Lower limb ischaemia and reperfusion injury in healthy volunteers measured by oxidative and inflammatory biomarkers

Halladin, Natalie; Ekeløf, Sarah; Alamili, Mahdi; Bendtzen, Klaus; Lykkesfeldt, Jens; Rosenberg, Jacob; Gögenur, Ismail

doi:10.1177/0267659114530769

Cited by 15 publications

(12 citation statements)

References 40 publications

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“…Oxidative plasma levels and pro-and anti-inflammatory parameters (ascorbic acid, Advances in Orthopedics dihydroascorbic acid, TNF, IL-1β, IL-6, and TNF-R) were not significantly different after reperfusion compared to baseline. ey concluded that lower limb ischemia for 20 minutes has not caused ischemia-reperfusion injury in healthy volunteers [31], which is in some parts inconsistent with the results of the present study. In the present study, the closing time of tourniquet was longer than 60 minutes for most of the patients, whereas in a study by Halladin et al [31] tourniquet closing time was 20 minutes and they concluded that this time was short for producing and/or increasing the inflammatory markers.…”

Section: Discussioncontrasting

confidence: 99%

“…e mean serum TNF-α level had no significant changes in both groups and during the study period. Halladin et al conducted a study entitled "lower limb ischemia and reperfusion injuries in healthy volunteers by inflammatory and oxidative markers" and exposed 10 male volunteers to lower limb ischemia for 20 minutes [31]. ey performed muscle biopsies, and blood samples were taken at 5, 15, 30, 60, and 90 minutes after tourniquet closure.…”

Section: Discussionmentioning

confidence: 99%

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The Comparison of Inflammatory Cytokines between Spinal and General Anesthesia following Changes in Ischemic Reperfusion due to Tourniquet during Lower Limb Surgery

Ganjifard

Kouzegaran

Abdi

et al. 2021

Advances in Orthopedics

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Background and Objective. The injuries caused by reperfusion of blood can lead to significant adverse effects after surgery. This study aimed to compare the effects of spinal and general anesthesia on inflammatory cytokines following changes in ischemic reperfusion due to tourniquet in lower limb surgeries. Methods. In this randomized controlled clinical trial, 34 patients with lower limb surgery admitted at the orthopedic ward of Imam Reza Hospital, Birjand, Iran, were selected by the available sampling method. They were randomly divided into two groups as follows: general anesthesia (n = 17) and spinal anesthesia (n = 17). Venous blood samples were taken from the patients of both groups at baseline (before the use of tourniquet) and 12 and 24 hours after reperfusion. Interleukin-6 (IL-6), tumor necrotizing factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and ferritin were measured and recorded. The data were analyzed using independent t-test, chi-square, and repeated measure at the significant level of 0.05. Results. The results showed that hs-CRP and IL-6 significantly increased during the study ( p < 0.001 ); however, the mean changes of TNF-α and ferritin were not significant during the study. Moreover, none of the inflammatory cytokines indicated significant differences between these two study groups ( p < 0.05 ). Conclusion. According to the results, the use of tourniquet can lead to inflammation, and the inflammation is similar in both groups.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Comparison of Inflammatory Cytokines between Spinal and General Anesthesia following Changes in Ischemic Reperfusion due to Tourniquet during Lower Limb Surgery

Ganjifard

Kouzegaran

Abdi

et al. 2021

Advances in Orthopedics

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“…To the best of our knowledge, this study is the rst to investigate the effect of tourniquet on acute muscular IRI following ankle arthroscopic surgery. We obtained the blood samples locally from the operated leg, as previous evidence indicated that oxidative stress markers obtained locally are more accurate and representative than the ones measured systemically [30], and found that tourniquet use markedly increased the levels of IRI-related biomedical markers, suggesting reperfusion of ischemic skeletal muscles might lead to local injuries during rapid reoxygenation when tourniquet was in ated. Normally, many associated symptoms could be applied to assess its severity, including joint swelling, range of motion (ROM) and wound pain [23].…”

Section: Discussionmentioning

confidence: 99%

Effect of Tourniquet Use in Ankle Arthroscopic Surgery on Postoperative Recovery: A Prospective Non- Randomized Controlled Study

