allopurinol and Ischemia

Allopurinol is a xanthine oxidase inhibitor and antioxidant free radical scavenger which facilitates the protection of ischemic organs in part via this mechanism of action. The accumulation of free radicals during ischemia and reperfusion is in great manner overcome by inhibitors of xanthine oxidase and by the development of endogenous antioxidants. The ischemic lesion generates a well-established inflammatory response with the subsequent production of inflammatory molecules characteristically present at the first stages of the injury. Inflammatory cytokines, chemokines, adhesion molecules, and other cellular and molecular compounds are consequently produced as the lesion sets in. Under these conditions, allopurinol diminishes the effect of inflammatory mediators during the ischemic inflammatory response. This study reviews the literature associated with allopurinol and renal ischemia making special emphasis on the best dose and time of administration of allopurinol regarding its protective effect. It also defines the most accepted mechanism of protection on ischemichally damaged kidneys.

Topics: Allopurinol; Animals; Calcium Channels; Cell Adhesion Molecules; Cytokines; Enzyme Inhibitors; Free Radical Scavengers; Humans; Immune System; Ischemia; Kidney; Lipid Peroxidation; Metabolic Networks and Pathways; NF-kappa B; Nitric Oxide; Reactive Oxygen Species; Receptors, Tumor Necrosis Factor; Reperfusion Injury; Tumor Necrosis Factor-alpha; Xanthine Oxidase

Xanthine oxidoreductase (XOR) catalyzes the final two reactions that lead to uric acid formation. XOR is a complex molibdoflavoenzyme present in two different functional forms: dehydrogenase and xantine oxidase (XO). XO is a critical source of reactive oxygen species (ROS) that contribute to vascular inflammation. Under normal physiological conditions, it is mainly found in the dehydrogenase form, while in inflammatory situations, posttranslational modification converts the dehydrogenase form into XO. These inflammatory conditions lead to an increase in XO levels and thus an increased ROS generation by the enzymatic process, finally resulting in alterations in vascular function. It has also been shown that XO secondarily leads to peroxynitrite formation. Peroxynitrite is one of the most powerful ROS that is produced by the reaction of nitric oxide and superoxide radicals, and is considered to be a marker for reactive nitrogen species, accompanied by oxidative stress. Febuxostat is a novel nonpurine XO-specific inhibitor for treating hyperuricemia. As febuxostat inhibits both oxidized and reduced forms of the enzyme, it inhibits the ROS formation and the inflammation promoted by oxidative stress. The administration of febuxostat has also reduced nitro-oxidative stress. XO serum levels are significantly increased in various pathological states such as inflammation, ischemia-reperfusion or aging and that XO-derived ROS formation is involved in oxidative damage. Thus, it may be possible that the inhibition of this enzymatic pathway by febuxostat would be beneficial for the vascular inflammation. In animal models, febuxostat treatment has already demonstrated anti-inflammatory effects, together with the reduction in XO activity. However, the role of febuxostat in humans requires further investigation.

Topics: Animals; Anti-Inflammatory Agents; Disease Models, Animal; Febuxostat; Heart Failure; Humans; Inflammation; Ischemia; Rabbits; Rats; Renal Insufficiency, Chronic; Thiazoles; Treatment Outcome; Xanthine Oxidase

A safe and effective preservation solution is a precondition for liver transplantation, which is accepted as the radical treatment for patients with end-stage liver disease. The increasing use of marginal donors and non-heart beating donors as well as the establishment of a national organ allocation network call for better preservation. New preservation solutions like histidine-tryptophan-ketoglutarate (HTK) solution and Celsior solution have been introduced to liver preservation, and protective gene intervention and other modifications have also been investigated. In this article, we review recent advances in liver preservation solutions.. An English-language literature search was conducted using MEDLINE (1990-2005) on liver preservation solution, biliary complication, protective gene and other related subjects.. Although the high viscosity of the University of Wisconsin (UW) solution proved harmful to the hepatic microcirculation, three solutions showed equivalent preservation effects. When the cold ischemia time was short, there were no significant differences among the three solutions in the incidence of biliary complications. So far, modifications of preservation solutions have achieved great success. Several types of protective genes like A20, Bcl-2, Bcl-X(L) and HO-1 were reported to have definite liver protective effects. The addition of other substrates like TNF-alpha antibody, tacrolimus (FK506) and fructose-1,6-bisphosphate (FBP) can also improve the preservation effect. However, addition of insulin to UW solution is harmful to the graft.. In centers with highly-developed transplantation techniques, HTK and Celsior solutions are acceptable in liver preservation. Protective gene modification and addition of substrates like TNF-alpha antibody, FK506 and FBP are prominent approaches to improve liver preservation.

Topics: Adenosine; Allopurinol; Animals; Antibodies; Bile Duct Diseases; Disaccharides; Electrolytes; Fructosediphosphates; Glucose; Glutamates; Glutathione; Histidine; Humans; Insulin; Ischemia; Liver; Mannitol; Microcirculation; Organ Preservation Solutions; Potassium Chloride; Procaine; Raffinose; Tacrolimus; Transformation, Genetic; Tumor Necrosis Factor-alpha

Ischemia-reperfusion injury of the intestine is a significant problem in abdominal aortic aneurysm surgery, small bowel transplantation, cardiopulmonary bypass, strangulated hernias, and neonatal necrotizing enterocolitis. It can also occur as a consequence of collapse of systemic circulation, as in hypovolemic and septic shock. It is associated with a high morbidity and mortality. This article is a comprehensive review of the current status of the molecular biology and the strategies to prevent ischemia-reperfusion injury of the intestine. Various treatment modalities have successfully been applied to attenuate reperfusion injury in animal models of reperfusion injury of the intestine. Ischemic preconditioning has been found to be the most promising strategy against reperfusion injury during the last few years, appearing to increase the tolerance of the intestine to reperfusion injury. Although ischemic preconditioning has been shown to be beneficial in the human heart and the liver, prospective controlled studies in humans involving ischemic preconditioning of the intestine are lacking. Research focused on the application of novel drugs that can mimic the effects of ischemic preconditioning to manipulate the cellular events during reperfusion injury of the intestine is required.

Topics: Animals; Biomarkers; Endothelins; Heat-Shock Proteins; Humans; Inflammation Mediators; Intestine, Large; Intestine, Small; Ischemia; Ischemic Preconditioning; Nitric Oxide; Prognosis; Rats; Reperfusion Injury; Severity of Illness Index; Survival Analysis; Xanthine Oxidase

During last years considerable interest has been devoted to understand the role of oxygen radicals in the ischemia induced cell injury associated with reperfusion. In the brain and in others tissues, free radicals play a role as modulators of vascular tone as well as a cytotoxic role as part of the ischemia associated pathology. This review discusses methods for free radical detection in brain and in other tissues, mechanisms of radical production in the course of the ischemia reperfusion process, and the efficacy of potential antioxidant agents in post ischemia therapy, especially with respect to allopurinol, an inhibitor of xanthine oxidase, and the role of taurine and its derivatives as antioxidants in different organs including the brain.

Topics: Antioxidants; Enzyme Inhibitors; Free Radicals; Humans; Ischemia; Neutrophils; Reactive Oxygen Species; Reperfusion Injury; Taurine; Xanthine Oxidase

Multiple studies have demonstrated that muscle poorly tolerates ischemia. When the ischemic state is unduly prolonged, the successfully replanted or revascularized limb undergoes deleterious biochemical reactions that cascade to vessel intimal damage, increased vessel permeability, and lowering of pH. The resultant tissue edema leads to increasing compartment pressures, which not only impede the recovery of function, but also can lead to irreversible muscle necrosis, increased risk of infection, and sepsis if not reversed in a timely fashion. The development of compartment syndrome jeopardizes not only the injured limb, but life itself secondary to the biochemical toxins produced by the ischemic extremity. A thorough understanding of the biochemistry of ischemia and reperfusion provides insight into the role of fasciotomy in the replanted or revascularized extremity. The scientific basis for fasciotomy in the revascularized or replanted limb is discussed as well as the potential "protective" role of pharmacologic agents in ischemic and reperfusion injury.

Topics: Animals; Arm; Compartment Syndromes; Fasciotomy; Glycolysis; Humans; Ischemia; Leg; Muscle, Skeletal; Regional Blood Flow; Replantation; Xanthine Oxidase

Topics: Humans; Ischemia; Models, Cardiovascular; Reperfusion; Superoxides; Xanthine Oxidase

Topics: Animals; Calcium; Embryo, Mammalian; Humans; Ischemia; Kidney; Liver; Lung; Mitochondria, Heart; Muscles; Myocardial Reperfusion Injury; Myocardium; Phagocytes; Placenta; Reactive Oxygen Species; Reperfusion Injury; Xanthine Oxidase

Topics: Cell Death; Free Radicals; Humans; Ischemia; Leg; Microcirculation; Oxygen; Reperfusion; Reperfusion Injury; Vascular Surgical Procedures; Xanthine Oxidase

In conclusion, a large body of evidence demonstrates that reperfusion of ischemic intestine results in significant microvascular and parenchymal cell injury. Reperfusion injury appears to be mediated by both reactive oxygen metabolites and activated polymorphonuclear leukocytes. Xanthine oxidase-derived oxidants initiate the production and release of proinflammatory agents, which in turn lead to polymorphonuclear leukocyte adherence and emigration. The adherent leukocytes mediate microvascular injury by either release of proteases, physical disruption of the endothelial barrier, or both.

Topics: Animals; Humans; Intestines; Ischemia; Neutrophils; Oxygen; Reperfusion Injury; Xanthine Oxidase

Topics: Allopurinol; Free Radicals; Hot Temperature; Humans; Ischemia; Kidney; Kidney Transplantation; Organ Preservation; Reperfusion Injury; Solutions; Superoxide Dismutase; Superoxides; Time Factors

Topics: Animals; Calcium; Energy Metabolism; Hydrogen Peroxide; Ischemia; Mitochondria; Oxidation-Reduction; Oxygen Consumption; Reperfusion; Xanthine Oxidase

Topics: Animals; Electrons; Flavin-Adenine Dinucleotide; Ischemia; Ketone Oxidoreductases; NAD; Protein Conformation; Xanthine Dehydrogenase; Xanthine Oxidase

Topics: Animals; Cats; Dimethyl Sulfoxide; Disease Models, Animal; Ethanol; Gastric Mucosa; Ischemia; Lipid Peroxides; Neutrophils; Rats; Stomach Ulcer; Sulfhydryl Compounds; Superoxide Dismutase; Xanthine Oxidase

In this lecture, evidence is presented to support the following hypothesis regarding the roles of xanthine oxidase-derived oxidants and granulocytes in ischemia-reperfusion-induced microvascular injury. During the ischemic period, ATP is catabolized to yield hypoxanthine. The hypoxic stress also triggers the conversion of NAD-reducing xanthine dehydrogenase to the oxygen radical-producing xanthine oxidase. During reperfusion, molecular oxygen is reintroduced into the tissue where it reacts with hypoxanthine and xanthine oxidase to produce a burst of superoxide anion and hydrogen peroxide. In the presence of iron, superoxide anion and hydrogen peroxide react via the Haber-Weiss reaction to form hydroxyl radicals. This highly reactive and cytotoxic radical then initiates lipid peroxidation of cell membrane components and the subsequent release of substances that attract, activate, and promote the adherence of granulocytes to microvascular endothelium. The adherent granulocytes then cause further endothelial cell injury via the release of superoxide and various proteases.

Topics: Animals; Granulocytes; Intestinal Mucosa; Intestine, Small; Ischemia; Perfusion; Xanthine Oxidase

Acute tubular necrosis is a frequent occurrence following hypovolemic shock and human renal transplantation. Although this postischemic injury was originally thought to result from ischemia alone, it has recently been recognized that significant tissue injury can occur during the period of reperfusion. The demonstration of the oxygen free-radical-mediated postischemic reperfusion injury by Granger, Rutili, and McCord in ischemic cat intestine suggested that this mechanism might also be operative following renal ischemia. In the kidney, postischemic injury results in necrosis of the proximal renal tubule and accumulation of erythrocytes in the outer renal medulla. It has been proposed that the primary event leading to these pathologic changes is a free-radical-mediated injury to the endothelial cells in the inner stripe of the outer medulla. Experimental evidence in animals subjected to warm and cold ischemia supports a free-radical-mediated mechanism. The clinical significance of these findings is demonstrated in preclinical animal studies of renal transplantation in which approximately two-thirds of the injury following cold ischemia could be ablated by superoxide dismutase administered just prior to reperfusion or by allopurinol when administered both at the time of preservation and reperfusion or at the time of preservation alone.

Topics: Acute Kidney Injury; Allopurinol; Animals; Cats; Free Radicals; Humans; Ischemia; Kidney; Kidney Transplantation; Kidney Tubular Necrosis, Acute; Perfusion; Postoperative Complications; Rabbits; Rats; Shock; Superoxide Dismutase; Temperature; Xanthine Oxidase

The role of oxygen-derived free radicals in the pathogenesis of acute pancreatitis has been investigated in a series of studies using an ex vivo, perfused canine pancreas preparation. Three models of experimental acute pancreatitis have been developed in this preparation: ischemic pancreatitis, gallstone pancreatitis, and alcohol-induced pancreatitis. In each model, the pancreas becomes edematous, gains weight, and the perfusate develops hyperamylasemia during the 4 hour period of perfusion. Pretreatment with the free radical scavengers superoxide dismutase and catalase significantly ameliorates these manifestations of pancreatic injury in each of the three models. The source of the free radical generation was investigated by pretreating the preparation with allopurinol, a quite specific inhibitor of xanthine oxidase. In each of the three models, this also significantly ameliorated the injury process. These experiments demonstrate that oxygen-derived free radicals, generated by activated xanthine oxidase, appear to play a central role in the pathogenesis of acute pancreatitis in these models. These findings shed light on the fundamental pathophysiology of this disease and may provide the basis for more effective therapy in the future.

Topics: Acute Disease; Alcoholism; Allopurinol; Animals; Catalase; Disease Models, Animal; Free Radicals; Humans; Ischemia; Oxygen; Pancreas; Pancreatitis; Superoxide Dismutase; Xanthine Oxidase

Topics: Animals; Capillary Permeability; Free Radicals; Gastric Mucosa; Humans; Intestinal Mucosa; Ischemia; Oxygen; Pancreatitis; Perfusion; Skin; Surgical Flaps; Xanthine Oxidase

It is now clear that oxygen-derived free radicals play an important part in several models of experimentally induced reperfusion injury. Although there are certainly multiple components to clinical ischemic and reperfusion injury, it appears likely that free-radical production may make a major contribution at certain stages in the progression of the injury. The primary source of superoxide in reperfused reoxygenated tissues appears to be the enzyme xanthine oxidase, released during ischemia by a calcium-triggered proteolytic attack on xanthine dehydrogenase. Reperfused tissues are protected in a variety of laboratory models by scavengers of superoxide radicals or hydroxyl radicals or by allopurinol or other inhibitors of xanthine oxidase. Dysfunction induced by free radicals may thus be a major component of ischemic diseases of the heart, bowel, liver, kidney, and brain.

Topics: Animals; Calcium; Coronary Disease; Free Radicals; Humans; Intestines; Ischemia; Shock; Superoxides; Transplantation; Xanthine Dehydrogenase; Xanthine Oxidase

Evidence is presented that supports a role of oxygen free radicals in the pathogenesis of various disorders of the digestive system. In the intestine, there is evidence that oxygen radicals play an important role in the endothelial and epithelial damage associated with certain models of ischemia. The mechanism for superoxide production in this condition differs from that described for other pathologic states (i.e., oxygen toxicity and neutrophil-mediated inflammation). This mechanism involves the reaction of xanthine oxidase, hypoxanthine, and molecular oxygen to produce a burst of oxygen radicals with reperfusion of the ischemic bowel. Evidence implicating oxygen radicals in inflammatory disorders of the digestive tract (i.e., pancreatitis), radiation injury, and hepatic cirrhosis is also presented. The available data suggest that oxygen radicals appear to be a fundamental mechanism of tissue injury in the pathogenesis of various disorders of the digestive system.

Topics: Allopurinol; Animals; Capillary Permeability; Cats; Digestive System Diseases; Dimethyl Sulfoxide; Enterocolitis, Pseudomembranous; Free Radicals; Humans; Inflammation; Intestinal Mucosa; Intestine, Small; Ischemia; Liver Diseases; Oxygen; Pancreatitis; Rats; Stomach Diseases; Superoxide Dismutase; Trypsin Inhibitors; Vascular Resistance; Xanthine Oxidase

Oxygen radicals appear to be involved in the microvascular and parenchymal cell injury associated with various pathologic disorders. Studies indicate that oxygen radicals increase microvascular permeability by creating large leakage sites predominantly in the small venules. The highly reactive hydroxyl radical appears to be responsible for the microvascular alterations associated with oxygen radical production. There is considerable indirect evidence implicating oxygen radicals in the pathogenesis of circulatory shock. The oxygen radicals are probably formed by the enzyme xanthine oxidase when intravascular volume is restored. Similar biochemical processes appear to be involved in reperfusion injury to the kidney and skin. Evidence is also presented that implicates oxygen radicals in the reperfusion injury associated with organ preservation and transplantation.

Topics: Animals; Cricetinae; Dogs; Free Radicals; Ischemia; Kidney; Microcirculation; Organ Preservation; Oxygen; Rats; Shock; Skin; Skin Transplantation; Surgical Flaps; Tissue Preservation; Xanthine Oxidase

Use of metabolic inhibitors has been proven useful in hypothermic anoxic storage. The data are sparse about its effects in machine preservation when the hypothermic organ is oxygenated and metabolizing, although at a slow rate. Concentration of a particular drug is also important. They can, in fact, be injurious at wrong concentrations. Various drugs have been proven to be beneficial in protecting kidneys from ischemic injury. At present, methylprednisolone seems to be the best agent, offering a predictable and complete protection, thereby justifying its use in all donors where there is reasonable suspicion of warm ischemic damage.

