The Combined Effect of Iloprost and N-Acetylcysteine in Preventing Spinal Cord Ischemia in Rabbits

Boğa, Mehmet; Discigil, Berent; Özkısacık, Erdem Ali; Gürcün, Uğur; Badak, M. İsmail; Dikicioğlu, Emel; Yenisey, Çiğdem; Meteoğlu, İbrahim

doi:10.1016/j.ejvs.2005.10.027

Cited by 13 publications

(4 citation statements)

References 26 publications

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“…on the spinal cord IRI [12,26]. In addition to other pharmacological effects, both iloprost and montelukast are shown to be neuroprotective against IRI [16,27-29].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of iloprost and montelukast combination on spinal cord ischemia/reperfusion injury in a rat model

Lafçı

Gedik

Korkmaz

et al. 2013

J Cardiothorac Surg

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BackgroundThe thoracic or thoracoabdominal aortic aneurysm surgery may cause spinal cord ischemia because of aortic cross-clamping and may result in severe postoperative complications caused by spinal cord injury. Ischemia/reperfusion injury may directly or indirectly be responsible for these complications. In this study we sought to determine whether combination of iloprost and montelukast can reduce the ischemia/reperfusion injury of spinal cord in a rat model.MethodsMedulla spinalis tissue concentrations of interleukin-6 (IL-6), myeloperoxidase (MPO) and heat shock protein 70 (HSP-70) were determined in 3 groups of Spraque Dawley rats: control group (operation with cross clamping and intraperitoneal administration of 0.9% saline, n = 7), sham group (operation without cross clamping, n = 7), and study group (operation with cross-clamping and intraperitoneal administration of iloprost (25 ng/kg) and montelukast (1 mg/kg), n = 7). The abdominal aorta was clamped for 45 minutes, with a proximal (just below the left renal artery) and a distal (just above the aortic bifurcation) clip in control and study groups. Hindlimb motor functions were evaluated at 6, 12, 24, and 48 hours using the Motor Deficit Index score. All rats were sacrificed 48 hours after the procedure and spinal cord tissue levels of myeloperoxidase, interleukin-6, and heat shock protein (HSP-70) were evaluated as markers of oxidative stress and inflammation. Histopathological analyses of spinal cord were also performed.ResultsThe tissue level of HSP-70 was found to be similar among the 3 groups, however, MPO was highest and IL-6 receptor level was lowest in the control group (p = 0.007 and p = 0.005; respectively). In histopathological examination, there was no significant difference among the groups with respect to the neuronal cell degeneration, edema, or inflammation, but vascular congestion was found to be significantly more prominent in the control group than in the sham or in the study group (p = 0.05). Motor deficit index scores at 24 and 48 hours after ischemia were significantly lower in the study group than in the control group.ConclusionThis study suggests that combined use of iloprost and montelukast may reduce ischemic damage in transient spinal cord ischemia and may provide better neurological outcome.

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“…on the spinal cord IRI [12,26]. In addition to other pharmacological effects, both iloprost and montelukast are shown to be neuroprotective against IRI [16,27-29].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of iloprost and montelukast combination on spinal cord ischemia/reperfusion injury in a rat model

Lafçı

Gedik

Korkmaz

et al. 2013

J Cardiothorac Surg

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“…But the spinal cord blood supply through the radicular medullary artery or longitudinal spinal arteries is not good enough to meet the metabolic need of the spinal cord [16] . In this study, we used a secondary clamp just proximal to the aortic bifurcation for occlusion of the iliac collateral circulation, and the ischemic period was chosen to be 40 min in order to maintain spinal cord ischemia [34] . Neurologic deficits may be noted during the immediate postoperative period or manifested many hours after operation.…”

Section: Discussionmentioning

confidence: 99%

Protection of the Spinal Cord from Ischemia: Comparative Effects of Levosimendan and Iloprost

Lafci¹,

Yasa²,

İlhan³

et al. 2008

Eur Surg Res

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Background: The purpose of the study was to investigate and compare iloprost and levosimendan on spinal cord ischemia in an experimental model. Materials and Methods: The study was done in two stages. For the 4-hour short survival study, 50 New Zealand white rabbits were randomly allocated into five groups. Spinal cord ischemia was induced by clamping the aorta just below the left renal artery and just proximal to the aortic bifurcation with bulldog artery clamps. The aortic clamps were removed after 40 min and restoration of blood flow was verified visually. The groups were analyzed at 1 and 4 h after reperfusion. For the 48-hour survival study, two different groups (iloprost plus levosimendan, n = 10; saline-treated controls, n = 10) were analyzed at 24 and 48 h after reperfusion. Results: The neurologic status of the animals in the treatment and sham groups was better than that in the control group both at 1 and 4 h after reperfusion. Viability index values in the levosimendan, iloprost and iloprost plus levosimendan groups were statistically higher than in the control group indicating less or no neuronal damage. Discussion: The results suggest that levosimendan, as well as iloprost, may reduce ischemic damage in transient spinal ischemia and provide better neurologic outcome.

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“…In literature there are several studies that evaluating the protective effects of the different pharmacological agents and their combination (simvastatin, pentoxifylline, dantrolen Na, vitamins, ilioprost and N-acetylcysteine combination, etc.) on the spinal cord I/R injury [ 29 , 30 ]. All researchers agree that many agents may partially prevent reperfusion injury, but none have been found to be sufficient by itself; it must be combined with other agents and protective surgical methods [ 28 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of N-acetylcysteine and allopurinol combination to protect spinal cord ischemia/reperfusion injury induced by aortic cross-clamping in rat model

Erkut

Onk

2015

J Cardiothorac Surg

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PurposeThe aim of this experimental study was to determine whether combination of N-acetylcysteine and allopurinol can reduce the ischemia/reperfusion injury of spinal cord in a rat model.MethodsTwenty-seven Spraque Dawley rats, all male, weighing between 220 to 370 (mean 325) gr were used in the study. 27 rats were divided into three groups: sham group, control group and experimental group. Abdominal aortic occlusion between the renal arteries and iliac bifurcations was carried out for 60 min with proximal and distal clip in control and experimental groups. Hindlimb motor functions were evaluated at 24, and 48 h using the Tarlov Scale. Besides, spinal cord samples were taken for determination of superoxide dismutase, and catalase activities as antioxidant enzymes, and malondialdehyde as an indicator of lipid peroxidation and xanthine oxidase levels as source hydroxyl radical for biochemical studies. Also, histopathological evaluation was made from cord tissue samples.ResultsThe experimental group subjects had better neurological functions than control group subjects. In experimental group; superoxide dismutase and catalase levels increased, while malondialdehyde and xantine oxidase levels decreased as compared with control group. Histopathological examination showed that experimental group had less cell degeneration, hemorrhage, edema and inflammation loss than control group.ConclusionsThis study offers that combined use of N-acetylcysteine and allopurinol might help protect the spinal cord against ischemia/reperfusion injury.

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The Combined Effect of Iloprost and N-Acetylcysteine in Preventing Spinal Cord Ischemia in Rabbits

Abstract: The use of iloprost and NAC may provide better protection from spinal cord ischemia.

Cited by 13 publications

References 26 publications

Efficacy of iloprost and montelukast combination on spinal cord ischemia/reperfusion injury in a rat model

Efficacy of iloprost and montelukast combination on spinal cord ischemia/reperfusion injury in a rat model

Protection of the Spinal Cord from Ischemia: Comparative Effects of Levosimendan and Iloprost

Effect of N-acetylcysteine and allopurinol combination to protect spinal cord ischemia/reperfusion injury induced by aortic cross-clamping in rat model

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