir, 2003) and can be a beneficial adjuvant in the treatment of seizures, diabetes and in the reduction of post-ischemic damages (Arato, Kurthy, Sinay, Kasza, Menyhei, Hardi, Masoud, Ripp, Szilagyi, Takacs, Miklos, Bator, Lantos, Kollar, Roth, and Jancso, 2010; dos Santos, Costa, Tome, Saldanha, de Souza, Feng, and de Freitas, 2011; Gupta, Sharma, Kaushik, and Shekhawat, 2011; Venditti, Napolitano, Di, Agnisola, and Di, 2011). Recently published in vitro studies by our group have clearly shown that both vitamin C and E can effectively protect the BBB against CSE-generated oxidative damage (Hossain, Mazzone, Tierney, and Cucullo, 2011b).…”