Topics: Adrenal Cortex Hormones; Allopurinol; Animals; Chlorpromazine; Dogs; Glutathione; Humans; Ischemia; Kidney; Kidney Transplantation; Magnesium Sulfate; Malonates; Organ Preservation; Oxamic Acid; Phenoxybenzamine; Rats; Tissue Preservation

Reduced glutathione (GSH), a component of University of Wisconsin (UW) solution, is reported to oxidize during storage. Consequently the commercial manufacturer of UW recommends the supplemental addition of GSH to UW before utilization. We investigated the influence of supplemental GSH during cold ischemia on early renal allograft function.. One hundred kidneys were locally procured from heart-beating donors, preserved in our laboratory, and transplanted during an 18-month period. Selected donor, preservation, and outcome characteristics were collected and compared by presence of supplemental GSH and method of preservation. All kidneys were randomized to receive 3.0 mM supplemental GSH to perfusate or no supplementation (control) and were preserved by either cold storage (CS) in UW or machine perfused (MP) in UW-machine perfusate solution (MPS). During MP, perfusion characteristics (flow, resistance, perfusate electrolytes, and pH) were serially measured.. There were no significant differences among the groups when the donor characteristics of age, serum creatinine, and intra-operative urine output were compared. Preservation characteristics were similar among the groups with the exception of cold ischemia time, which was longer in the MP group compared to CS (26.1 h vs. 21.9 h, P=0.03). When compared with CS, kidneys preserved by MP exhibited a 33.4% increase in immediate function (93% vs. 62%, P=0.01), a corresponding 29.4% decrease in the incidence of delayed graft function (10% vs. 34%, P=0.02), and a 10% improvement in short-term (6-month) graft survival (98% vs. 88%, P=0.02). The addition of GSH supplementation to perfusate resulted in no significant differences in graft outcomes.. Despite recommendations by the manufacturer that UW solution be routinely supplemented with GSH, supplemental GSH does not influence early renal allograft function. Our data suggest that a far greater beneficial impact on early graft function is achieved by machine perfusion. We conclude that GSH supplementation of commercially available UW is not necessary.

Topics: Adenosine; Adult; Allopurinol; Cold Temperature; Glutathione; Graft Survival; Humans; Insulin; Ischemia; Kidney Transplantation; Middle Aged; Organ Preservation; Organ Preservation Solutions; Perfusion; Raffinose; Reactive Oxygen Species; Tissue Donors; Transplantation, Homologous

The aim of the study was to investigate the time course of neutrophil activation after skeletal muscle ischemia in humans and to assess the effect of xanthine oxidase inhibitor allopurinol or cyclooxygenase inhibitor indomethacin. In patients undergoing tourniquet ischemia of the upper limb, polymorphonuclear neutrophils (PMN) were simultaneously isolated from antecubital vein blood of both the contralateral control arm and the tourniquet arm. PMN-superoxide production (PMN-SOP) was determined by a cytochrome C reduction assay, PMN-myeloperoxidase activity (PMN-MPO) by guaiacol oxidation and serum PMN-elastase concentration by an enzyme immunoassay. At 60 min after release of the tourniquet, significant increases of PMN-SOP, PMN-MPO, and serum elastase concentrations were observed in tourniquet arms as compared with control arms (p < .05). Allopurinol (300 mg orally, 12 and 2 h before ischemia) significantly inhibited the increase of PMN-SOP, PMN-MPO, and serum elastase (p < .05). Indomethacin (50 mg orally, 2 h before ischemia) prevented increased PMN-MPO and serum elastase, but prevented increased PMN-SOP only when neutrophils were incubated in the presence of their autologous plasma. These findings suggest that ischemia/reperfusion of human skeletal muscle involves both xanthine oxidase-dependent oxygen free radicals and cyclooxygenase metabolites. These pathways could activate circulating neutrophils which potentially inflict local and remote endothelial injury.

Topics: Adolescent; Adult; Allopurinol; Cyclooxygenase Inhibitors; Enzyme Inhibitors; Female; Humans; Indomethacin; Ischemia; Leukocyte Count; Leukocyte Elastase; Male; Middle Aged; Muscle, Skeletal; Neutrophil Activation; Peroxidase; Xanthine Oxidase

The use of University of Wisconsin (UW) solution in liver transplantation (LTX) has significantly prolonged preservation times and facilitated semielective transplant procedures. Despite this advantage potential risk factors related to the donor, recipient, or cold storage method will persist in the UW era and detrimental effects will be reflected by primary dysfunction (PDF) after LTX. Concern has been voiced about the maximum period of UW preservation in LTX and various cold ischemia times (CIT) are mentioned. To evaluate the effect of UW solution in LTX, a prospective European multicenter study was initiated in 1988 and short-term results have been reported previously. This report focuses on the long-term effects and survival of prolonged preservation with UW solution and primary function after LTX. Three hundred and fifteen LTXs were performed in 288 patients in participating European centers. Complete follow up of at least 6 years was available for 296 grafts in 277 patients. Effects of donor, preservation, and recipient risk factors on PDF including primary non-function (PNF) and initial poor function (IPF) were evaluated. Next, the effect of risk factors on graft survival (GS) was analyzed including the long-term impact of PNF and IPF using multivariate analyses and the Kaplan-Meyer method. PDF occurred in 15.2% (45/296) with PNF in 7.8% and IPF in 7.4%. Patients with IPF had a 34% lower GS at 3 months those with immediate function (IF; 58% vs 91%; P < 0.001). This difference persisted up to 6 years for patients with IPF with a 39% GS vs 72% after IF (P < 0.001). Median CIT was significantly longer in grafts with PNF compared to IPF or IF (P = 0.03). Long-term GS, however, was significantly influenced at a lower CIT threshold with a 6-year GS for CIT < or = 16 h of 67%, compared to a CIT > 16 h of 51% (P = 0.02). Other independent risk factors for the 6-year survival rate were re-LTX, ABO incompatibility, and recipient diagnosis of acute hepatic failure. In conclusion, liver patients with PNF, but not with IPF, have a significantly lower CIT. IPF is associated with a significantly lower 3 month GS compared to IF, but this difference of 34% does not further increase during a 6-year follow up. Although a short term follow up (3 months) shows that with UW solution CIT up to 18 h has no adverse effect on GS, the 6-year data clearyl suggest that CIT should be kept to less than < 16 h to avoid tetrimental effects on lang-term GS after LTX.

Topics: Adenosine; Allopurinol; Cold Temperature; Follow-Up Studies; Glutathione; Graft Survival; Humans; Insulin; Ischemia; Liver; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Survival Rate; Time Factors

Surgically induced ischemia and reperfusion is frequently accompanied by local and remote organ injury. It was hypothesized that this procedure may produce injurious oxidants such as hydrogen peroxide (H2O2), which, if unscavenged, will generate the highly toxic hydroxyl radical (.OH). Accordingly, it was proposed that tourniquet-induced exsanguination for limb surgery may be a useful ischemia-reperfusion model to investigate the presence of oxidants, particularly H2O2.. In ten patients undergoing knee surgery, catheters were placed in the femoral vein of the limb operated on for collection of local blood and in a vein of the arm for sampling of systemic blood. Tourniquet-induced limb exsanguination was induced for about 2 h. After tourniquet release (reperfusion), blood samples were collected during a 2-h period for measurement of H2O2, xanthine oxidase activity, xanthine, uric acid (UA), glutathione, and glutathione disulfide.. At 30 s of reperfusion, H2O2 concentrations increased (approximately 90%) from 133 +/- 5 to 248 +/- 8 nmol.ml-1 (P < 0.05) in local blood samples, but no change was evident in systemic blood. However, in both local and systemic blood, xanthine oxidase activity increased approximately 90% (1.91 +/- 0.07 to 3.93 +/- 0.41 and 2.19 +/- 0.07 to 3.57 +/- 0.12 nmol UA.ml-1.min-1, respectively) as did glutathione concentrations (1.27 +/- 0.04 to 2.69 +/- 0.14 and 1.27 +/- 0.03 to 2.43 +/- 0.13 mumol.ml-1, respectively). At 5 min reperfusion, in local blood, H2O2 concentrations and xanthine oxidase activity peaked at 796 +/- 38 nmol.ml-1 (approximately 500%) and 11.69 +/- 1.46 nmol UA.ml-1.min-1 (approximately 520%), respectively. In local blood, xanthine and UA increased from 1.49 +/- 0.07 to 8.36 +/- 0.33 nmol.ml-1 and 2.69 +/- 0.16 to 3.90 +/- 0.18 mumol.ml-1, respectively, whereas glutathione and glutathione disulfide increased to 5.13 +/- 0.36 mumol.ml-1 and 0.514 +/- 0.092 nmol.ml-1, respectively. In systemic blood, xanthine oxidase activity peaked at 4.75 +/- 0.20 UA nmol.ml-1.min-1. At 10 min reperfusion, local blood glutathione and UA peaked at 7.08 +/- 0.46 mumol.ml-1 and 4.67 +/- 0.26 mumol.ml-1, respectively, while the other metabolites decreased significantly toward pretourniquet levels. From 20 to 120 min, most metabolites returned to pretourniquet levels; however, local and systemic blood xanthine oxidase activity remained increased 3.76 +/- 0.29 and 3.57 +/- 0.37 nmol UA.ml-1.min-1, respectively. Systemic blood H2O2 was never increased during the study. During the burst period (approximately 5-10 min), local blood H2O2 concentrations and xanthine oxidase activities were highly correlated (r = 0.999).. These studies suggest that tourniquet-induced exsanguination for limb surgery is a significant source for toxic oxygen production in the form of H2O2 and that xanthine oxidase is probably the H2O2-generating enzyme that is formed during the ischemia-reperfusion event. In contrast to the reperfused leg, the absence of H2O2 in arm blood demonstrated a balanced oxidant scavenging in the systemic circulation, despite the persistent increase in systemic xanthine oxidase activity.

Topics: Adult; Antioxidants; Glutathione; Glutathione Disulfide; Humans; Hydrogen Peroxide; Ischemia; Knee Joint; Leg; Oxidants; Reperfusion; Superoxides; Tourniquets; Uric Acid; Xanthine; Xanthine Oxidase; Xanthines

Topics: Adenosine; Allopurinol; Cadaver; Cold Temperature; Glucose; Glutathione; Graft Survival; Histocompatibility Testing; Humans; Hypertonic Solutions; Insulin; Ischemia; Kidney Transplantation; Mannitol; Organ Preservation; Organ Preservation Solutions; Potassium Chloride; Procaine; Raffinose; Retrospective Studies; Time Factors

University of Wisconsin solution has become the most commonly used vascular perfusate during multiorgan donation world-wide. In the UK however, hyperosmolar citrate remains in common use. The purpose of this prospective randomized study was to compare the effect of systemic perfusion with UW or HOC on subsequent islet yield and purification for pancreata with short cold ischemic times. Seven pancreata were randomized to each group, with the donor age, pancreas weight, and period of cold ischemia being similar in both. Perfusion with UW was shown to inhibit collagenase digestion, and a higher concentration of this enzyme was needed to achieve comparable numbers of islets with good separation of exocrine and islet tissue after a similar period of digestion. There were no differences in the number, size, purity, or viability of islets between the two groups. In conclusion, UW solution offers no benefits over HOC for pancreata with short cold ischemic times, and because of its expense and need to use greater amounts of collagenase enzyme, we continue to use HOC.

Topics: Adenosine; Allopurinol; Cell Survival; Citrates; Citric Acid; Cold Temperature; Collagenases; Glutathione; Humans; Insulin; Ischemia; Islets of Langerhans; Organ Preservation Solutions; Osmolar Concentration; Pancreas; Perfusion; Prospective Studies; Raffinose; Random Allocation; Tissue Donors

Topics: Adenosine; Adult; Alanine Transaminase; Alkaline Phosphatase; Allopurinol; Aspartate Aminotransferases; Bilirubin; Child; Glutathione; Humans; Insulin; Ischemia; Liver Function Tests; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Retrospective Studies; Serum Albumin; Solutions; Time Factors

Xanthine oxidase (XO), a form of xanthine oxidoreductase, is widely distributed in various human tissues. As a major source for the generation of superoxide radicals, XO is involved in the induction of oxidative stress and inflammation during ischemic and hypoxic tissue injury. Therefore, we designed this study to identify the role of serum XO levels in acute ischemic stroke (AIS) pathogenesis. In this single-center prospective study, 328 consecutive patients with AIS for the first time were included, and 107 age- and sex-matched healthy controls from a community-based stroke screening population were also included. The serum levels of XO and several conventional stroke risk factors were assessed. Multivariate analysis was applied to evaluate the relationship between serum levels of XO and clinical outcomes, and nomogram models were developed to predict the onset, progression and prognosis of AIS. Compared with the healthy control group, the serum level of XO was significantly higher in the AIS group (P < 0.05) and was an independent risk factor for AIS (OR 8.68, 95% CI 4.62-14.33, P < 0.05). Patients with progressive stroke or a poor prognosis had a much higher serum level of XO than patients with stable stroke or a good prognosis (all P < 0.05). In addition, the serum level of XO was an independent risk factor for stroke progression (OR 1.98, 95% CI 1.12-3.50, P = 0.018) and a poor prognosis (OR 2.51, 95% CI 1.47-3.31, P = 0.001). The nomogram models including XO to predict the onset, progression and prognosis of AIS had good prediction and differentiation abilities. The findings of this study show that the serum level of XO on admission was an independent risk factor for AIS and had certain clinical predictive value for stroke progression and prognosis in patients with AIS.

Topics: Humans; Ischemia; Ischemic Stroke; Prospective Studies; Stroke; Xanthine Oxidase

Intrapartum hypoxia-ischemia leading to neonatal encephalopathy (NE) results in significant neonatal mortality and morbidity worldwide, with > 85% of cases occurring in low- and middle-income countries (LMIC). Therapeutic hypothermia (HT) is currently the only available safe and effective treatment of HIE in high-income countries (HIC); however, it has shown limited safety or efficacy in LMIC. Therefore, other therapies are urgently required. We aimed to compare the treatment effects of putative neuroprotective drug candidates following neonatal hypoxic-ischemic (HI) brain injury in an established P7 rat Vannucci model. We conducted the first multi-drug randomized controlled preclinical screening trial, investigating 25 potential therapeutic agents using a standardized experimental setting in which P7 rat pups were exposed to unilateral HI brain injury. The brains were analysed for unilateral hemispheric brain area loss after 7 days survival. Twenty animal experiments were performed. Eight of the 25 therapeutic agents significantly reduced brain area loss with the strongest treatment effect for Caffeine, Sonic Hedgehog Agonist (SAG) and Allopurinol, followed by Melatonin, Clemastine, ß-Hydroxybutyrate, Omegaven, and Iodide. The probability of efficacy was superior to that of HT for Caffeine, SAG, Allopurinol, Melatonin, Clemastine, ß-hydroxybutyrate, and Omegaven. We provide the results of the first systematic preclinical screening of potential neuroprotective treatments and present alternative single therapies that may be promising treatment options for HT in LMIC.

Topics: Allopurinol; Animals; Animals, Newborn; Asphyxia Neonatorum; Brain; Brain Injuries; Caffeine; Clemastine; Disease Models, Animal; Hedgehog Proteins; Humans; Hydroxybutyrates; Hypothermia, Induced; Hypoxia; Hypoxia-Ischemia, Brain; Infant, Newborn; Ischemia; Melatonin; Neuroprotective Agents; Rats

The protective effects of carbon monoxide (CO) against ischemia/reperfusion (IR) injury during organ transplantation have been extensively investigated. Likewise, CO-releasing molecules (CORMs) are known to exert a variety of pharmacological activities via liberation of controlled amounts of CO in organs. Therefore, we hypothesized that intraluminal administration of water-soluble CORM-3 during cold storage of intestinal grafts would provide protective effects against IR injury.. Orthotopic syngeneic intestinal transplantation was performed in Lewis rats following 6 h of cold preservation in Ringer solution or University of Wisconsin solution. Saline containing CORM-3 (100 µmol/L) or its inactive counterpart (iCORM-3) was intraluminally introduced in the intestinal graft before cold preservation.. Histopathological analysis of untreated and iCORM-3-treated grafts revealed a similar erosion and blunting of the intestinal villi. These changes in the mucosa structure were significantly attenuated by intraluminal administration of CORM-3. Intestinal mucosa damage caused by IR injury led to considerable deterioration of gut barrier function 3 h postreperfusion. CORM-3 significantly inhibited upregulation of proinflammatory mRNA levels, ameliorated intestinal morphological changes, and improved graft blood flow and mucosal barrier function. Additionally, CORM-3-treated grafts increased recipient survival rates. Pharmacological blockade of soluble guanylyl cyclase activity significantly reversed the protective effects conferred by CORM-3, indicating that CO partially mediates its therapeutic actions via soluble guanylyl cyclase activation.. Our study demonstrates that luminally delivered CORM-3 provides beneficial effects in cold-stored rat small intestinal grafts and could be an attractive therapeutic application of CO in the clinical setting of organ preservation and transplantation.

Topics: Adenosine; Allopurinol; Animals; Carbon Monoxide; Glutathione; Humans; Insulin; Ischemia; Organ Preservation Solutions; Organometallic Compounds; Raffinose; Rats; Rats, Inbred Lew; Reperfusion Injury; Soluble Guanylyl Cyclase; Water

Xanthine oxidase (XO) utilizes molecular oxygen as a substrate to convert purine substrates into uric acid, superoxide, and hydrogen peroxide, which is one of the main enzyme pathways to produce reactive oxygen species (ROS) during septic inflammation and oxidative stress. However, it is not clear whether XO inhibition can improve sepsis-induced renal hypoxia in sepsis-induced acute kidney injury (SI-AKI) mice. In this study, pretreatment with febuxostat, an XO-specific inhibitor, or kidney knockdown of XO by shRNA in vivo significantly improved the prognosis of SI-AKI, not only by reducing the levels of blood urea nitrogen, serum creatinine, tumor necrosis factor-

Topics: Acute Kidney Injury; Animals; Febuxostat; Hypoxia; Inflammation; Ischemia; Kidney; Lipopolysaccharides; Mice; Oxygen; Reactive Oxygen Species; RNA, Small Interfering; Sepsis; Xanthine Oxidase

Transplantation is lifesaving and the most effective treatment for end-stage organ failure. The transplantation success depends on the functional preservation of organs prior to transplantation. Currently, the University of Wisconsin (UW) and histidine-tryptophan-ketoglutarate (HTK) are the most commonly used preservation solutions. Despite intensive efforts, the functional preservation of solid organs prior to transplantation is limited to hours. In this study, we modified the UW solution containing components from both the UW and HTK solutions and analyzed their tissue-protective effect against ischemic injury. The composition of the UW solution was changed by reducing hydroxyethyl starch concentration and adding Histidine/Histidine-HCl which is the main component of HTK solution. Additionally, the preservation solutions were supplemented with melatonin and glucosamine. The protective effects of the preservation solutions were assessed by biochemical and microscopical analysis at 2, 10, 24, and 72 h after preserving the rat kidneys with static cold storage. Lactate dehydrogenase (LDH) activity in preservation solutions was measured at 2, 10, 24, and 72. It was not detectable at 2 h of preservation in all groups and 10 h of preservation in modified UW+melatonin (mUW-m) and modified UW+glucosamine (mUW-g) groups. At the 72nd hour, the lowest LDH activity (0.91 IU/g (0.63-1.17)) was measured in the mUW-m group. In comparison to the UW group, histopathological damage score was low in modified UW (mUW), mUW-m, and mUW-g groups at 10, 24, and 72 hours. The mUW-m solution at low temperature was an effective and suitable solution to protect renal tissue for up to 72 h.