Huang

Liu

et al. 2020

Preprint

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The aim of this prospective non- randomized controlled study was to explore the effect of tourniquet use on joint swelling, pain, functional outcome, and tourniquet- related ischemia- reperfusion injury (IRI) during ankle arthroscopic surgery.52 patients who received ankle arthroscopy were allocated to had the procedure done with the tourniquet inflated (the Control group, n= 27) or without the tourniquet inflated (the NT group, n= 25). The main outcome measures were: (1) The amount of swelling of the ankle; (2) Pain as measured by a visual analog scale (VAS); (3) The levels of MDA, IMA,TOS, TAS and OSI at 10 min before incision (T1)，after the completion of surgery (T2), and 30 min after tourniquet deflation (T3); (4) The functional outcome as measured by American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score; (5) The rate of complication. All patients were reviewed at a mean follow- up of 14.2 months (range, 12- 19 months). The mean circumferences of the ankle in the NT group were significantly lower than those in the Control group on postoperative day 2 and 5 (p<0.05). The mean level of VAS in the Control group was significantly higher on postoperative day 2 (p<0.05). The outcomes of AOFAS ankle hindfoot score were comparable between groups postoperatively (p>0.05). The levels of MDA, IMA, TOS and OSI were all significantly lower in the NT group compared at T2 and T3 (p<0.05), and the level of TAS was significantly lower in the NT group at T3 (p<0.05). The complication rates of two groups were comparable (p>0.05).With the use of tourniquet during ankle arthroscopic surgery, there was increased joint swelling and pain postoperatively, and a trend toward increased levels of MDA, IMA, TOS, TAS and OSI intraoperatively. Thus, we do not recommend using a tourniquet in this type of procedure.

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“…The IR injury in organs is caused by various factors, including inflammation. During the inflammatory reaction, pro-inflammatory factors, including IL-6 and IL-1β, were released, and the level of anti-inflammatory cytokines (IL-10 and IL-1Ra) was decreased (53). Previous studies have indicated that IPreC markedly suppressed the gene expression level of pro-inflammatory factors (TNF-α, IL-1β, and IL-6) and chemokines in patients with renal IR injury (54).…”

Section: Discussionmentioning

confidence: 99%

Acute remote ischemic preconditioning alleviates free radical injury and inflammatory response in cerebral ischemia/reperfusion rats

2019

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Remote ischemic preconditioning (IPreC) is an effective strategy to defend against cerebral ischemia/reperfusion (IR) injury; however, its mechanisms remain to be elucidated. The aim of the present study was to investigate the effect of IPreC on brain tissue following cerebral ischemia, as well as the underlying mechanisms. Adult male Sprague-Dawley rats were treated with IPreC for 72 h prior to the induction of transient cerebral ischemia and reperfusion. The results demonstrated that IPreC reduced the area of cerebral infarction in the IR rats by 2,3,5-triphenyl-tetrazolium chloride staining. In addition, cell apoptosis was markedly suppressed by IPreC with an increased expression of B-cell lymphoma 2 (Bcl-2)/Bcl-2-associatd X protein using Terminal deoxynucleotidyl-transferase-mediated dUTP nick end labeling assay and western blot analysis. IR induced a decrease in the level of superoxide dismutase, and IPreC significantly suppressed increased levels of malondialdehyde, lactate dehydrogenase and nitric oxide. The expression of CD11b and CD18 was markedly inhibited by IpreC unsing flow cytometry. Furthermore, IPreC markedly decreased the release of pro-inflammatory factors interleukin (IL)-6 and IL-1β, and enhanced the level of anti-inflammatory factors (IL-10 and IL-1 receptor antagonist) by ELISA assay. Finally, IPreC reduced the levels of transforming growth factor-β-activated kinase 1, phosphorylated-P65/P65, and tumor necrosis factor-α, indicating that the nuclear factor-κB pathway was involved in IPreC-mediated protection against cerebral ischemia. Taken together, the results suggested that IPreC decreased ischemic brain injury through alleviating free radical injury and the inflammatory response in cerebral IR rats.

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Lower limb ischaemia and reperfusion injury in healthy volunteers measured by oxidative and inflammatory biomarkers

Abstract: Twenty minutes of lower limb ischaemia does not result in an ischaemia-reperfusion injury in healthy volunteers, measurable by oxidative and pro- and anti-inflammatory biomarkers in muscle biopsies and in the systemic circulation.

Cited by 15 publications

References 40 publications

The Comparison of Inflammatory Cytokines between Spinal and General Anesthesia following Changes in Ischemic Reperfusion due to Tourniquet during Lower Limb Surgery

The Comparison of Inflammatory Cytokines between Spinal and General Anesthesia following Changes in Ischemic Reperfusion due to Tourniquet during Lower Limb Surgery

Effect of Tourniquet Use in Ankle Arthroscopic Surgery on Postoperative Recovery: A Prospective Non- Randomized Controlled Study

Acute remote ischemic preconditioning alleviates free radical injury and inflammatory response in cerebral ischemia/reperfusion rats

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