Effects of bradykinin on the survival of multiterritory perforator flaps in rats

Abstract

Background Bradykinin, a vasoactive peptide, has many biological functions. For example, it accelerates angiogenesis. Thus, we studied the effects of bradykinin on the survival of perforator flaps. Methods Averagely, 50 male Sprague–Dawley rats were divided into control and bradykinin groups and underwent procedures to the multiterritory perforator flap. Areas of flap survival were tested 7 days later. Flap perfusion was evaluated by laser Doppler imaging. We assessed the extent of autophagy by determining LC3-II/I, Beclin 1, and p62. Flap angiogenesis was assessed by immunohistochemistry and H&E staining. We measured the level of vascular endothelial growth factor (VEGF) protein using western blot. We assessed oxidative stress by measuring the activity of superoxide dismutase (SOD) and malondialdehyde (MDA) levels. The apoptotic index was also evaluated by western blot, and we determined nitric oxide (NO) production using an NO assay kit. Results The bradykinin group exhibited significantly larger areas of flap survival, higher blood supply, and more neovascularization. The bradykinin group also had higher SOD activity, higher VEGF expression and NO content, and reduced MDA compared to the control group. Rats treated with bradykinin also had lower levels of apoptosis and autophagy relative to the control group. Conclusion Our results suggest that bradykinin promotes the survival of multiterritory perforator flaps by increasing angiogenesis, promoting the release of NO, suppressing apoptosis, reducing oxidative stress, and inhibiting autophagy.

Bradykinin‐bradykinin receptor (B1R) signalling is involved in the blood–brain barrier disruption in moyamoya disease

“…However, there are discrepancies between previous studies and our results. Wang et al showed that BK promotes angiogenesis 33 . Additionally, another study demonstrated that BK increases vascular permeability during the early phase via B2R in the endothelial cells to promote angiogenesis 34 .…”

“…Wang et al showed that BK promotes angiogenesis. 33 Additionally, another study demonstrated that BK increases vascular permeability during the early phase via B2R in the endothelial cells to promote angiogenesis. 34 Moreover, BK promotes angiogenesis and the growth of tumours in vivo.…”

Comparison of arterial supercharging and venous superdrainage on improvement of survival of the extended perforator flap in rats

“…In cases with large size defects, an extended cutaneous flap with multiple vascular territories is sometimes inevitable for the reliable resurfacing. However, if the flap is nourished by only one perforator vessel, distal end necrosis can occur due to insufficient blood supply, oxidative stress, and cells apoptosis (Mohan, Zhu, Wang, Vijayasekaran, & Saint‐Cyr, 2016; Wang et al, 2019a; Wang et al, 2019b). Numerous measures have been developed to improve the survival of a flap with multiple vascular territories, such as transposition of a main vascular pedicle (Ding et al, 2017; Wang et al, 2019c), injection of angiogenic growth factors (Akimoto et al, 2013; Aksakal et al, 2016; Tao et al, 2016a), vascular delay (Lineaweaver et al, 2004; Mao et al, 2019; Seyhan, Deniz, Borman, Ulusal, & Cağlar, 2010), and use of venous superdrainage or arterial supercharging (Hallock & Rice, 2005; Park, Cho, Imanishi, & Chang, 2018; Mao et al, 2019; Xin, Luan, Mu, & Mu, 2013; Yi et al, 2017).…”