Topics: Adenosine; Allopurinol; Animals; Glucosamine; Glucose; Glutathione; Histidine; Insulin; Ischemia; Kidney; Mannitol; Melatonin; Organ Preservation; Organ Preservation Solutions; Potassium Chloride; Raffinose; Rats

Oxidative damage is critical in the pathogenesis of ovarian ischaemia/reperfusion (I/R) injury, and statins have been reported to exert antioxidant activity. However, the role of VCAM-1 and xanthine oxidase (XO)/uric acid (UA) in ovarian I/R injury is not known. Also, whether or not atorvastatin exerts antioxidant activity like other statins is unclear.. This study investigated the involvement of VCAM-1 and XO/UA in ovarian I/R injury and the likely protective role of atorvastatin.. Forty female Wistar rats were randomized into sham-operated, ischaemia, ischaemia/reperfusion (I/R), ischaemia and atorvastatin, and I/R and atorvastatin.. In comparison with the sham-operated group, atorvastatin blunted ischaemia and I/R-induced distortion of ovarian histoarchitecture and follicular degeneration. Also, atorvastatin alleviated ischaemia and I/R-induced rise in XO, UA, and malondialdehyde, which was accompanied by inhibition of ischaemia and I/R-induced reductions in reduced glutathione level, enzymatic antioxidant activities and increase in myeloperoxidase activity and TNF-α and IL-6 levels by atorvastatin treatment. Additionally, atorvastatin blocked ischaemia and I/R-induced increase in VCAM-1 expression, caspase 3 activity, 8-hydroxydeoxyguanosine level and ovarian DNA fragmentation index.. For the first time, this study revealed that atorvastatin-mediated downregulation of VCAM-1 and XO/UA/caspase 3 signaling averts oxidative injury, inflammation, and apoptosis induced by ovarian ischaemia/reperfusion injury.

Topics: 8-Hydroxy-2'-Deoxyguanosine; Animals; Antioxidants; Apoptosis; Atorvastatin; Caspase 3; Down-Regulation; Female; Glutathione; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Interleukin-6; Ischemia; Malondialdehyde; Oxidative Stress; Peroxidase; Rats; Rats, Wistar; Reperfusion Injury; Tumor Necrosis Factor-alpha; Uric Acid; Vascular Cell Adhesion Molecule-1; Xanthine Oxidase

Oxidative stress is related to the progression of renal diseases and modulation of oxidative stress can lead to a reduction in vascular events in patients with chronic renal insufficiency (CRI). Indoxyl sulfate (IS) and xanthine oxidase (XO) are related to impaired neovasculogenesis in CRI. Hydralazine is suggested for blood pressure control in CRI. This study aimed to investigate whether hydralazine could improve ischemia-induced neovasculogenesis in CRI animals by reducing reactive oxygen species (ROS) levels. Mice underwent subtotal nephrectomy or sham surgery. Nitrendipine, probenecid, and allopurinol were used to reduce blood pressure, uric acid (UA), and XO activity levels, respectively, for comparison. Blood pressure, XO activity and UA levels that were increased after subtotal nephrectomy were reduced by hydralazine treatment. Allopurinol decreased blood XO activity and UA levels. Only hydralazine and allopurinol increased the number of circulating endothelial progenitor cells (EPCs) and improved neovasculogenesis in CRI mice. IS activated XO mRNA and ROS and inhibited the functions of EPCs and endothelial cells, which could be reversed by hydralazine. However, no additional beneficial effects were observed when XO was inhibited with both hydralazine and siRNA. In conclusion, hydralazine, as a potential XO inhibitor, not only reduced blood pressure and UA levels but also increased the number of circulating EPCs and improved neovasculogenesis in CRI animals. Hydralazine directly inhibited IS-induced ROS and XO activation in EPCs and endothelial cells, and restored their functions in vitro. Future studies should evaluate whether hydralazine could provide additional vascular protection in patients with CRI.

Topics: Allopurinol; Animals; Antihypertensive Agents; Blood Pressure; Cells, Cultured; Enzyme Inhibitors; Humans; Hydralazine; Ischemia; Male; Mice; Neovascularization, Physiologic; Reactive Oxygen Species; Renal Insufficiency, Chronic; Xanthine Oxidase

Reperfusion surgery following testicular ischemia is a reproductive health threatening status and may result with organ dysfunction in men. The high level of reactive oxygen species (ROS) and cease of blood flow to the testis are the most important reasons of this testicular injury. Until today, numerous experimental studies reported that antioxidants might be efficient to alleviate oxidative stress induced organ dysfunction. For this purpose, in this study, we have investigated the protective effects of xanthine oxidase (XO) inhibitor, allopurinol, and ROS scavenger, trolox, in a comparative perspective in testicular ischemia reperfusion injury subjected rats.. Twenty-eight adult male Sprague Dawley rats were divided into four groups of seven animals in each; control, ischemia/reperfusion (I/R), allopurinol and trolox. The rats in control group did not receive any application. Animals in I/R, allopurinol and trolox groups were subjected to 2 h testicular reperfusion injury following 5 h ischemia. Intraperitoneally (i.p.) 1 ml isotonic, 200 mg/kg allopurinol and 50 mg/kg trolox were administered to the animals in these groups 30 min prior reperfusion. At the end of experiment, all animals were sacrificed and blood serum malondialdehyde (MDA) levels were measured. Histological sections were obtained from the testis and stained with hematoxylin and eosin (H&E), proliferating cell nuclear antigen (PCNA) and cleaved caspase-3. Apoptotic index was evaluated with TUNEL Assay.. Severe morphological degenerations, increased serum MDA, cleaved caspase-3 and TUNEL Assay positivity rate, but reduced PCNA positivity rate was observed in ischemia and reperfusion group. Morphological degenerations, MDA level, apoptotic index and PCNA positive cell rate were slightly alleviated in allopurinol administered animals compared with ischemia and reperfusion group. Protection with trolox was more successful and the results of the analysis were similar to the control group.. Ischemia that leading to testicular torsion is a reproductive health affecting problem and current surgical treatment methods might be insufficient to recover testis. Various types of ROS generating mechanisms in cell are limiting protective potency of allopurinol, and cocktail administration of different ROS inhibitors might be more effective. However, our results indicate that free radical scavenger trolox might be a candidate drug to alleviate degenerative effects of testicular ischemia reperfusion injury.. This is the first study that demonstrates antioxidant trolox was more successful than XO inhibitor allopurinol to protect testis against ischemia and reperfusion injury in rats.

Topics: Allopurinol; Animals; Chromans; Humans; Ischemia; Male; Malondialdehyde; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Spermatic Cord Torsion; Testis

Topics: Allopurinol; Animals; Chromans; Ischemia; Male; Rats; Reperfusion Injury; Testis

Topics: Allopurinol; Animals; Chromans; Ischemia; Male; Rats; Reperfusion Injury; Testis

To investigate the potential protective effect of allopurinol on reperfusion injury by determining the inflammatory response through the measurement of tumor necrosis factor-alpha (TNF-alpha).. Sixty rats were distributed into two groups: control and allopurinol and each group was divided into three subgroups, ischemia for two hours, ischemia for three hours and ischemia simulation. Allopurinol group rats received 100mg/kg dose of allopurinol, whereas control group rats received an equivalent dose of saline. Clamping of the infrarenal aorta was performed for two or three hours depending on the subgroup. Ischemia simulation subgroups did not suffer ischemia, just aortic dissection, and maintenance for three hours. After 72 hours of reperfusion, blood was collected by cardiac puncture for TNF-alpha measurement.. Allopurinol reduced TNF-alpha significantly (p <0.001) when compared to the matching control subgroups (control X allopurinol in ischemia for two hours and for three hours).. Allopurinol reduced the concentrations of serum TNF-alpha when used at different times of ischemia followed by reperfusion, which might indicate reduction of the inflammation provoked by the reperfusion injury.

Topics: Abdominal Cavity; Allopurinol; Animals; Antimetabolites; Inflammation; Ischemia; Models, Animal; Random Allocation; Rats, Wistar; Reactive Oxygen Species; Reperfusion Injury; Time Factors; Tumor Necrosis Factor-alpha

The kidney is vulnerable to hypoxia, and substantial efforts have been made to ameliorate renal ischemic injury secondary to pathological conditions. Stimulation of the nitrate-nitrite-nitric oxide pathway is associated with renal and cardiovascular protection in disease models, but less is known about the vascular effects during renal ischemia. This study was aimed at investigating the vascular effects of nitrite in the kidney during normoxic and ischemic conditions. Using a multiwire myograph system, we assessed nitrite-mediated relaxation (10(-9)-10(-4)mol/L) in isolated and preconstricted renal interlobar arteries from C57BL/6 mice under normal conditions (pO2 13kPa; pH 7.4) and with low oxygen tension and low pH to mimic ischemia (pO2 3kPa; pH 6.6). Xanthine oxidoreductase expression was analyzed by quantitative PCR, and production of reactive nitrogen species was measured by DAF-FM DA fluorescence. During normoxia significant vasodilatation (15±3%) was observed only at the highest concentration of nitrite, which was dependent on NO-sGC-cGMP signaling. The vasodilatory responses to nitrite were greatly sensitized and enhanced during hypoxia with low pH, demonstrating significant dilatation (11±1%) already in the physiological range (10(-8)mol/L), with a maximum response of 27±2% at 10(-4) mol/L. In contrast to normoxia, and to that observed with a classical NO donor (DEA NONOate), this sensitization was independent of sGC-cGMP signaling. Moreover, inhibition of various enzymatic systems reported to reduce nitrite in other vascular beds, i.e., aldehyde oxidase (raloxifene), aldehyde dehydrogenase (cyanamide), and NO synthase (L-NAME), had no effect on the nitrite response. However, inhibition of xanthine oxidoreductase (XOR; febuxostat or allopurinol) abolished the sensitized response to nitrite during hypoxia and acidosis. In conclusion, in contrast to normoxia, nitrite exerted potent vasorelaxation during ischemic conditions already at physiological concentrations. This effect was dependent on functional XOR but independent of classical downstream signaling by sGC-cGMP.

Topics: Animals; Cell Hypoxia; Cyclic GMP; Ischemia; Kidney; Male; Mice, Inbred C57BL; Nitrites; Second Messenger Systems; Vasodilation; Xanthine Oxidase

Appropriate hypothermic packaging techniques are an essential part of organ procurement. We present a case in which deviation from standard packaging practice may have caused sub-zero storage temperatures during transport, resulting in a clinical picture resembling PNF. An 18-month-old male with alpha-1-antitrypsin deficiency underwent liver transplant from a size-matched pediatric donor. Upon arrival at the recipient hospital, ice crystals were noted in the UW solution. The transplant proceeded uneventfully with short ischemia times. Surprisingly, transaminases, INR, and total bilirubin were markedly elevated in the postoperative period but returned to near normal by discharge. Follow-up of over five yr has demonstrated normal liver function. Upon review, it was discovered that organ packaging during recovery included storage in the first bag with only 400 mL of UW solution, and pure ice in the second bag instead of slush. This suggests that the postoperative delayed graft function was related to sub-zero storage of the graft during transport. This is the first report of sub-zero cold injury, or frostbite, following inappropriate packaging of an otherwise healthy donor liver. The clinical picture closely resembled PNF, perhaps implicating this mechanism in other unexpected cases of graft non-function.

Topics: Adenosine; Allopurinol; alpha 1-Antitrypsin Deficiency; Bilirubin; Cold Temperature; Delayed Graft Function; Frostbite; Glutathione; Humans; Ice; Infant; Insulin; International Normalized Ratio; Ischemia; Liver Transplantation; Male; Organ Preservation Solutions; Postoperative Period; Raffinose; Tissue and Organ Procurement; Treatment Outcome

Institut Georges Lopez-1 preservation solution (IGL-1) is an emerging extracellular-type electrolyte solution, low in viscosity, containing polyethylene glycol 35 as a colloid. Although IGL-1 has shown beneficial outcomes in kidney and liver preservation, this pilot study is the first to evaluate the efficacy of IGL-1 in pancreas transplantation (PT) compared with the University of Wisconsin solution (UW).. Sixteen Landrace pigs underwent allogeneic PT with 16 hr of cold ischemia. Grafts were preserved with IGL-1 (n=8) or UW (n=8). No immunosuppression was administered. We analyzed graft function, the acute-phase response, and oxidative stress in the pancreatic graft monitoring membrane fluidity and lipid peroxidation.. All eight grafts with IGL-1, but only six with UW, were functioning. Graft failures with UW resulted from graft thrombosis. There were no differences between the two solutions in the number of normoglycemic days (IGL-1: 11.5 ± 6.2 versus UW: 8.5 ± 4.4 days, P=0.1357), nor in lipid peroxidation during 16-hr cold ischemia (P=0.672), or reperfusion (P=0.185), but IGL-1 prevented changes in membrane fluidity after reperfusion when compared with UW (P=0.026).. IGL-1 offered the same degree of safety and effectiveness as UW in our model of pig PT with 16 hr of cold ischemia.

Topics: Adenosine; Allopurinol; Animals; Colloids; Electrolytes; Female; Glutathione; Immunosuppression Therapy; Insulin; Ischemia; Kidney; Lipid Peroxidation; Liver; Organ Preservation; Organ Preservation Solutions; Oxidative Stress; Pancreas; Pancreas Transplantation; Pilot Projects; Polyethylene Glycols; Raffinose; Swine; Time Factors; Viscosity

To investigate whether allopurinol exerts a protective effect on kidneys by measuring new kidney injury biomarkers (NGALp, NGALu, KIM 1 and IL 18) and analysing the renal function and histology in uninephrectomised rats subjected to ischaemia-reperfusion injury.. Thirty two Wistar rats were randomly allocated to four groups: Sham (S): laparotomy; Control (C): laparotomy and ischaemia-reperfusion in the left kidney; Control Allopurinol (CA): laparotomy and allopurinol at a dose of 100mg·kg 1·d 1; and Allopurinol (A): laparotomy ischaemia-reperfusion in the left kidney and allopurinol at a dose of 100mg·kg 1·d 1. The NGALp, NGALu, KIM 1, IL 18 and creatinine levels and the kidney histology were analysed. The significance level was established as p<0.05.. Creatinine level increased in all the groups, with A ≈ C > S ≈ CA. The NGALp, NGALu and IL 18 levels exhibited similar behaviour in all the groups. KIM 1 was higher in group A than C and showed intermediate values in groups S and CA. Severity of injury in the left kidney was greater in groups C and A compared to S and CA.. Allopurinol did not exert protective or damaging effects on the kidneys of rats subjected to ischaemia-reperfusion injury.

Topics: Acute-Phase Proteins; Allopurinol; Animals; Antimetabolites; Biomarkers; Creatinine; Interleukin-18; Ischemia; Kidney; Lipocalin-2; Lipocalins; Male; Proto-Oncogene Proteins; Random Allocation; Rats, Wistar; Reperfusion Injury

Laparoscopic and robotic partial nephrectomy involves temporary clamping of the renal artery, making the kidney susceptible to ischemic damage. Isoprostane represents one potential marker of oxidative injury. The objective was to determine if renal interstitial isoprostane levels can quantitate renal damage secondary to warm ischemia. A second goal is to investigate allopurinol for renoprotective abilities using this model. We chose to investigate potential renoprotection of allopurinol because previous studies have demonstrated transplant kidneys pretreated with allopurinol to have less damage from ischemia.. A microdialysis probe was inserted into the renal parenchyma of rats to allow continuous dialysis and collection of the effluent for isoprostane levels. After clamping of the renal vessels for predefined intervals of ischemia, the interstitial effluent from the probe was collected and subsequently analyzed for isoprostane levels with and without allopurinol pretreatment.. Clamping of the renal artery and vein produced increases in isoprostane levels during the ischemic period and larger increases during reperfusion. There was a trend for increased postclamp isoprostane levels as clamp times increased. When comparing isoprostane levels in rats that did not receive allopurinol, there were significant differences between the clamp and postclamp levels of isoprostane, with allopurinol offering protection to the kidney from ischemic changes caused by clamping the renal hilum.. Our data have demonstrated that isoprostane levels are a potential real-time marker of renal ischemia and reperfusion injury. We also found allopurinol administration demonstrated a trend toward renoprotective abilities in the hilar occluded kidney.

Topics: Allopurinol; Animals; Constriction; Disease Models, Animal; Ischemia; Isoprostanes; Kidney; Male; Microdialysis; Rats; Rats, Sprague-Dawley; Renal Artery; Reperfusion Injury

This study examined the cytoprotective mechanisms of a combination of ischemic preconditioning (IPC) and allopurinol against liver injury caused by ischemia/reperfusion (I/R). Allopurinol (50mg/kg) was intraperitoneally administered 18 and 1h before sustained ischemia. A rat liver was preconditioned by 10 min of ischemia, followed by 10 min of reperfusion, and then subjected to 90 min of ischemia, followed by 5h of reperfusion. Rats were pretreated with adenosine deaminase (ADA), 3,7-dimethyl-1-[2-propargyl]-xanthine (DMPX), and N-nitro-l-arginine methyl ester (l-NAME) before IPC. Hepatic nitrite and nitrate and eNOS protein expression levels were increased by the combination of IPC and allopurinol. This increase was attenuated by ADA, DMPX, and l-NAME. I/R induced an increase in alanine aminotransferase activity, whereas it decreased the hepatic glutathione level. A combination of IPC and allopurinol attenuated these changes, which were abolished by ADA, DMPX, and l-NAME. The increase in the liver wet weight-to-dry weight ratio after I/R was attenuated by the combination of IPC and allopurinol. In contrast, hepatic bile flow was decreased after I/R, which was attenuated by the combination of IPC and allopurinol. These changes were restored by l-NAME. I/R induced a decrease in the level of mitochondrial dehydrogenase, whereas it increased mitochondrial swelling. A combination of IPC and allopurinol attenuated these changes, which were restored by ADA, DMPX, and l-NAME. Our findings suggest that a combination of IPC and allopurinol reduces post-ischemic hepatic injury by enhancing NO generation.

