Atike KUNT TEKELİ, Selim İŞBİR, Ali CİVELEK, Serdar AKGÜN, H. Arzu ERGEN, Kurtkaya Özlem YAPICIER, Murat Aydın SAV, Sinan ARSAN

Sıçanlarda alt ekstremite iskemi reperfüzyon hasarını takiben gelişen akciğer hasarının iloprost ile önlenmesi

Amaç: İskemi ve bunu takip eden reperfüzyon dönemi sonrasında ortaya çıkan doku hasarıbüyük ölçüde reperfüzyon sırasında gerçekleşir. Aktive olmuş nötrofillerden salınan serbestoksijen radikalleri bu hasarda önemli rol oynarlar. Alt ekstremite iskemi-reperfüzyonusonrasında görülen akciğer hasarında nötrofil infiltrasyonunun ve serbest oksijenradikallerinin önemi gösterilmiştir. Bu hasarı farmakolojik olarak önlemek için birçok çalışmayapılmıştır. İloprost, uzun etkili bir prostasiklin analoğudur. Çalışmanın amacı, alt ekstremiteiskemi reperfüzyonu sonrası ortaya çıkan akciğer hasarını önlemedeki iloprostun etkisiniaraştırmaktır.Gereç ve Yöntemler: Çalışmada 20 adet Spraque-Dawley cinsi erkek sıçan kullanıldı. Orta hattanyapılan laparotomi ile abdominal aortaya ulaşıldı. Grup I (n=8) ve Grup II (n=8) de bulunandeneklerin infrarenal aortalarına 2 saat boyunca kross klemp uygulandı. Klemp kaldırıldığısırada Grup I’de bulunan deneklere 0,1 g/kg/dk dozunda iloprost ve Grup II’de bulunandeneklere 0,1ml/kg/dk serum fizyolojik sürekli infüzyon şeklinde 4 saat boyunca verildi. GrupIII(n=4) sham grubu olarak belirlendi. Denekler 4. saatin sonunda sakrifiye edilerek akciğerdokuları çıkarıldıve biyokimyasal ve histopatolojik inceleme yapıldı.Bulgular: İloprost verilen grupta malondealdehyde seviyeleri kontrol grubuna göreistatistiksel olarak anlamlı derecede düşük bulundu (p<0.05). Glutatyon düzeylerinde isekontrol ve iloprost grupları arasında anlamlı fark bulunmadı (p>0.05). Histopatolojikincelemede, iloprost verilen grupta akciğer dokusunun korunmuş olduğu gözlenirken kontrolgrubunda akciğer doku harabiyeti tespit edilmiştir.Sonuç: Sonuçlarımız alt ekstremite iskemi-reperfüzyonu sonrasında ortaya çıkan akciğerhasarının önlenmesinde iloprostun serbest oksijen radikal oluşumunu azaltarak etkili olduğunu göstermektedir.

Anahtar Kelimeler:

iloprost, iskemi, reperfüzyon, iloprost

Prevention of lung injury by iloprost following hind limb ischemia and reperfuison model in rats

Aim: The major part of tissue damage occurs upon reperfusion and is mediated by activated neutrophils that release oxygen free radicals. Following hind-limb ischemia/reperfusion, lung injury due to neutrophil infiltration and oxygen free radicals has been demonstrated. Previous studies have shown that this injury can be prevented pharmacologically. Iloprost is a long acting stable analog of prostacyclin. The aim of this study is to test the effect of iloprost in prevention of lung injury due to lower limb ischemia/reperfusion. Material and Methods: Through a midline laparotomy infrarenal abdominal aorta was approached and cross-clamped in 20 male Spraque-Dawley rats for 2 hours. At the time of declamping Group I animals (n=8) received iloprost (0,1µg/kg/min) and Group II animals (n=8) received normal saline (0,1ml/kg/min) continously for 4 hours. Third group was the sham group (n=4). The lung tissue assays were performed for measurement of lipid peroxidation end product malondealdehyde and also total glutathione. Lung tissues were also examined histopathologically under light microscopy. Results: The malondealdehyde levels in the iloprost group were significantly lower than the control group (p<0,05). The glutathione levels did not show any difference between the iloprost and the control groups (p>0,05). Histopathological examination revealed that the structure of the lung tissue was preserved in the iloprost group whereas lung tissue of the control group had evidence of injury. Conclusion: Our results suggest that iloprost reduces the production of oxygen free radicals and prevents lung injury due to lower limb ischemia reperfusion.

Keywords:

ischemia, reperfusion, iloprost,

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