Topics: Adenosine Deaminase; Alanine Transaminase; Allopurinol; Animals; Arginine; Cyclic GMP; Glutathione; Ischemia; Ischemic Preconditioning; Liver; Male; Mitochondria, Liver; Mitochondrial Swelling; Nitric Oxide; Nitric Oxide Synthase Type II; Nitric Oxide Synthase Type III; Organ Size; Rats; Rats, Sprague-Dawley; Theobromine

Hepatic ischemia-reperfusion (I/R) can lead to liver failure in association with remote organ damage, both of which have significant rates of morbidity and mortality. In this study, novel spin trapping and histopathological techniques have been used to investigate in vivo free radical formation in a rat model of warm liver I/R injury. 5,5-Dimethyl-1-pyrroline N-oxide (DMPO) was administered to rats via intraperitoneal injection at a single dose of 1.5g of pure DMPO/kg body wt 2h before the initiation of liver ischemia. Blood vessels supplying the median and left lateral hepatic lobes were occluded with an arterial clamp for 60min, followed by 60min reperfusion. The effects of DMPO on I/R injury were evaluated by assessing the hepatic ultrastructure via transmission electron microscopy and by histopathological scoring. Immunoelectron microscopy was performed to determine the cellular localization of DMPO nitrone adducts. Levels of nitrone adducts were also measured to determine in situ scavenging of protein and DNA radicals. Total histopathological scoring of cellular damage was significantly decreased in hepatic I/R injury after DMPO treatment. DMPO treatment significantly decreased the hepatic conversion of xanthine oxidase and 4-hydroxynonenal formation in I/R injury compared to the untreated I/R group. The distribution of gold-nanoparticle-labeled DMPO nitrone adducts was observed in mitochondria, cytoplasm, and nucleus of hepatocytes. The formation of protein- and DNA-nitrone adducts was increased in DMPO-treated I/R livers compared to DMPO controls, indicating increased in situ protein and DNA radical formation and scavenging by DMPO. These results suggest that DMPO reduces I/R damage via protection against oxidative injury.

Topics: Alanine Transaminase; Animals; Cyclic N-Oxides; Free Radical Scavengers; Free Radicals; Immunohistochemistry; Ischemia; Lipid Peroxidation; Liver; Male; Malondialdehyde; Microscopy, Electron, Transmission; Oxidation-Reduction; Rats; Rats, Wistar; Reperfusion Injury; Spin Trapping; Tissue Distribution; Xanthine Dehydrogenase; Xanthine Oxidase

Arterial hypertension is a major risk factor that can lead to complication of peripheral vascular disease due, in part, to endothelial dysfunction. Because sodium nitrite (SN) can be converted to nitric oxide (NO), which counteracts endothelial dysfunction, we explored the effect of nitrite on neovascularization following hind limb ischemia in different models of hypertension (HT). Chronic delivery of angiotensin II (Ang II, 400 ng/kg/min) or N(omega)-nitro-L-arginine-methyl-ester (L-NAME, 0.1 g/L) was used for a 2-week period to induce hypertension. Mice were subjected to femoral artery ligation-induced ischemia in the hind limb followed by treatment with SN (50 mg/L) for 2 weeks. SN significantly reduced systolic arterial blood pressure in mice receiving Ang II and L-NAME but had no effect in sham animals. After 2 weeks, blood flow and microangiography showed 60 % ± 1.0 recovery in sham compared with 40 % ± 1.3 in HT mice. Importantly, sham and HT mice treated with SN showed a 100 % blood flow recovery associated with normalization in capillary density. The inhibition of xanthine-oxido-reductase (allopurinol) or VEGFR (SU-5416) prevented the neovascularization in HT mice treated with SN. Cyclic GMP (cGMP) content in the hind limb was significantly increased in mice treated with SN compared with non-treated mice. Nitrite/nitrate content was only increased in the sham group treated with SN. Immunoprecipitation and Western blot analysis revealed an increase in eNOS/Akt/VEGFR phosphorylation in skeletal muscle from mice treated with SN compared with non-treated mice. Our findings indicate that SN therapy rescues the neovascularization and blood flow recovery in the ischemic hind limb of sham and HT mice likely through the Akt/NO/cGMP and VEGFR pathways.

Topics: Allopurinol; Angiotensin II; Animals; Arterial Pressure; Capillaries; Cyclic AMP; Cyclic GMP; Femoral Artery; Hindlimb; Hypertension; Indoles; Ischemia; Male; Mice; Mice, Inbred C57BL; Muscle, Skeletal; Neovascularization, Pathologic; NG-Nitroarginine Methyl Ester; Nitric Oxide; Nitric Oxide Synthase Type III; Proto-Oncogene Proteins c-akt; Pyrroles; Receptors, Vascular Endothelial Growth Factor; Regional Blood Flow; Sodium Nitrite; Xanthine Dehydrogenase

Hydrogen sulfide (H(2)S) therapy is recognized as a modulator of vascular function during tissue ischemia with the notion of potential interactions of nitric oxide (NO) metabolism. However, little is known about specific biochemical mechanisms or the importance of H(2)S activation of NO metabolism during ischemic tissue vascular remodeling. The goal of this study was to determine the effect of H(2)S on NO metabolism during chronic tissue ischemia and subsequent effects on ischemic vascular remodeling responses.. The unilateral, permanent femoral artery ligation model of hind-limb ischemia was performed in C57BL/6J wild-type and endothelial NO synthase-knockout mice to evaluate exogenous H(2)S effects on NO bioavailability and ischemic revascularization. We found that H(2)S selectively restored chronic ischemic tissue function and viability by enhancing NO production involving both endothelial NO synthase and nitrite reduction mechanisms. Importantly, H(2)S increased ischemic tissue xanthine oxidase activity, hind-limb blood flow, and angiogenesis, which were blunted by the xanthine oxidase inhibitor febuxostat. H(2)S treatment increased ischemic tissue and endothelial cell hypoxia-inducible factor-1α expression and activity and vascular endothelial growth factor protein expression and function in a NO-dependent manner that was required for ischemic vascular remodeling.. These data demonstrate that H(2)S differentially regulates NO metabolism during chronic tissue ischemia, highlighting novel biochemical pathways to increase NO bioavailability for ischemic vascular remodeling.

Topics: Animals; Enzyme-Linked Immunosorbent Assay; Hydrogen Sulfide; Hypoxia-Inducible Factor 1, alpha Subunit; Ischemia; Male; Mice; Mice, Inbred C57BL; Neovascularization, Physiologic; Nitric Oxide Synthase; Nitrites; Regional Blood Flow; Vascular Endothelial Growth Factor A; Xanthine Oxidase

The differences and efficacy of standard preservation solutions in kidney transplantation, University of Wisconsin (UW) and histidine-tryptophan-ketoglutarate (HTK), remain a topic of debate in recent clinical studies. P-selectins represent glycoproteins expressed on endothelial cells and platelets responsible for the earliest events in ischemia/reperfusion injury in kidney transplantation. This study aimed to compare the levels of P-selectin expression between cold preserved kidney tissues in UW and HTK solutions. Thirty kidneys were procured from male Lewis rats and stored in cold (4°C) solutions for periods of 4, 12, 16, 20, and 24h. Group 1 (n=15) kidneys were stored in UW solutions, and group 2 (n=15) kidneys were submerged in HTK solutions. At the end of each time point, the kidneys underwent preparation and levels of P-selectin expression in the tissues were measured using Immunoblot analyses and adjusted volumetric quantification of Western blot signals. For all periods of cold preservation, P-selectin expression was significantly down-regulated in kidney tissues stored in UW compared with HTK solutions (P<0.001). In summary, UW demonstrated a significant benefit over HTK solution in down-regulating P-selectin expression in cold preserved kidney grafts.

Topics: Adenosine; Allopurinol; Animals; Cryopreservation; Down-Regulation; Glucose; Glutathione; Insulin; Ischemia; Kidney; Male; Mannitol; Models, Animal; Necrosis; Organ Preservation Solutions; P-Selectin; Potassium Chloride; Procaine; Raffinose; Rats; Rats, Inbred Lew

Our study investigated the effect of ischemic postconditioning (IPO) in intestinal warm ischemia/reperfusion (I/R) and autotransplantation models.. Warm ischemia was performed by occlusion of superior mesenteric artery for 1, 3 and 6 hours in white domestic pigs (n = 15). Prior to 3 hours reperfusion the intestine was postconditioned by 3 cycles of 30-seconds ischemia and 30-seconds reperfusion (IPO protocol). In the cold ischemia group (n = 15) the bowel was preserved in University of Wisconsin solution for 1, 3, and 6 hours. Prior to 3 hours reperfusion IPO protocol was applied, too. Tissue samples were collected after laparotomy (control) and at the end of the reperfusion periods. As far as oxidative stress markers, malondialdehyde and reduced glutathione (GSH) levels and superoxide dismutase (SOD) activity were determined. Tissue damage was evaluated by qualitative (Park-classification) and quantitative (Scion Image) methods.. As regards oxidative stress parameters, lipidperoxidation decreased and the protective effect of endogenous antioxidants (GSH, SOD) retained significantly by IPO procedure at the end of reperfusion. Tissue injury correlated significantly by the duration of warm ischemia and cold preservation. Quantitative analysis demonstrated that IPO ameliorated tissue injury in each group (p < 0.05).. IPO significantly attenuated intestinal oxidative stress and morphological damages in warm and cold I/R models.

Topics: Adenosine; Allopurinol; Animals; Antioxidants; Disease Models, Animal; Glutathione; Insulin; Intestines; Ischemia; Ischemic Postconditioning; Laparotomy; Lipid Peroxidation; Malondialdehyde; Organ Preservation Solutions; Oxidative Stress; Raffinose; Reperfusion Injury; Superoxide Dismutase; Sus scrofa; Time Factors; Transplantation, Autologous; Warm Ischemia

Liver grafts preserved in cold storage undergo changes mainly manifested by morphological modifications of the sinusoidal endothelium that result in poor graft function upon reperfusion. The present studies aimed to determine if the addition of polyethylene glycol-albumin to University of Wisconsin (Peg-AlbUW) solution ameliorates the cold preservation injuries of liver grafts. Rat livers were preserved cold with various preservation solutions and evaluated for weight changes and endothelial morphology. Solutions that preserved graft weight and endothelial morphology were tested in the isolated perfused rat liver model to assess graft function. A rat hepatocyte cell line was evaluated for both viability and glutathione concentrations emulating cold preservation and reperfusion conditions. Liver grafts preserved with Peg-AlbUW maintained their initial weight and showed a conserved endothelial morphology compared with liver grafts preserved in UW for 30 h (P<0.05). Liver grafts preserved with Peg-AlbUW had improved portal blood flow and bile secretion compared with liver grafts preserved in UW for 30 h (P<0.05). In vitro we noted comparable hepatocyte viability when cells were preserved in Peg-AlbUW versus UW under similar preservation conditions (P>0.05); glutathione concentrations (reduced and total) were significantly increased in hepatocytes preserved in 3% Peg-AlbUW compared with other preservation solutions (P<0.05). The addition of Peg-Alb to UW preservation solution ameliorated the cold preservation injuries of rat liver grafts as shown by stable liver graft weight, a better preservation of the endothelial morphology, improved portal vein blood flow, and increased bile secretion. Peg-Alb-UW solution improved the integrity of the glutathione redox buffer system of a hepatocyte cell line after cold storage and reperfusion.

Topics: Adenosine; Albumins; Allopurinol; Animals; Apoptosis; Cell Line; Cryopreservation; Endothelial Cells; Glutathione; Graft Survival; Hepatocytes; Insulin; Ischemia; Liver Transplantation; Male; Organ Preservation; Organ Preservation Solutions; Organ Size; Oxidative Stress; Polyethylene Glycols; Raffinose; Rats; Rats, Wistar

Ischemic-type biliary lesions (ITBL) account for a major part of patients' morbidity and mortality after orthotopic liver transplantation (OLT). The exact origin of this type of biliary complication remains unknown. This study retrospectively evaluated 1843 patients. Patients with primary sclerosing cholangitis were excluded from this study. The diagnosis of ITBL was established only when all other causes of destruction of the biliary tree were ruled out. Donor age (P = 0.028) and cold ischemic time (CIT) (P = 0.002) were found to be significant risk factors for the development of ITBL. Organs that were perfused with University of Wisconsin (UW) solution developed ITBL significantly more often than Histidine-Tryptophan-Ketoglutarate (HTK)-perfused organs (P = 0.036). The same applied to organs harvested externally and shipped to our center versus those that were procured locally by our harvest teams (P < 0.001). Pressure perfusion via the hepatic artery significantly reduced the risk of ITBL (P = 0.001). The only recipient factor that showed a significant influence was Child-Pugh score status C (P = 0.021). Immunologic factors had no significant impact on ITBL. The clinical consequences of this study for our institution have been the strict limitation of CIT to <10 h and the exclusive use of HTK solution. We further advocate that all organ procurement teams perform pressure perfusion on harvested organs.

Topics: Adenosine; Adult; Allopurinol; Berlin; Biliary Tract Diseases; Cold Ischemia; Female; Glucose; Glutathione; Humans; Incidence; Insulin; Ischemia; Liver Transplantation; Male; Mannitol; Middle Aged; Organ Preservation Solutions; Perfusion; Potassium Chloride; Pressure; Procaine; Raffinose; Retrospective Studies; Risk Factors; Tissue and Organ Harvesting; Tissue Donors

Donor hearts cannot be preserved beyond 6h using cold storage (CS). Improving preservation methods may permit prolonged storage of donor heart. We compared graft function in large animal model after prolonged preservation (8h) using continuous perfusion (CP) and CS method. Twenty-four miniature pigs were used as donors and recipients. Donor hearts were either stored in University of Wisconsin solution (UW solution) for 8h at 0-4°C (CS group, n=6) or were continuously perfused with oxygenated blood cardioplegia at 26°C for 8h (CP group, n=6). After preservation, hearts were transplanted into recipients and reperfused for 3h. Left ventricular (LV) function, cardiac output (CO), malondialdehyde (MDA) and adenosine triphosphate (ATP) levels, and water content were measured. Although water content of CP hearts was higher than that of CS, LV contractility and diastolic function of CP hearts were superior to those of CS. In addition, CP hearts performed better than CS hearts on CO in working heart state. ATP was better preserved and MDA levels were lower in CP hearts compared with those of CS (P<0.0001). Donor hearts can be preserved longer using continuous perfusion with oxygenated blood cardioplegia and this method prevents time-dependent ischemic injury.

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Cardiac Output; Glutathione; Heart Arrest, Induced; Heart Failure; Heart Transplantation; Insulin; Ischemia; Male; Malondialdehyde; Organ Preservation; Organ Preservation Solutions; Perfusion; Raffinose; Swine; Swine, Miniature; Time Factors

In complicated labor, neonatal outcome may depend not only on the extent of fetal asphyxia and acidosis but also on the effects on the fetal cardiovascular system of reactive oxygen species (ROS) generated during the ischemia-reperfusion (I/R) associated with repeated compressions of the umbilical cord. This study tested the hypothesis that maternal treatment with clinical doses of the antioxidant allopurinol in the setting of fetal asphyxia would reduce oxidative stress in the fetal cardiovascular system. The hypothesis was tested in chronically instrumented fetal sheep in late gestation by investigating the effects of maternal treatment with therapeutic doses of allopurinol or vehicle on the fetal cardiovascular system during and after episodes of I/R. The latter were produced by repeated, measured compressions of the umbilical cord. The data show that maternal treatment with allopurinol helped maintain umbilical blood flow and it reduced fetal cardiac oxidative stress after I/R of the type associated with clinically relevant acidemia and repetitive fetal heart rate decelerations. The data support the hypothesis tested and suggest that maternal treatment with allopurinol may offer plausible clinical intervention in the management of perinatal asphyxia in complicated labor.

Topics: Allopurinol; Animals; Blood Pressure; Cardiovascular System; Enzyme Inhibitors; Female; Fetus; Free Radical Scavengers; Ischemia; Oxidative Stress; Oxypurinol; Pregnancy; Reactive Oxygen Species; Reperfusion; Sheep, Domestic

The intestine is extremely sensitive to ischemic preservation and reoxygenation injury. Current vascular perfusion and cold storage with University of Wisconsin (UW) solution neglect the intestinal lumen and the ongoing mucosal metabolism during hypothermia. This study was designed to test the effects of luminal preservation with an alternative preservation solution in addition to the common vascular flush with UW solution on graft viability after preservation and ex vivo reoxygenation.. Rat intestine was preserved on ice for 6 hr in UW solution or Williams Medium E with additional buffering, impermeants, and a colloid (WMEplus) after being stapled or after flushing and filling the lumen with the respective preservation solution. Tissue slices were prepared from fresh and preserved intestines and were incubated with oxygen for 6 hr at 37°C to assess the viability after reoxygenation.. Directly after preservation, histologic damage was mild and unaffected by preservation strategy. Contrary to luminal preservation, closed preservation resulted in significantly decreased ATP levels compared with control. Reoxygenation aggravated damage and revealed differences between the strategies. Luminal preservation better maintained the ATP levels and histologic integrity (vs. closed preservation) for both solutions. Histomorphologic integrity was superior after preservation with WMEplus (vs. UW solution). Expression of stress responsive genes was least up-regulated in the slices from tissue preserved luminally with WMEplus.. In conclusion, preservation and reoxygenation injury can be attenuated by luminal preservation with WMEplus.

Topics: Adenosine; Allopurinol; Animals; Cell Survival; Gene Expression Regulation; Glutathione; Ice; Insulin; Intestinal Mucosa; Intestines; Ischemia; Microvilli; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; RNA, Messenger

To investigate the correlation of the ultrasonographic appearance of different degrees of experimentally induced acute unilateral testicular ischemia with the protective effect of allopurinol.. Forty-two male white rabbits were equally randomized into 7 groups: sham-operation control, ischemic A, B and C, and treatment D, E and F. Models of different degrees of unilateral testicular ischemia were established in the ischemic and treatment groups under the dynamic observation by color Doppler ultrasound. The ischemic testes showed slightly decreased homogeneous echoes and flow signals in groups A and D, obviously decreased heterogeneous echoes and flow signals in groups B and E, and radial or fragmental low-echo areas and disappearance of flow signals in groups C and F. The ischemic groups received reperfusion after the appearance of the above ultrasonographic changes, while the treatment groups following the intraperitoneal injection of allopurinol at 200 mg/kg. Contrast-enhanced ultrasonography (CEUS) was performed on the bilateral testes before and 3 days after the reperfusion. After 3 days of breeding, the histological changes and malondialdehyde (MDA) contents of the ischemic testes were observed, and the correlation was analyzed between the protective effect of allopurinol and the ultrasonographic appearance of different degrees of acute unilateral testicular ischemia.. CEUS showed fast wash-in and fast wash-out in the sham-operation control group, slow wash-in and slow wash-out in groups A and B and extensive central filling defect in group C before the reperfusion. Fast wash-in and slow wash-out were observed in all the ischemic groups 3 days after the reperfusion, most obviously in group C. Groups D, E and F exhibited the same CEUS appearance as A, B and C before and 3 days after the reperfusion. Johnsen's scores were significantly increased in groups D (9.10 +/- 0.23) and E (7.03 +/- 0.20) in comparison with A (8.53 +/- 0.22) and B (5.82 +/- 0.33) (P < 0.05), but with no significant differences between C (2.30 +/- 0.53) and F (2.45 +/- 0.33) (P > 0.05). The rates of apoptosis were significantly decreased in groups D ([1.68 +/- 0.43]%) and E ([12.53 +/- 0.59]%) compared with A ([7.12 +/- 0.84]%) and B ([20.87 +/- 1.59]%) (P < 0.05), but with no significant differences between C ([52.93 +/- 2.62 ]%) and F ([51.23 +/- 2.53 ]%) (P > 0.05). Significant decreases of MDA contents in the ischemic testes were observed in groups D ([0.64 +/- 0.05] nmol/mg prot), E ([1.59 +/- 0.06] nmol/mg prot) and F ([3.10 +/- 0.17] nmol/mg prot) in comparison with A ([1.38 +/- 0.07] nmol/mg prot), B ([2.11 +/- 0.08] nmol/mg prot) and C ([3.25 +/- 0.14] nmol/mg prot) (P < 0.05).. Allopurinol contributes to the recovery of spermatogenesis when testicular ischemia is sonographically shown to be mild or moderate, but produces no significant effect when it is shown to be severe. Ultrasonography helps to choose the right therapy of testicular torsion and predict spermatogenesis of ischemic testes after reperfusion.

Topics: Allopurinol; Animals; Disease Models, Animal; Ischemia; Male; Rabbits; Reperfusion Injury; Testicular Diseases; Testis; Ultrasonography

Kidneys obtained from donors after cardiac death are damaged by the combination of warm and cold ischemia. Although the parenchymal damage of these kidneys is well studied, little is known about the functional effects of warm and cold ischemia on the renal vascular bed. We compared kidney preservation using the new extracellular-type cold storage solution from Institut Georges Lopez (IGL-1) with the University of Wisconsin solution (UW) and focused on vasomotor functions.. The influence of warm and cold ischemia on vasomotor functions was studied in an isolated perfused kidney model. Six groups of donation after cardiac death donor kidneys were studied with warm ischemia of 0, 15, and 30 min followed by 0 or 24 h cold storage preservation in IGL-1 or UW at 4 degrees C. Endothelial dependent vasodilation was studied using acetylcholine, smooth muscle cell (SMC) constriction was assessed using phenylephrine, and finally endothelial independent relaxation was tested using papaverine-sulfate.. SMCs were significantly affected by cold ischemia showing a 50% reduction of phenylephrine mediated constriction after preservation. Additional warm ischemia did not affect SMCs. After UW preservation endothelial dependent vasodilation was only significantly reduced when the combination of warm and cold ischemia was present. IGL-1 preserved kidneys showed a reduction in endothelial dependent vasodilation after isolated warm ischemia. Both preservation solutions rendered equal results after 24 h preservation.. Vasomotor functions are negatively influenced by the combination of warm and cold ischemia. Both IGL-1 and UW performed equally in preserving vasomotor functions. The interesting finding of the rapid decline of SMC function might point at the first step toward intimal hyperplasia as seen in late transplant dysfunction.

Topics: Adenosine; Allopurinol; Animals; Cadaver; Cold Temperature; Endothelium, Vascular; Glutathione; Insulin; Ischemia; Kidney; Male; Muscle, Smooth, Vascular; Organ Preservation Solutions; Raffinose; Rats; Rats, Inbred F344; Renal Circulation; Reperfusion; Tissue and Organ Harvesting; Tissue Donors; Vasoconstriction

The improvement of the ischaemic tolerance of myocutaneous flaps is of clinical importance and hence the subject of numerous investigations.. In an attempt to increase the ischaemic tolerance, 20 myocutaneous flaps (rectus abdominis muscle) in pigs were elevated and perfused with various, established solutions prior to the onset of ischaemia. The flaps were elevated, utilizing the superior epigastric vessels as the pedicle. Ten flaps were flushed with the University of Wisconsin solution, five with the Euro-Collins solution and the last five with a Ringer-Lactate solution, prior to the 6h long, normothermic ischaemia. On the day of operation, the first, third, fifth, seventh and tenth postoperative day clinical examinations and thermography were performed as well as biopsies. Additionally, on the tenth postoperative day, the rate of necrosis was determined morphometrically as the average of three measurements.. Ten days after surgery, the flaps pretreated with the University of Wisconsin solution displayed a vital surface area of 89%, the Euro-Collins solution 23% and the Ringer-Lactate solution 14%. Histologically, muscle tissue proved to be more susceptible to ischaemia than skin.. Regarding the rectus abdominis flap in a pig model, the University of Wisconsin solution proved superior in the prevention of ischaemic injury compared with the Euro-Collins solution and Ringer Lactate. In accordance with the literature, muscle tissue proved to be more susceptible to ischaemia than skin in our study.

Topics: Adenosine; Allopurinol; Animals; Biopsy; Disease Susceptibility; Epigastric Arteries; Glutathione; Graft Survival; Hypertonic Solutions; Insulin; Ischemia; Ischemic Preconditioning; Isotonic Solutions; Models, Animal; Necrosis; Organ Preservation Solutions; Raffinose; Rectus Abdominis; Reperfusion; Ringer's Lactate; Skin Transplantation; Surgical Flaps; Swine; Thermography; Time Factors; Tissue Preservation; Transplantation Conditioning; Warm Ischemia

An emerging theme in the study of the pathophysiology of persistent pain is the role of reactive oxygen species (ROS). In the present study, we examined the hypothesis that the exogenous supply of antioxidant drugs during peri-reperfusion would attenuate pain induced by ischemia/reperfusion (IR) injury. We investigated the analgesic effects of three antioxidants administered during peri-reperfusion using an animal model of complex regional pain syndrome-type I consisting of chronic post-ischemia pain (CPIP) of the hind paw.. Application of a tight-fitting tourniquet for a period of 3 h produced CPIP in male Sprague-Dawley rats. Low-dose allopurinol (4 mg/kg), high-dose allopurinol (40 mg/kg), superoxide dismutase (SOD, 4000 U/kg), N-nitro-L-arginine methyl ester (L-NAME, 10 mg/kg), or SOD (4000 U/kg)+L-NAME (10 mg/kg) was administered intraperitoneally just after tourniquet application and at 1 and 2 days after reperfusion for 3 days. The effects of antioxidants in rats were investigated using mechanical and cold stimuli. Each group consisted of seven rats.. Allopurinol caused significant alleviation in mechanical and cold allodynia for a period of 4 weeks in rats with CPIP. Both SOD and L-NAME, which were used to investigate the roles of superoxide (O2(-)) and nitric oxide (NO) in pain, also attenuated neuropathic-like pain symptoms in rats for 4 weeks.. Our findings suggest that O2(-) and NO mediate IR injury-induced chronic pain, and that ROS scavengers administered during the peri-reperfusion period have long-term analgesic effects.

Topics: Allopurinol; Animals; Chronic Disease; Cold Temperature; Enzyme Inhibitors; Free Radical Scavengers; Ischemia; Male; NG-Nitroarginine Methyl Ester; Nitric Oxide; Pain; Physical Stimulation; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Reperfusion Injury; Superoxide Dismutase; Xanthine Oxidase

Diabetes mellitus is characterized by a chronic hyperglycemia and might cause skin pathologies resulting from an ischemic insult. A variety of mechanisms have been suggested for the damage provided by ischemia-reperfusion injury (IRI) or for hyperglycemic conditions. Yet, the association between IRI and hyperglycemia together in skin has been poorly investigated even thought they are both present in diabetic patients.. To examine the effect of a dual stress combining IRI and hyperglycemia on human keratinocytes-its ability to cause oxidative damage and inflammatory response via the enzymes xanthine oxidase (XO) and inducible nitric oxide synthase (iNOS).. HaCaT cells were used as a model to induce IRI and hyperglycemia. In order to assess the oxidative damage, total antioxidant scavenging capacity (TSC) and GSH/GSSG ratio were evaluated. iNOS expression was evaluated and its metabolite nitric oxide was estimated by measuring nitrite levels. XO activity was assessed by uric acid quantification and by superoxide radical formation. Inflammatory response was determined through interleukin-6 secretion.. Our observations demonstrate different responses of the cells exposed to single stress (IRI) compared to dual stress combining also hyperglycemia. However, cells response exhibited similarity during reperfusion, by enhancing iNOS expression as well as superoxide levels. While ischemia led to changes in TSC and redox state, reperfusion restored them to basal levels. IRI also caused the enhancement of secreted IL-6 and uric acid levels.. iNOS and XO play a major role in IRI and hyperglycemia. Inhibition of one of these enzymes may be beneficial to skin cells under these conditions.

Topics: Biomarkers; Cell Hypoxia; Cell Line; Cell Survival; Glucose; Glutathione; Glutathione Disulfide; Humans; Hyperglycemia; Inflammation Mediators; Interleukin-6; Ischemia; Keratinocytes; Nitric Oxide; Nitric Oxide Synthase Type II; Nitrites; Oxidative Stress; Reperfusion Injury; Superoxides; Uric Acid; Xanthine Oxidase

We used a rat model of pancreas cold preservation to assess its effects on islets. Glands were surgically retrieved and stored in University of Wisconsin (UW) solution for 3 hours (Short) or 18 hours (Long) cold ischemia time (CIT). Islet yield was significantly lower in the Long-CIT than the Short-CIT group, as well as islet recovery after overnight culture (P < .01). Islet cell viability after isolation was significantly reduced in the Long-CIT group (P < .05). Reversal of diabetes following transplantation of suboptimal islet grafts occurred earlier in the Short-CIT group than the Long-CIT. All animals in the Short-CIT group and 80% in the Long-CIT group achieved euglycemia. Freshly isolated islets showed a significant increase of JNK and p38 (P < .05) phosphorylation in Long-CIT compared with Short-CIT. Histopathological assessment of the pancreas showed a significantly higher injury score. Proteomic analysis of pancreatic tissue led to identification of 5 proteins consistently differentially expressed between Short-CIT and Long-CIT. Better understanding of the molecular pathways involved in this phenomenon will be of assistance in defining targeted interventions to improve organ use in the clinical arena.

Topics: Adenosine; Allopurinol; Animals; Cell Survival; Glutathione; Insulin; Ischemia; Islets of Langerhans; Male; Mitogen-Activated Protein Kinase Kinases; Organ Preservation Solutions; Pancreas; Phosphotransferases; Raffinose; Rats; Rats, Inbred Lew; Tissue and Organ Harvesting

Cold flush preservation prolongs tissue viability during ischemia. However, there is little understanding of the effects of various preservation fluids on events during this period. A study of cold ischemia in rat livers was undertaken to compare biochemical and histological changes over time, using three preservation solutions: University of Wisconsin (UW), histidine-tryptophan-ketoglutarate (HTK), and Leeds solution (LS) under development at our institution. Leeds solution is a phosphate-based sucrose solution that like UW contains the impermeant lactobionate and the metabolite allopurinol (1,5-dihydro-4H-pyrazolo[3,4-d]pyrimidin-4-one) which acts as a competitive inhibitor of xanthine oxidase, stopping the breakdown of hypoxanthine to xanthine by oxidizing it to alloxanthine, inhibiting both the conversion of hypoxanthine to xanthine and the conversion of xanthine to uric acid.. At various time points, samples were analyzed for adenosine triphospate (ATP) and metabolites by high-performance liquid chromatography as well as for histological changes.. In all livers, ATP, ADP, and AMP degraded over 4 hours. In UW and LS groups, degradation beyond hypoxanthine was halted, and it continued in the HTK group. This blockade led to a significant reduction in the accumulation of xanthine and uric acid. Histological analysis showed protected architecture and maintenance of reticulin scaffolds in the UW and LS groups, whereas tissue breakdown was seen from earlier time points in the HTK group. Additionally, throughout ischemia, signs of pathological injury were more pronounced with UW- than with LS-preserved tissue.. These results implied that cold ischemia in the liver is characterized by dynamic biochemical changes coincident with pathological injury which are initiated from the time of organ perfusion and influenced by the choice of the perfusion fluid. Allopurinol in UW and LS appears to be critical. We hypothesized that it may also affect the degree of subsequent reperfusion injury. The data supported the assertion that LS offerred improved preservation over UW, adding to the impetus to shorten ischemic times in clinical transplantation.

Topics: Adenosine; Adenosine Monophosphate; Adenosine Triphosphate; Allopurinol; Animals; Energy Metabolism; Glutathione; Hypoxanthine; Insulin; Ischemia; Kinetics; Liver; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Reperfusion Injury; Reticulin; Uric Acid; Uridine; Xanthine

Reactive oxygen species (ROS) participate in tissue injury after ischemia-reperfusion. Their implication in leukocyte adherence and increase in permeability at the venular side of the microcirculation have been reported, but very little is known about ROS production in arterioles. The objective of this work was to evaluate, in the arteriole wall in vivo, the temporal changes in superoxide anion production during ischemia and reperfusion and to identify the source of this production. Mouse cremaster muscle was exposed to 1 h of ischemia followed by 30 min of reperfusion, and superoxide anion production was assessed by a fluorescent probe, i.e., intracellular dihydroethidium oxidation. During ischemia, we found a significant increase in dihydroethidium oxidation; however, we observed no additional increase in fluorescence during the subsequent reperfusion. This phenomenon was significantly inhibited by pretreatment with superoxide dismutase. Allopurinol (xanthine oxidase inhibitor) or stigmatellin [Q(o)-site (oriented toward the intermembrane space) inhibitor of mitochondrial complex III] or simultaneous administration of these two inhibitors significantly reduced superoxide production during ischemia to 80%, 88%, and 72%, respectively, of that measured in the untreated ischemia-reperfusion group. By contrast, no significant inhibition was found when NADPH oxidase was inhibited by apocynin or when mitochondrial complex I or complex II was inhibited by rotenone or thenoyltrifluoroacetone. A significant increase in ROS was found with antimycin A [Q(i)-site (located in the inner membrane and facing the mitochondrial matrix) inhibitor of mitochondrial complex III]. We conclude that a significant increase in ROS production occurs during ischemia in the arteriolar wall. This increased production involves both a cytoplasmic source (i.e., xanthine oxidase) and the mitochondrial complex III at the Q(o) site.

Topics: Animals; Arterioles; Blood Pressure; Ethidium; Fluorescent Dyes; Ischemia; Mice; Mice, Inbred BALB C; Microcirculation; Mitochondria, Muscle; Muscle, Skeletal; Reactive Oxygen Species; Regional Blood Flow; Reperfusion Injury; Superoxide Dismutase; Xanthine Oxidase

Especially in damaged organs, adequate organ preservation is critically important to maintain viability. Institut Georges Lopez-1 (IGL-1) is a new preservation solution, with an extracellular sodium/potassium ratio and polyethylene glycol as a colloid. The influence of warm and cold ischemia was evaluated in a rat Lewis-Lewis transplant model with a follow up of 14 days. Eight groups of donation after cardiac death donor kidneys were studied with warm ischemia of 0 and 15 min followed by 0- or 24-h cold storage (CS) preservation in IGL-1 or UW-CSS. Blood was collected daily during the first week and at day 14. Recipients were placed in metabolic cages at day 4 and 14 after transplantation allowing urine collection and adequate measurement of glomerular filtration rate. Focussing on inflammation, reactive oxygen species production, proximal tubule damage, proteinuria, histology, and renal function after transplantation we could not show any relevant difference between IGL-1 and UW-CSS. Furthermore, the combination of 15-min warm ischemia and by 24-h cold ischemia did not result in life sustaining kidney function after transplantation, irrespective of the used solution. In the present experiment, static CS preservation of ischemically damaged rat kidneys in either IGL-1 or UW-CSS rendered equal results after transplantation.

Topics: Adenosine; Allopurinol; Animals; Cold Temperature; Glomerular Filtration Rate; Glutathione; Insulin; Ischemia; Kidney; Kidney Transplantation; Kidney Tubules, Proximal; Male; Organ Preservation; Organ Preservation Solutions; Proteinuria; Raffinose; Rats; Rats, Inbred Lew; Reactive Oxygen Species

Cold ischemia time and preservation of organs are limited by I/R injury leading to primary nonfunction of the graft. In a rat heart transplant model, we compared cardioplegic St Thomas (ST) to histidine-tryptophan-ketoglutarate (HTK) and University of Wisconsin preservation solutions in terms of contractile function, and mitochondrial respiratory and enzymatic defects after prolonged cold ischemia and reperfusion. Contractile function was scored after transplantation and 24 h of reperfusion. Mitochondrial function was investigated by high-resolution respirometry of permeabilized myocardial fibers. Graft performance in terms of contractile function declined with the duration of cold storage. Recovery was significantly improved after 10 h of cold storage in HTK compared with ST (cardiac scores, 3.3+/-0.5 and 1.8+/-0.8, respectively). Tissue lactate dehydrogenase was better preserved in HTK than ST. Increase of tissue water content (edema) was less pronounced in HTK than ST (3.33+/-0.14 and 3.73+/-0.21 mg/mg dry weight, respectively). Similar cardiac scores (2.6+/-0.9 and 2.9+/-1.2, respectively) and mitochondrial respiratory parameters were obtained after preservation in HTK and University of Wisconsin. Decline in contractile function of individual grafts correlated well with loss of mitochondrial respiratory capacity, whereas citrate synthase activity remained largely preserved, indicating specific damage of respiratory complexes. Our data provide evidence for the superiority of preservation solutions versus a cardioplegic solution for prolonged cold storage of the heart. The correlation of graft performance and mitochondrial function indicates the potential of high-resolution respirometry for quantitative assessment of myocardial injury upon cold I/R, providing a basis for diagnostic approaches and evaluation of improved preservation solutions for heart transplantation.

Topics: Adenosine; Allopurinol; Animals; Cardioplegic Solutions; Citrate (si)-Synthase; Glutathione; Heart Transplantation; Insulin; Ischemia; Male; Mitochondria; Myocardial Contraction; Myocardium; Organ Preservation Solutions; Permeability; Raffinose; Rats; Rats, Inbred Lew; Reperfusion Injury

Activated protein C (APC) is a serine protease with anticoagulant and antiinflammatory activities. The delaying effects of remote reperfusion injury on the wound-healing process in colonic anastomoses have been previously shown. In this study, we aimed to investigate whether APC protects against deleterious systemic effects of intestinal ischemia/reperfusion (I/R) injury on colonic anastomotic wound healing process.. Male Wistar-albino rats were randomly allocated into 4 groups, and a left colonic anastomosis was performed in all animals: (1) sham-operated group, simultaneously with left colonic anastomosis, the superior mesenteric artery and collateral branches were divided from the celiac axis, and the inferior mesenteric artery were isolated but not occluded (group 1, n = 12), (2) sham + APC group, identical to group 1 except for APC treatment (100 microg/kg, intravenously, 15 minutes before construction of the colonic anastomosis), (group 2, n = 12), (3) intestinal I/R group, 60 minutes of superior mesenteric ischemia followed by reperfusion (group 3, n = 12), and (4) APC-treated group, (100 microg/kg, intravenously, 15 minutes before reperfusion) (group 4, n = 12). All animals were sacrificed, and colonic anastomotic bursting pressures were measured in vivo on day 7. Tissue samples were obtained for analysis of hydroxyproline contents, nitrate/nitrite levels, and activities of oxidative and antioxidative enzymes. The plasma levels of proinflammatory cytokines and D-dimer were also measured.. Intestinal I/R led to significant decreases in colonic anastomotic bursting pressures, tissue hydroxyproline contents, and activities of antioxidative enzymes, along with increases in tissue nitrate/nitrite levels, activities of oxidative enzymes, and plasma levels of proinflammatory cytokines and D-dimer (P < .05). However, APC treatment led to significant increases in colonic anastomotic bursting pressures, tissue hydroxyproline contents, and activities of antioxidative enzymes, along with decreases in tissue nitrate/nitrite levels, activities of oxidative enzymes, and plasma levels of proinflammatory cytokines and D-dimer (P < .05).. This study clearly showed that APC treatment prevented the delaying effects of remote I/R injury on colonic anastomotic wound healing process. Further clinical studies are required to determine whether APC has a useful role in the enhancement of colonic anastomotic wound healing after particular operations in which I/R injury occurs.

Topics: Analysis of Variance; Anastomosis, Surgical; Animals; Chi-Square Distribution; Glutathione; Glutathione Reductase; Interleukin-6; Intestines; Ischemia; Male; Malondialdehyde; Mesenteric Arteries; Mice; Nitrates; Nitrites; Peroxidase; Protein C; Random Allocation; Reperfusion Injury; Tumor Necrosis Factor-alpha; Wound Healing; Xanthine Oxidase

In kidney transplantation, cold storage is the dominant modality used to prolong organ viability ex vivo, but is inevitably followed by a period of warm ischemia. Preservation fluids limit tissue damage during the ischemic period, but there is little information on the influence of preservation fluids on the physiologic consequences of warm ischemia alone, or on the comparative ability of such preservation fluids to limit warm ischemic injury. In this study, warm ischemia was induced in rat kidneys by crossclamping the left renal pedicle for 45 min with contralateral nephrectomy. The ischemic kidneys were flushed with Euro-Collins (EC), hyper osmolar citrate (HOC), University of Wisconsin (UW), or phosphate buffered sucrose (PBS)140 solution. Over a period of 2 h after reperfusion, urine and blood samples were collected and physiological parameters related to the function of the postischemic kidneys were assessed. The data show that postischemic renal function can be influenced by the choice of preservation fluid. Essentially, the continued use of EC as a renal preservation solution finds little support in these data, and, while HOC and UW solutions were better able to limit the decline in renal function after warm ischemia than EC, the solution most able to limit functional impairment after warm ischemia was PBS140. This analysis compares the efficacies of the commonly used preservation solutions and could form the basis for future solid-organ transplant studies that may ultimately allow us to propose best-practice guidelines and an optimum platform for improved preservation solutions.

Topics: Adenosine; Allopurinol; Animals; Citric Acid; Glutathione; Hypertonic Solutions; In Vitro Techniques; Insulin; Ischemia; Kidney; Kidney Transplantation; Male; Organ Preservation; Organ Preservation Solutions; Osmolar Concentration; Raffinose; Rats; Rats, Wistar; Reperfusion Injury; Sugar Phosphates; Temperature

To investigate the impact of garlic extract (GE), which is known for its antioxidant activity, on a testicular torsion/detorsion model in animals and to help understand how to prevent both ischemic and reperfusion injuries after testicular torsion and detorsion.. Six groups of rats (n=7 in each group) were used. The animals in the control group (Group I) did not receive any treatment. The animals in the sham group (Group II) underwent scrotal incision and testicular fixation only. The animals in Groups III-VI underwent 720 degrees of left testicular torsion for 2 h; subsequent detorsion was performed for 2h in Groups IV and VI only. Animals in Groups V and VI were treated exactly the same as those in Groups III and IV, respectively except that they were pretreated with oral GE for 5 days at a dosage of 5 ml/kg. Both testicles in all rats were removed and tissue malondialdehyde (MDA) levels and enzymatic activities of xanthine oxidase (XO) were studied, in addition to a histological evaluation after hematoxylin-eosin staining.. Testicular MDA levels and XO activities were higher in Group III compared to Group II (p<0.05). Pretreatment with GE prevented these increases. Detorsion caused more damage and resulted in a further increase in MDA levels but MDA levels were not increased in animals pretreated with GE. Histologically, torsion caused some separation between germinative cells in the seminiferous tubules, which became much more prominent in Group IV and was attenuated by GE pretreatment. There were no significant changes in any of the above-mentioned enzymatic activities or histopathologic changes in the contralateral testicle in any of the groups.. We believe that both testicular torsion and detorsion result in testicular tissue damage by means of lipid peroxidation, which is evident by an increase in the tissue levels of MDA. Dietary supplementation with GE seems to attenuate the generation of toxic free radicals, as evidenced indirectly by low tissue MDA levels.

Topics: Animals; Antioxidants; Disease Models, Animal; Free Radical Scavengers; Immunohistochemistry; Ischemia; Male; Malondialdehyde; Probability; Protective Agents; Random Allocation; Rats; Rats, Inbred BN; Reference Values; Reperfusion Injury; Risk Factors; Sensitivity and Specificity; Spermatic Cord Torsion; Statistics, Nonparametric; Testis; Tissue Culture Techniques; Xanthine Oxidase

Ischemic type biliary lesions lead to considerable morbidity following orthotopic liver transplantation. The exact pathogenesis is unknown. One major hypothesis is that insufficient perfusion of the arterial vessels of the biliary tree, especially under perfusion with the high viscous University of Wisconsin solution, might be responsible for ischemic type biliary lesions. Due to low viscosity, HTK solution is reported to have a lower incidence of biliary complications. However, there is no data concerning ischemic type biliary lesions in HTK preserved livers. In this paper we report our results after orthotopic liver transplantation with special regard to ischemic type biliary lesions in liver grafts preserved with HTK solution. Between 09/1997 and 01/2005 300 liver transplantations were performed in our center. Thirty-two (10.7%) liver grafts were preserved with HTK solution, 268 (89.3%) were preserved with UW solution. Six and 43 grafts showed ischemic type biliary lesions after orthotopic liver transplantation in HTK- (18.8%) and UW- (16.0%) groups, respectively (p=0.696). There was no statistical significant difference between the two groups. Donor related factors, recipient age, indication for transplantation, transplantation technique, immunosuppression and ischemia time were comparable in both groups. Ischemic type biliary lesions occurred with the same frequency in HTK preserved livers compared to UW preserved organs. We suggest that low viscosity of the preservation fluid by itself does not guarantee reliable perfusion of the small arteries of a liver graft and a pressure perfusion might be beneficial even in HTK solution.

Topics: Adenosine; Allopurinol; Bile Ducts; Glucose; Glutathione; Humans; Insulin; Ischemia; Liver Transplantation; Mannitol; Middle Aged; Organ Preservation; Organ Preservation Solutions; Potassium Chloride; Procaine; Prospective Studies; Raffinose

Redox-active iron, catalyzing the generation of reactive oxygen species, has been implicated in experimental renal ischemia-reperfusion injury. However, in clinical transplantation, it is unknown whether redox-active iron is involved in the pathophysiology of ischemic injury of non-heart-beating (NHB) donor kidneys. We measured redox-active iron concentrations in perfusate samples of 231 deceased donor kidneys that were preserved by machine pulsatile perfusion at our institution between May 1998 and November 2002 using the bleomycin detectable iron assay. During machine pulsatile perfusion, redox-active iron was released into the preservation solution. Ischemically injured NHB donor kidneys had significantly higher perfusate redox-active iron concentrations than heart-beating (HB) donor kidneys that were not subjected to warm ischemia (3.9 +/- 1.1 vs. 2.8 +/- 1.0 micromol/L, p = 0.001). Moreover, redox-active iron concentration was an independent predictor of post-transplant graft viability (odds ratio 1.68, p = 0.01) and added predictive value to currently available donor and graft characteristics. This was particularly evident in uncontrolled NHB donor kidneys for which there is the greatest uncertainty about transplant outcomes. Therefore, perfusate redox-active iron concentration shows promise as a novel viability marker of NHB donor kidneys.

Topics: Adenosine; Allopurinol; Cadaver; Cell Survival; Glutathione; Graft Survival; Heart Arrest; Humans; Hypothermia; Insulin; Iron; Ischemia; Kidney; Kidney Transplantation; Organ Preservation Solutions; Oxidation-Reduction; Perfusion; Predictive Value of Tests; Raffinose; Reactive Oxygen Species; Tissue Donors; Treatment Outcome

Prolonged tissue ischemia leads to changes in microcirculation and production of oxygen free radicals. The event eventually responsible for tissue death is the no-reflow phenomenon and its management is a challenge for the surgeon dealing with replantation or transplantation. We introduce a model of warm ischemia and reperfusion of the lower limb of rats with which we studied the effect of allopurinol and streptokinase.. Section of the lower limb with preservation of vessels and nerves was performed in 110 rats. Femoral vessels clamped for periods of 0, 2, 4, 6, and 8 hours of ischemia were allowed to reperfuse (groups M0, M2, M4, M6, and M8 respectively). Other groups, E1, E2, and E3, received streptokinase, allopurinol, or a combination of the two drugs after 6 hours of ischemia.. Viability rates of the ischemic limbs after 7 days were 100% (M0), 80% (M2), 63.6% (M4), 50% (M6), and 20% (M8). In the experimental groups, E1, E2, and E3, viability rates were 67% (E1), 70% (E2), and 70% (E3). Groups M0, M2, M4, M6, and M8 differed among themselves except for groups M4 and M6. Group E1 had a higher rate of limb viability than M6 (control group) but not than M4. Groups E1, E2 and E3 had higher rates of limb viability than M6 but not than M2 or M4.. The results suggest that increased viability of limbs after 6 hours of ischemia occurs when allopurinol or streptokinase is used. The combination of the two drugs does not appear to produce any additional effect.

Topics: Allopurinol; Animals; Fibrinolytic Agents; Free Radical Scavengers; Ischemia; Lower Extremity; Male; Models, Animal; Rats; Rats, Wistar; Reperfusion; Replantation; Streptokinase; Time Factors

Transplantation of the uterus has been suggested as a possible future treatment of absolute uterine infertility. The tolerability of human uterine tissue to cold ischaemic storage was tested in the present study.. Small tissue samples of human uteri were subjected to cold (4 degrees C) ischaemia (6 and 24 h) in Ringer acetate (RIN), the intracellular-like University of Wisconsin solution (UW) or the extracellular-like Perfadex solution (PER). The ability of myometrial strips to contract, histology by light and electron microscopy as well as tissue concentrations of glutathione, ATP and protein were used as parameters to detect cold ischaemic injuries.. Contractile ability and response to prostaglandin F(2alpha) (PGF(2alpha)) was better preserved after 6 h cold ischaemia in UW and PER in comparison with the other groups. Histological examination did not reveal any major changes after 6 and 24 h cold ischaemic storage in UW and PER solutions, while specimens stored in RIN for 24 h displayed degenerative changes on the electron microscopy level. UW and PER preserved ATP concentrations significantly better than RIN. Myometrium stored in UW contained more total glutathione but also a larger proportion of oxidized glutathione than specimens stored in RIN and PER. Protein concentrations did not change with storage time in any of the solutions.. The results show that human uterine myometrial tissue is resistant towards cold ischaemia for at least 6 h if stored in UW and PER solutions.

Topics: Adenosine; Adenosine Triphosphate; Adult; Allopurinol; Citrates; Cold Temperature; Cryopreservation; Dinoprost; Female; Glutathione; Humans; Insulin; Ischemia; Isotonic Solutions; Microscopy, Electron; Middle Aged; Muscle Contraction; Myometrium; Organ Preservation; Organ Preservation Solutions; Organ Transplantation; Premenopause; Raffinose; Reperfusion; Specimen Handling; Temperature; Time Factors; Uterine Contraction; Uterus

Cold ischemia is the best known method to preserve kidneys for transplant. However, it produces several detrimental effects. First, cellular necrosis. Secondarily, during the hypothermic period a mitochondrial injury process develops which makes the cell entering a pre-apoptotic state. This apoptosis occurs definitively in the reperfusion. Preservation solutions currently available are not perfect and are not able to avoid cold-related cell injuries. The addition of certain substances to UW solution (desferrioxamine) has shown experimentally a reduction in mitochondrial cold-related lesions. Isolated hypothermic kidney perfusion reduces initial graft dysfunction about 20% in comparison to hypothermic storage. This fact relates to important either economical as functional consequences.

Topics: Adenosine; Allopurinol; Cold Temperature; Glutathione; Graft Survival; Humans; Insulin; Ischemia; Kidney; Kidney Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Reperfusion Injury

The current models of liver ischemia/reperfusion injury (IRI) in mice are largely limited to a warm ischemic component. To investigate the mechanism of hepatic "cold" IRI, we developed and validated a new mouse model of prolonged cold preservation followed by syngeneic orthotopic liver transplantation (OLT). Two hundred and forty-three OLTs with or without rearterialization and preservation in University of Wisconsin solution at 4 degrees C were performed in Balb/c mice. The 14-day survivals in the nonarterialized OLT groups were 92% (11/12), 82% (9/11), and 8% (1/12) after 1-hour, 6-hour and 24-hour preservation, respectively. In contrast, hepatic artery reconstruction after 1-hour, 6-hour, and 24-hour preservation improved the outcome as evidenced by 2-week survival of 100% (12/12), 100% (10/10), and 33% (4/12), respectively, and diminished hepatocellular damage (serum alanine aminotransferase /histology). Moreover, 24-hour (but not 1-h) cold preservation of rearterialized OLTs increased hepatic CD4+ T-cell infiltration and proinflammatory cytokine (tumor necrosis factor-alpha, interleukin 2, interferon-gamma) production, as well as enhanced local apoptosis, and Toll-like receptor 4/caspase 3 expression. These cardinal features of hepatic IRI validate the model. In conclusion, we have developed and validated a new mouse model of IRI in which hepatic artery reconstruction was mandatory for long-term animal survival after prolonged (24-h) OLT preservation. With the availability of genetically manipulated mouse strains, this model should provide important insights into the mechanism of antigen-independent hepatic IRI and help design much needed refined therapeutic means to combat hepatic IRI in the clinics.

Topics: Adenosine; Allopurinol; Animals; Apoptosis; CD4 Lymphocyte Count; Disease Models, Animal; Glutathione; Immunohistochemistry; Inflammation; Insulin; Ischemia; Liver; Liver Transplantation; Male; Mice; Mice, Inbred BALB C; Organ Preservation Solutions; Postoperative Complications; Raffinose; Reverse Transcriptase Polymerase Chain Reaction; T-Lymphocytes; Treatment Outcome

The aims of the present study were to determine the effects and mechanisms of angiotensin II (Ang II) on leukocyte-endothelium interactions and the role of Ang II in a novel model of ischemia/reperfusion (I/R) in the mouse colon. Ang II dose-dependently increased leukocyte rolling and adhesion in colonic venules. Importantly, Ang II-induced leukocyte rolling was completely inhibited by immunoneutralization of P-selectin, and leukocyte adhesion was abolished in lymphocyte function antigen-1 (LFA-1)-deficient mice. The P-selectin-dependent rolling was found to be a precondition for the subsequent LFA-1-dependent leukocyte adhesion. Moreover, Ang II-induced leukocyte responses involved generation of reactive oxygen species and up-regulation of CXC chemokines. Notably, CXC chemokines, but not Ang II, stimulated leukocyte chemotaxis in vitro. I/R increased gene expression of angiotensin converting enzyme (ACE) in the colon and plasma concentrations of Ang II. Inhibition of ACE and the type 1 angiotensin (AT1) receptor significantly decreased the I/R-induced leukocyte adhesion. Taken together, these novel findings demonstrate that Ang II exerts potent pro-inflammatory effects in the colonic microcirculation and that inhibition of Ang II expression or function protects against I/R-induced leukocyte responses in the colon. Thus, it is suggested that Ang II is a major target to control pathological inflammation in the colon.

Topics: Allopurinol; Angiotensin II; Angiotensin-Converting Enzyme Inhibitors; Animals; Capillaries; Captopril; Cell Adhesion; Chemokines; Chemotaxis, Leukocyte; Colon; Constriction; Disease Models, Animal; Endothelium, Vascular; Enzyme Induction; Gene Expression Regulation; Inflammation; Ischemia; Leukocyte Count; Leukocytes; Losartan; Male; Mesenteric Artery, Superior; Mice; Mice, Inbred C57BL; Mice, Knockout; P-Selectin; Reactive Oxygen Species; Reperfusion Injury; Superoxide Dismutase

Topics: Allopurinol; Animals; Autonomic Nervous System Diseases; Electric Stimulation; Ischemia; Jejunum; Male; Muscle Contraction; Organ Preservation; Rats; Rats, Wistar

Although the use of Celsior has been recently described for heart, lung, liver, and kidney transplantation, no data are available on its use for clinical pancreas preservation.. We herein describe the results of 112 pancreas transplants preserved with either University of Wisconsin (UW; (n = 56) or Celsior (n = 56) solution at two Italian transplant centers. The groups were comparable with regard to all donor and recipient characteristics.. Mean cold and warm ischemia times were 10.1 +/- 2.2 hours and 37.2 +/- 8.2 minutes for UW compared to 10.8 +/- 2.4 hours and 38.3 +/- 6.7 minutes for Celsior (P = NS). Delayed endocrine pancreas function was recorded in two UW-preserved grafts (3.6%). Actuarial 1-year patient survival was 94.6% for UW as compared with 100% for Celsior (P = NS). Equivalent graft survival figures were 91.0% for UW as compared with 96.4% for Celsior (P = NS).. Within the range of cold ischemia times reported in this study, UW and Celsior solutions have similar safety profiles for pancreas transplantation.

Topics: Adenosine; Adult; Allopurinol; Blood Glucose; Disaccharides; Electrolytes; Female; Glutamates; Glutathione; Graft Survival; Histidine; Histocompatibility Testing; Humans; Insulin; Ischemia; Italy; Male; Mannitol; Middle Aged; Organ Preservation; Organ Preservation Solutions; Organ Transplantation; Pancreas; Pancreas Transplantation; Raffinose; Retrospective Studies; Survival Analysis; Tissue Donors

To evaluate the viability and energy metabolism of long warm ischemically damaged pancreas during preservation by the UW solution cold storage method.. The pancreas grafts subjected to 30-120 min warm ischemia were preserved by the UW solution cold storage method for 24 h. The tissue concentrations of adenine nucleotides (AN) and adenosine triphosphate (ATP) and total adenine nucleotides (TAN) were determined by using high performance liquid chromatography (HPLC) and the viability of the pancreas graft was tested in the canine model of segmental pancreas autotransplantation.. The functional success rates of pancreas grafts of groups after 30 min, 60 min, 90 min, 120 min of warm ischemia were 100%, 100%, 67.7%, 0%, respectively. There was an excellent correlation between the posttransplant viability and tissue concentration of ATP and TAN at the end of preservation.. The UW solution cold storage method was effective for functional recovery of the pancreas suffering 60-min warm ischemia. The tissue concentration of ATP and TAN at the end of 24 h preservation by the UW solution cold storage method would predict the posttransplant outcome of pancreas graft subjected to significant warm ischemia.

Topics: Adenosine; Adenosine Diphosphate; Adenosine Monophosphate; Adenosine Triphosphate; Allopurinol; Animals; Cold Temperature; Dogs; Energy Metabolism; Female; Glutathione; Graft Survival; Hot Temperature; Insulin; Ischemia; Islets of Langerhans; Male; Organ Preservation Solutions; Pancreas; Pancreas Transplantation; Raffinose

Topics: Allopurinol; Animals; Blood Flow Velocity; Intercellular Adhesion Molecule-1; Intestines; Ischemia; Male; Rats; Reperfusion Injury

Human pancreas preservation for islet transplantation holds additional challenges and considerations compared with whole pancreas transplantation. The purpose of this study was to clarify the limitations of the University of Wisconsin (UW) solution and the potentials of the two-layer method (TLM) for pancreas preservation before human islet isolation.. We retrospectively evaluated human islet isolation records between January 2001 and February 2003. One hundred forty-two human pancreata were procured from cadaveric donors and preserved by means of the UW solution (n=112) or TLM (n=30). Human islet isolations were performed using a standard protocol and assessed by islet recovery and in vitro function of islets.. Eight to ten hours of cold ischemia in the UW solution is a critical point for successful islet isolations. It is difficult to recover a sufficient number of viable islets for transplantation from human pancreata with more than 10 hours of cold storage in the UW solution. The overall islet recovery in the TLM group was significantly higher than in the UW group. With 10 to 16 hours of cold storage, the success rates of islet isolations remained at 62% in the TLM group but decreased to 22% in the UW group. Transplanted islets in the TLM group worked well in the recipients.. There are time limitations for using the UW solution for pancreas preservation before human islet isolation. The TLM is a potential method to prolong the optimal cold storage time for successful islet isolations.

Topics: Adenosine; Adult; Aged; Allopurinol; Cadaver; Fluorocarbons; Glutathione; Graft Survival; Humans; Insulin; Ischemia; Islets of Langerhans Transplantation; Middle Aged; Organ Preservation; Organ Preservation Solutions; Raffinose; Recovery of Function; Retrospective Studies

Cold ischemic injury plays an important role in short- and long-term function of kidneys after transplant. Antimicrobial peptides have not previously been studied for their impact on cold ischemia in transplanted kidneys.. Bactenecin (L- and D-forms) was added to University of Wisconsin (UW) preservation solution for 3-day cold storage of dog kidneys. Effects on membrane permeability were studied in synthetic liposomes and in kidney cortex tissue slices. The role of bactenecin as a tissue mitogen and direct cytoskeletal stabilizer were studied with cultured cells and in vitro.. Bactenecin (both L- and D- forms) resulted in significant decreases in postoperative serum creatinine and time required for return of creatinine to the normal range showing the effect was independent of chirality. Bactenecin permeabilized synthetic liposomes and altered kidney cortex tissue slice membrane permeability characteristics, irrespective of chirality. Neither did bactenecin act as a mitogen for either primary renal tubule or Madin-Darby canine kidney (MDCK) cells stored in UW solution, nor did it appear to directly affect cytoskeletal dynamics.. These results show that the antimicrobial peptide bactenecin can improve the quality of static cold storage of kidneys. The mechanism of its action is independent of receptor binding and does not appear to involve either an effect on the cytoskeleton or via activity as a mitogen. Current evidence best supports the hypothesis that bactenecin protects against cold ischemic injury by a controlled permeabilization of the membranes of the kidney during cold storage.

Topics: Actins; Adenosine; Allopurinol; Animals; Antimicrobial Cationic Peptides; Cell Line; Cold Temperature; Cryopreservation; Culture Media, Serum-Free; Cytoskeleton; Dogs; Dose-Response Relationship, Drug; Female; Fluoresceins; Glutathione; Insulin; Ischemia; Kidney; Kidney Tubules; Liposomes; Membranes; Microtubules; Mitogens; Organ Preservation; Organ Preservation Solutions; Paclitaxel; Peptides, Cyclic; Permeability; Protein Binding; Raffinose; Reperfusion Injury; Stereoisomerism; Temperature; Time Factors

We measured time course and extent of xanthine dehydrogenase (XD) to xanthine oxidase (XO) conversion in ischemic human and rat intestine. To model normothermic no-flow ischemia, we incubated fresh biopsies for 0, 2, 4, 8 and 16h. At t = 0h, XO was less in humans than in rats (P < 0.0004), while XD was essentially the same (P = NS). After 16h incubation at 37 degrees C, there was no appreciable XD-to-XO conversion and no change in neither XO nor XD activity in human intestine. In contrast, the rat intestine had XO/(XO + XD) ratio doubled in the first 2h and then maintained that value until t = 16 h. In conclusion, no XO-to-XD conversion was appreciable after 16 h no-flow normothermic ischemia in human intestine; in contrast, XO activity in rats increased sharply after the onset of ischemia. An immunohistochemical labelling study shows that, whereas XO + XD expression in liver tissue is localised in both hepatocytes and endothelial cells, in the intestine that expression is mostly localised in epithelial cells. We conclude that XO may be considered as a major source of reactive oxygen species in rats but not in humans.

Topics: Animals; Colon; Humans; Immunohistochemistry; In Vitro Techniques; Ischemia; Liver; Male; Rats; Rats, Sprague-Dawley; Xanthine Dehydrogenase; Xanthine Oxidase

Animal myocardial dysfunction induced by remote ischemia-reperfusion (IR) was shown to be partly accomplished via a direct effect of the pro-oxidant xanthine oxidase (XO). This direct remote effect was not tested in humans. We now assessed the performance of human auricles in the presence of solutions containing XO and/or allopurinol and compared them to those of rat myocardial strips.. Human and rat specimens (n=64) were separately exposed for 2h to Krebs-Henseleit solution that either (1) exited from rat livers that were earlier perfused for 2h (control-human or control-rat), (2) exited from livers that were earlier made ischemic for 2h (IR-human, IR-rat), (3) contained xanthine (X) 3.8 microM + XO 3 mU ml(-1) (X+XO-human, X+XO-rat), or (4) exited from post 2h-ischemic livers and contained 100 microM allopurinol (human or rat IR + allopurinol groups).. Unlike the unchanged electromechanical performance in the control and IR+allopurinol auricles and strips, the rates of contraction, maximal force of contraction and working index of either preparation were reduced by 75-98% (P<0.01) when exposed to the IR reperfusate or to the X+XO-enriched Krebs. The basal amplitudes of contraction in these four latter groups increased twofold (P<0.01). XO activity was similarly low in the control and in the IR+allopurinol groups, but four- to 45-fold (P<0.001) higher in the IR and the X+XO groups, both in the rat and human organs. The reduced glutathione was reduced by approximately 50% (P<0.01) in either preparation in the IR and the X+XO groups compared to the control and IR+allopurinol groups.. Remotely and exogenously originated oxidative burst directly induces electromechanical dysfunction and disrupts oxidant/antioxidant balance in human auricles as it does in the rat myocardial strip.

Topics: Aged; Allopurinol; Analysis of Variance; Animals; Atrial Appendage; Coculture Techniques; Electrophysiology; Glutathione; Humans; Ischemia; Liver; Middle Aged; Myocardial Contraction; Oxidants; Oxidative Stress; Rats; Reactive Oxygen Species; Time Factors; Xanthine Oxidase

Topics: Adenosine; Allopurinol; Animals; Body Weight; Dogs; Female; Glutathione; Hepatectomy; Hypertonic Solutions; Insulin; Ischemia; Liver; Liver Transplantation; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Reperfusion; Time Factors; Tissue and Organ Harvesting; Transplantation, Autologous

The deleterious effect of steatosis on transplanted livers is mainly related to a microcirculation impairment. We investigated the effect of preservation duration on the recovery of isolated perfused rat steatotic livers and tested the effect of pentoxifylline (PTX), known to have a beneficial effect on hepatic microcirculation.. Fatty rat livers were obtained using a diet able to induce an 80% to 100% microvesicular steatosis within 7 days. We studied the effect of the duration of preservation (12 hr, 18 hr, and 24 hr) on fatty and normal isolated perfused rat liver. PTX was added to University of Wisconsin solution during cold storage (30 mM/kg of weight) and at reperfusion (3 mM) (n=5 livers in each group). Lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, bile production, and vascular resistance were evaluated. The liver injury at the end of perfusion was assessed by optical and electron microscopy.. For a 24-hr preservation period, fatty livers demonstrated increased enzymatic release (aspartate aminotransferase: 42+/-16 vs. 17+/-5 IU/L/g of liver, P<0.005; alanine aminotransferase: 32+/-13 vs. 13+/-3 IU/L/g of liver, P<0.005; lactate dehydrogenase: 1,207+/-497 vs. 291+/-195 IU/L/g of liver, P<0.001). Vascular resistance (0.32 vs. 0.15 cm H(2)O/min/mL, P<0.0005) and bile output (67+/-24 vs. 141+/-61 mg/g of liver, P<0.05) were decreased. Peliosis appeared after an 18-hr preservation period for fatty livers compared with a 24-hr preservation period for controls. All these negative effects were suppressed by PTX.. Diffuse microvesicular steatosis became deleterious only after long preservation times (24 hr). PTX prevented this effect.

Topics: Adenosine; Allopurinol; Animals; Fatty Liver; Free Radical Scavengers; Glutathione; Insulin; Ischemia; Liver; Liver Circulation; Liver Function Tests; Male; Organ Preservation; Organ Preservation Solutions; Pentoxifylline; Raffinose; Rats; Rats, Wistar; Time Factors

Ischemic biliary lesions are a threatening complication following orthotopic liver transplantation. Their exact pathophysiological mechanism is unknown so far, but insufficient perfusion of biliary arterial vessels might be responsible for the development of these lesions. This might be changed by improved perfusion techniques. We performed a controlled study of cases since February 2000.. We used arterial back table pressure perfusion to achieve reliable perfusion of the capillary system of the biliary tract, which may be impaired by the high viscosity of University of Wisconsin solution. In this study, 190 orthotopic liver transplantations performed between September 1997 and July 2002 were investigated with regard to ischemic biliary lesions.. One hundred thirty-one grafts were preserved by in situ standard perfusion including portal perfusion,whereas additional arterial back table pressure perfusion was performed in 59 cases. Donor-related factors, recipient age, indications for transplantation, transplantation techniques, and ischemia times were comparable between groups. Twenty-one (16%) of the patients in the standard perfusion group and only one of the those receiving arterial back table pressure perfusion developed ischemic biliary lesions. This difference was highly significant (P=0.004). Maximal aspartate aminotransferase and alanine aminotransferase levels in the first 3 days were significantly lower in the arterial back table pressure perfusion group (P>0.05).. Arterial back table pressure perfusion is an easy and reliable method for preventing ischemic biliary lesions in orthotopic liver transplantation. It should, therefore, be the standard technique in liver procurement.

Topics: Adenosine; Adult; Allopurinol; Angiography; Biliary Tract; Capillaries; Cholestasis; Female; Follow-Up Studies; Glutathione; Hepatic Artery; Humans; Hydrostatic Pressure; Insulin; Intraoperative Complications; Ischemia; Liver Function Tests; Liver Transplantation; Male; Middle Aged; Organ Preservation Solutions; Perfusion; Postoperative Complications; Raffinose; Reperfusion Injury

The purpose of this study is to examine the possibility of a long-term preservation of the ischemically damaged intestine by the cavitary two-layer method (TLM) in canine small intestinal transplantation.. The grafts were allotransplanted without preservation immediately (group 1) or after 30 minutes of warm ischemia (group 2). The ischemically damaged grafts were also allotransplanted after cold preservation for 24 hours in University of Wisconsin (UW) solution (group 3) or the cavitary TLM (group 4). Seven-day survivals, tissue adenosine triphosphate (ATP) concentrations, absorption tests, and histopathology were examined.. seven-day survivals in groups 1, 2, 3, and 4 were 8 of 8, 6 of 8, 0 of 8, and 6 of 8, respectively. In group 4, significant recovery of ATP tissue level was seen after preservation compared with group 3, and absorption function and regeneration of the graft mucosa recovered at day 14.. Ischemically damaged canine small intestine could be preserved for 24 hours by the cavitary TLM.

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Cold Temperature; Dogs; Female; Glutathione; Graft Survival; Hot Temperature; Insulin; Intestine, Small; Ischemia; Male; Organ Preservation; Organ Preservation Solutions; Raffinose

A two-layer cold storage method (TLM) allows sufficient oxygen delivery to pancreata during preservation and resuscitates the viability of ischemically damaged pancreata. This study determined the effect of additional preservation of ischemically damaged human pancreata by the TLM before islet isolation. Human pancreata were procured from cadaveric organ donors and preserved by the TLM for 3.2 +/- 0.5 hours (mean +/- SEM) at 4 degrees C after 11.1 +/- 0.9 hours of cold storage in University of Wisconsin solution (UW) (TLM group), or by cold UW alone for 11.0 +/- 0.3 hours (UW group). Islet isolations of all pancreata were performed using the Edmonton protocol. Islet recovery and in vitro function of isolated islets were significantly increased in the TLM group compared with the UW group. In the metabolic assessment of human pancreata, ATP levels were significantly increased after the TLM preservation. This study showed that additional short-term preservation by the TLM resuscitates the viability of ischemically damaged human pancreata before islet isolation, leading to improvements in islet recovery and in vitro function of isolated islets.

Topics: Adenosine; Allopurinol; Cadaver; Cell Separation; Glutathione; Humans; Insulin; Ischemia; Islets of Langerhans; Organ Preservation; Organ Preservation Solutions; Pancreas; Raffinose; Resuscitation; Tissue and Organ Harvesting; Tissue Donors

The aim of this study was to evaluate the effect of allopurinol, methylene blue, and a monoclonal antibody to the adhesion molecule ICAM-1 in intestinal ischemia and reperfusion injury.. The rats were divided into 5 groups. CG (n = 8) was untreated controls, SISG (n = 11) received sterile isotonic saline solution, ICAMG (n = 12) received a monoclonal antibody to rat ICAM-1, ALLOG (n = 12) received allopurinol, and MBG (n = 14) received methylene blue. Intestinal ischemia was performed for 60 minutes followed by 60 minutes of reperfusion. The agents were injected 10 minutes before the reperfusion to animals. After 60 minutes of reperfusion, the plasma samples for myeloperoxidase (MPO) activity, tumor necrosis factor alpha (TNF-alpha) and uric acid levels, and the intestinal biopsies of ileum and jejunum for histopathologic examination were taken.. The mucosal damage was attenuated, and TNF-alpha level significantly decreased in ALLOG and ICAMG compared with SISG. The MPO activity was the lowest in ICAMG, and uric acid level was significantly decreased in ALLOG compared with the other groups. Methylene blue decreased TNF-alpha response to reperfusion injury but significantly increased the grade of the mucosal damage and the MPO activity.. This study shows that prereperfusion application of allopurinol and monoclonal antibody to the adhesion molecule ICAM-1 may attenuate the damage caused by intestinal ischemia and reperfusion, but the different time-points for application, the effects observed in the different ischemia and reperfusion durations, and the long-term results also should be investigated in the same experimental model before the final conclusion. Methylene blue was not effective to prevent or attenuate the intestinal tissue injury, but because this was the first study examining the effect of methylene blue on intestinal reperfusion injury, further studies with the different doses, ischemic duration, and application times will be needed.

Topics: Allopurinol; Animals; Antibodies, Monoclonal; Drug Evaluation, Preclinical; Ileum; Intercellular Adhesion Molecule-1; Intestines; Ischemia; Jejunum; Male; Methylene Blue; Peroxidase; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Tumor Necrosis Factor-alpha; Uric Acid

The objectives of this study were to compare the protective influence of exogenous nitric oxide on renal ischemia reperfusion (I/R) injury with that of the antioxidant vitamins C and E. Sprague-Dawley rats were divided into three groups ( n=12 per group). Normal saline solution was given in group 1, a vitamin C (200 mg/kg/d) plus vitamin E (100 mg/kg/d) combination in group 2 for 3 days before operating and Na-nitroprusside (5 mg/kg/d) in group 3 before reperfusion. The left kidneys were exposed to warm ischemia for 40 min followed by reperfusion for 90 min. The right kidneys were used as internal controls. After both kidneys were removed, histopathological examinations were performed, and oxidative and antioxidative parameters were measured. In the postischemic reperfused rat kidneys, the renal lipid peroxidation level was significantly lower, and the renal GSH level higher in the group given Na-nitroprusside compared with groups 1 and 2. Renal specific xanthine oxidase activity was also significantly lower in the group treated with Na-nitroprusside than in the groups given vitamins or saline. There was a significant, negative correlation between lipid peroxidation and reduced glutathione levels. Our results suggest that the exogenous nitric oxide (Na-nitroprusside) inhibits xanthine oxidase, and has more apparent preventive features for renal I/R injury than the antioxidant vitamins C+E.

Topics: Animals; Antioxidants; Ascorbic Acid; Glutathione; Ischemia; Kidney; Lipid Peroxides; Male; Nitric Oxide; Rats; Rats, Sprague-Dawley; Reference Values; Renal Circulation; Reperfusion Injury; Vitamin E; Xanthine Oxidase

This study was designed to evaluate whether ischemic preconditioning could confer protection against liver and lung damage associated with liver transplantation. The effect of preconditioning on the xanthine/xanthine oxidase (XOD) system in liver grafts subjected to 8 and 16 hours of cold ischemia was also evaluated. Increased xanthine levels and marked conversion of xanthine dehydrogenase (XDH) to XOD were observed after hepatic cold ischemia. Xanthine/XOD could play a role in the liver and lung damage associated with liver transplantation. This assumption is based on the observation that inhibition of XOD reduced postischemic reactive oxygen species (ROS) generation and hepatic injury as well as ensuing lung inflammatory damage, including neutrophil accumulation, oxidative stress, and edema formation. Ischemic preconditioning reduced xanthine accumulation and conversion of XDH to XOD in liver grafts during cold ischemia. This could diminish liver and lung damage following liver transplantation. In the liver, preconditioning prevented postischemic ROS generation and hepatic injury as well as the injurious effects in the lung following liver transplantation. Administration of xanthine and XOD to preconditioned rats led to hepatic ROS and transaminase levels similar to those found after reperfusion and abolished the protective effect of preconditioning on the lung inflammatory damage. In conclusion, ischemic preconditioning reduces both liver and lung damage following liver transplantation. This endogenous protective mechanism is capable of blocking xanthine/XOD generation in liver grafts during cold ischemia.

Topics: Animals; Cold Temperature; Ischemia; Ischemic Preconditioning; Liver; Liver Transplantation; Lung; Male; Organ Preservation Solutions; Pulmonary Edema; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Xanthine Oxidase; Xanthines

Topics: Adenosine; Allopurinol; Animals; Biological Transport; Cold Temperature; Dogs; Glutathione; Hepatocytes; Indocyanine Green; Insulin; Ischemia; Liver; Organ Preservation; Organ Preservation Solutions; Raffinose; Reperfusion

Ischaemia/reperfusion injury of the liver is the major cause of liver dysfunction and cellular death in transplantation and in liver resection with hepatic pedicle clamping. Many agents are used to prevent this phenomenon, which occurs following interaction of different mediators during both ischaemia and reperfusion. In this study, we aimed to assess the effects of allopurinol, a xanthine oxidase inhibitor, and pentoxifilline, on liver ischaemia/reperfusion injury when used together and to compare these with the effects of using these agents singly.. Thirty-two rats were divided into four groups consisting of eight rats: Group C, control; Group P, pentoxifilline; Group A, allopurinol; and Group PA, pentoxifilline + allopurinol. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) levels were measured before hepatic pedicle clamping, on the 45th minute of ischaemia and 15 and 45 minutes after reperfusion. Group P rats were injected with 50 mg/kg pentoxifilline, Group A rats 50 mg/kg allopurinol and Group PA rats were injected with both agents 15 minutes before hepatic pedicle clamping.. Ischaemia/reperfusion injury was produced by hepatic pedicle clamping, as demonstrated by AST, ALT and LDH increase. Injury prevention occurred in Groups P, A and PA. No significantly different (better) prevention was provided by giving allopurinol plus pentoxifilline to the rats. Furthermore, no difference was observed between the allopurinol and pentoxifilline injected groups in terms of preventing ischaemia/reperfusion injury.. Pretreatment with allopurinol or pentoxifilline resulted in significantly lower hepatic enzyme elevation than that in controls in the rat liver ischaemia/reperfusion model. Using both agents does not provide better protection than using either agent alone.

Topics: Allopurinol; Animals; Disease Models, Animal; Drug Therapy, Combination; Enzyme Inhibitors; Ischemia; Liver Circulation; Pentoxifylline; Rats; Reperfusion Injury

A two-layer (University of Wisconsin solution/perfluorochemical [UW/PFC]) cold-storage method delivers sufficient oxygen to the pancreas during preservation and restores the ischemically damaged pancreas. In this study, we determined whether the additional preservation by the two-layer method could improve islet recovery from human pancreases with prolonged cold storage in UW.. Human pancreases were procured from cadaveric organ donors and preserved by the two-layer method (UW/PFC) for 2.9+/-0.7 hours (mean+/-SEM) at 4 degrees C after 11.8+/-1.5 hours of cold storage in UW (UW/PFC group, n=7), or by cold UW alone for 11.3+/-0.3 hours (UW group, n=14). The selected pancreases met the criteria of having at least 10 hours of cold storage in UW. All were processed by using a standard protocol of Liberase perfusion with Pefabloc by way of the duct, gentle mechanical dissociation, and Ficoll gradient purification. Transplanted islets were selected with the criteria of the Edmonton protocol (>5,000 islet equivalents [IE]/kg recipient body weight).. The islet recovery was significantly increased in the UW/PFC group compared with the UW group (349.2+/-44.1 x 10 and 214.0+/-31.0 x 10 IE, respectively; <0.05). This resulted in islet yields of 4.6+/-1.0 x 10 IE/g of pancreas in the UW/PFC group compared with 2.0+/-0.3 x 10 IE/g of pancreas in the UW group ( <0.05). Five of 7 cases (71%) in the UW/PFC group and 5 of 14 cases (36%) in the UW group were transplanted. The islet grafts in the UW/PFC group improved the ability of glycemic control and decreased exogenous insulin administration in all recipients.. Improvements in methods to preserve and recover ischemically damaged human pancreases before islet isolation and transplant could be extremely beneficial to the field of clinical islet transplantation. This preliminary study shows that additional short preservation by the two-layer (UW/PFC) cold-storage method can significantly improve islet recovery and increase opportunities of islet transplantation from human pancreases after prolonged cold ischemia.

Topics: Adenosine; Adult; Aged; Allopurinol; Cell Separation; Female; Fluorocarbons; Glutathione; Graft Survival; Humans; Hypothermia, Induced; Insulin; Insulin Secretion; Ischemia; Islets of Langerhans; Islets of Langerhans Transplantation; Male; Middle Aged; Organ Preservation; Organ Preservation Solutions; Raffinose

Preconditioning protects against both liver and lung damage after hepatic ischemia-reperfusion (I/R). Xanthine and xanthine oxidase (XOD) may contribute to the development of hepatic I/R.. To evaluate whether preconditioning could modulate the injurious effects of xanthine/XOD on the liver and lung after hepatic I/R.. Hepatic I/R or preconditioning previous to I/R was induced in rats. Xanthine and xanthine dehydrogenase/xanthine oxidase (XDH/XOD) in liver and plasma were measured. Hepatic injury and inflammatory response in the lung was evaluated.. Preconditioning reduced xanthine accumulation and conversion of XDH to XOD in liver during sustained ischemia. This could reduce the generation of reactive oxygen species (ROS) from XOD, and therefore, attenuate hepatic I/R injury. Inhibition of XOD prevented postischemic ROS generation and hepatic injury. Administration of xanthine and XOD to preconditioned rats led to hepatic MDA and transaminase levels similar to those found after hepatic I/R. Preconditioning, resulting in low circulating levels of xanthine and XOD activity, reduced neutrophil accumulation, oxidative stress, and microvascular disorders seen in lung after hepatic I/R. Inhibition of XOD attenuated the inflammatory damage in lung after hepatic I/R. Administration of xanthine and XOD abolished the benefits of preconditioning on lung damage.. Preconditioning, by blocking the xanthine/XOD pathway for ROS generation, would confer protection against the liver and lung injuries induced by hepatic I/R.

Topics: Animals; Glutathione; Ischemia; Ischemic Preconditioning; Liver; Male; Malondialdehyde; Neutrophils; Rats; Rats, Wistar; Reactive Oxygen Species; Reperfusion; Superoxide Dismutase; Xanthine; Xanthine Dehydrogenase; Xanthine Oxidase

Topics: Adenosine; Allopurinol; Animals; Electron Spin Resonance Spectroscopy; Glutathione; Insulin; Iron; Ischemia; Liver; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Time Factors

Topics: Adenosine; Allopurinol; Animals; Blood Glucose; Glucose; Glutathione; Hyperinsulinism; Insulin; Ischemia; Mannitol; Organ Preservation; Organ Preservation Solutions; Pancreas; Pancreas Transplantation; Potassium Chloride; Procaine; Raffinose; Reperfusion; Swine; Temperature; Time Factors

Topics: Adenosine; Adult; Age Factors; Allopurinol; Body Mass Index; Cadaver; Cause of Death; Cell Separation; Female; Glutathione; Humans; Insulin; Ischemia; Islets of Langerhans; Male; Middle Aged; Organ Preservation Solutions; Raffinose; Retrospective Studies; Tissue and Organ Harvesting; Tissue Donors; Tissue Preservation

Topics: Adenosine; Allopurinol; Animals; Carrier Proteins; Fatty Acid-Binding Protein 7; Fatty Acid-Binding Proteins; Glutathione; Immunohistochemistry; Insulin; Intestine, Small; Ischemia; Jejunum; Male; Neoplasm Proteins; Nerve Tissue Proteins; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Inbred Lew; Time Factors

Hemodynamic disorders in brain dead organ donors induce hypoxia, warm ischemia and finally tissue damage. A cold preservation period also induces tissue and cellular lesions. The two major modes of preservation are cold storage (CS) and hypothermic pulsatile perfusion (HPP). We aimed to compare the influence of each mode of preservation and their combination on oxidative stress, perfusion characteristics and tissue damage, after a period of warm ischemia. Rat kidneys which had undergone ischemia (0, 30, 60 min) were preserved either by CS (12, 24 h), or by HPP (12 h), or by a combination of both (HPP+CS, CS+HPP), in University of Wisconsin cold storage solution (UWCSS) at + 4 degrees C. During HPP, renal vascular pressure decreased then increased to reach 90 mmHg after perfusion for 7 h. If HPP followed CS, the mean pressure reached 200 mmHg, showing successive high amplitude peaks. HPP had a deleterious effects on tissue structure with tubular necrosis, and induced an increase in catalase (Cat) and a decrease in manganese superoxide dismutase (Mn SOD) and gluthatione peroxidase (GPx) activity. Copper zinc superoxide dismutase (Cu/Zn SOD) activity was not reduced except with CS+HPP. During CS, we observed an increase in GPx, Cu/Zn SOD and Cat activity, a decrease in Mn SOD activity and no histological alterations in the kidney. CS induces a slight oxidative stress which is not important enough to induce major tissue damage. HPP with UWCSS induces a stronger stress, which overpowers the antioxidant defences, inducing tissue damage. The reperfusion of HPP with UWCSS emphasises the stress initiated by CS. In addition an increase in damage occurred in the CS + HPP group.

Topics: Adenosine; Allopurinol; Animals; Catalase; Cryopreservation; Glutathione; Glutathione Peroxidase; Hot Temperature; Insulin; Ischemia; Kidney; Male; Organ Preservation; Organ Preservation Solutions; Oxidative Stress; Perfusion; Pressure; Pulsatile Flow; Raffinose; Rats; Rats, Sprague-Dawley; Renal Circulation; Superoxide Dismutase

The relationship between zonal oxidative stress and cell death after ischemia-reperfusion injury in rat liver was investigated. Oxidative stress was detected in situ by perfusion with nitroblue tetrazolium, which is converted to insoluble blue formazan by reducting agents. Cell death was detected in situ by perfusion with trypan blue. When isolated liver was perfused after 30 or 60 min of warm ischemia, oxidative stress was detected in periportal parenchymal cells after 30 min of reperfusion. It spread in the shape of a doughnut to midzonal cells after 60 min of reperfusion. On the other hand, cell death was observed in parenchymal cells that were within the doughnut-like area in which oxidative stress was detected. The extent of oxidative stress and cell death was higher after 60 min of ischemia than after 30 min of ischemia. In nonparenchymal cells, oxidative stress was observed in midzonal and pericentral regions after only 12 min of reperfusion, but minor cell death was observed only in periportal and midzonal regions after 30 min of reperfusion. Administration of allopurinol, an inhibitor of xanthine oxidase, suppressed oxidative stress and cell death in periportal parenchymal cells. These findings indicate that periportal and midzonal parenchymal cell death can be caused by zone-specific and xanthine-oxidase-mediated oxidative stress in parenchymal cells.

Topics: Allopurinol; Animals; Cell Death; Free Radical Scavengers; Ischemia; Liver; Liver Circulation; Male; Microcirculation; Oxidative Stress; Portal Vein; Rats; Rats, Wistar; Reperfusion Injury; Time Factors

Reactive oxygen species generated by xanthine oxidase during reperfusion of ischemic liver might in part be responsible for ischemic organ injury. In normothermic ischemia/reperfusion rat model, we investigated whether allopurinol pretreatment improved ischemia-induced mitochondrial dysfunction. Rats were subjected to 60 min of hepatic ischemia and to 1 h and 5 h of reperfusion thereafter. At 18 h and 1 h before ischemia, the animals received 0.25 mL of either saline or allopurinol (50 mg/kg) i.p. In saline-treated ischemic rats, serum aspartate aminotransferase levels increased significantly at 5 h (4685 +/- 310 IU/L) and were significantly reduced with allopurinol pretreatment. Similarly, mitochondrial lipid peroxidation was elevated in the saline-treated ischemic group, but this elevation was prevented by allopurinol. In contrast, mitochondrial glutamate dehydrogenase activity and ketone body ratio decreased in the saline-treated group, but this decrease was also inhibited by allopurinol. Hepatic ATP levels in the saline-treated rats were 42% lower 5 h after reperfusion. However, treatment with allopurinol resulted in significantly higher ATP levels. Allopurinol treatment preserved the concentration of AMP in ischemic liver but inhibited the accumulation of xanthine in reperfused liver. Our findings suggest allopurinol protects against mitochondrial injury, which prevents a mitochondrial oxidant stress and lipid peroxidation and preserves the hepatic energy metabolism.

Topics: Allopurinol; Animals; Aspartate Aminotransferases; Energy Metabolism; Enzyme Inhibitors; Glutamate Dehydrogenase; Ischemia; Ketones; Lipid Peroxidation; Liver; Male; Mitochondria, Liver; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Xanthine Oxidase

We investigated the effect of a hydroxyl radical scavenger, 1,3-dimethyl-2-thiourea (dimethylthiourea), and two xanthine oxidase inhibitors, oxypurinol and allopurinol, on the threshold shift of the compound action potential (CAP) after transient ischemia of the cochlea. Transient ischemia of 30 min duration was induced in albino guinea pigs via a skull base approach. The animals were treated with perilymphatic perfusion of dimethylthiourea, oxypurinol or allopurinol from 10 min before the onset of ischemia to 4 h after the termination of ischemia. Dimethylthiourea ameliorated the CAP threshold shifts at 4 h after the onset of reperfusion in a dose-dependent manner. However, oxypurinol and allopurinol did not affect the post-ischemic cochlear dysfunction. These results imply that the hydroxyl radical plays an important role in generation of cochlear dysfunction induced by ischemia-reperfusion and that xanthine oxidase may not be the primary source of this radical.

Topics: Action Potentials; Allopurinol; Animals; Cochlea; Enzyme Inhibitors; Free Radical Scavengers; Guinea Pigs; Hydroxyl Radical; Ischemia; Oxypurinol; Reperfusion Injury; Thiourea; Xanthine Oxidase

The complex series of pathophysiologic alterations associated with obstruction nephropathy includes renal ischemia. Free-radical production follows relief of obstruction. We sought to determine whether free radicals caused additional reduction in blood flow after relief of obstruction.. In White-Landrace pigs, the left ureter was divided 6 cm distal to the ureteropelvic junction, and a nephrostomy tube was passed into the renal pelvis and exteriorized. A catheter was placed in the renal vein and exteriorized. Mean renal blood flow was measured before manipulation and during and after 6 hours of obstruction in animals receiving (N = 7) or not receiving (N = 7) allopurinol. The control groups were not subjected to ureteral obstruction and received (N = 7) or did not receive (N = 7) allopurinol. Free radicals in venous blood were measured by the Fox-1 assay for lipid peroxidation.. After obstruction, renal blood flow declined significantly by the sixth hour (-28.73% +/- 1.81). The increase after relief of obstruction was only temporary, and by the third hour, the blood flow was again reduced (-20.14% +/- 2.67). Free radical production was significantly increased, with a peak of +24.63% being found 60 minutes after relief of obstruction. Allopurinol prevented free radical production after relief of obstruction and was associated with a return of blood flow to baseline values.. Free radicals contribute to renal blood flow reduction after relief of ureteral obstruction. Functional impairment may be preventable by free radical blockade, but further studies are required to confirm this hypothesis.

Topics: Allopurinol; Animals; Female; Free Radical Scavengers; Free Radicals; Ischemia; Renal Circulation; Renal Veins; Reperfusion Injury; Swine; Ureteral Obstruction

Human lung allografts can only be preserved for 6 hours. Experimental interventions that reduce ischemia-reperfusion (I/R) lung injury can be used to improve the properties of the preservation solution. The best solution for lung preservation is still a matter of controversy. The purpose of this study was to compare the protective effects of various solutions on I/R lung injury in Sprague-Dawley rats.. The following solutions were compared: a physiological salt solution; an intracellular preservation solution (the University of Wisconsin Solution, UW); an extracellular preservation solution (EP3); and the extracellular preservation solution with the addition of various protective agents--EP3 plus dexamethasone (Dex) (EP3-a), plus glutathione (GLU) and allopurinol (ALL) (EP3-b), and EP3 plus GLU, ALL, lactobionate (LACT), and raffinose (RAF) (EP3-c). I/R lung injury was induced by ischemia for either 45 or 60 minutes, followed by reperfusion for 60 minutes. Hemodynamic changes, lung weight gain (LWG), and capillary filtration coefficients were measured.. Both EP3 and UW preservation solutions had partial attenuation effects on I/R lung injury, but UW produced a better attenuation effect than EP3. Use of modified EP3 solutions containing either protective agents (GLU, ALL, or Dex) or impermeants (LACT and RAF) improved the ability of EP3 to reduce I/R lung injury. The LWG using the modified EP3-c solution was the lowest among all groups. UW induced pulmonary hypertension. After I/R challenge, pulmonary arterial pressure with EP3-c was lower than with UW. Based on a lower LWG and the changes in hemodynamics, EP3-c is a better lung preservation solution than UW and EP3.. Based on the attenuation of I/R injury, we conclude that there is no significant difference between intracellular UW and extracellular (EP3-a, EP3-b) preservation solutions in this rat model, but the addition of protective agents and impermeants to the solution are important. The findings suggest that EP3-c might be a better lung preservation solution than UW.

Topics: Adenosine; Allopurinol; Animals; Dextrans; Glucose; Glutathione; Hemodynamics; Heparin; Insulin; Ischemia; Lung; Lung Transplantation; Male; Organ Preservation Solutions; Organ Size; Phosphates; Prednisolone; Raffinose; Rats; Rats, Sprague-Dawley; Reperfusion Injury

The development of biliary strictures (BSs) after liver transplantation (LT) continues to affect 10% to 30% of patients, causing substantial morbidity. The cause of BSs is multifactorial, including technical, immune, and, in particular, ischemic factors. The importance of adequate flushing of the peribiliary arterial tree has been stressed. We hypothesized that high-viscosity (HV) preservation solutions in the donor do not completely flush the small donor peribiliary plexus, leading to inadequate preservation of the bile ducts and posttransplant BSs. To test this hypothesis, we retrospectively compared the incidence of BSs in 2 groups of adults undergoing LT using different types of aortic preservation solution in the donor: group 1 (n = 24), low-viscosity (LV) Marshall solution; and group 2 (n = 27), HV University of Wisconsin (UW) solution. All donors in both groups received additional portal flushes with UW. All LTs were performed between November 1995 and August 1998 at 2 centers by the same surgeon, eliminating a technical bias. Terminal duct-to-duct anastomosis was performed in all recipients except 1 patient in group 1, who underwent a bile duct-to-jejunum anastomosis. BSs were first suspected on clinical and biochemical grounds and then confirmed by endoscopic retrograde cholangiopancreatography. Identical medical protocols were used in all patients. One-year patient survival rates in groups 1 and 2 were 92% and 100%, respectively (P =.9). One-year graft survival was identical to patient survival. The incidence of BSs in group 1 was 4.1% (1 of 24 patients), compared to 29.7% in group 2 (8 of 27 patients; P =.02). The BS in group 1 occurred 4 months post-LT and was anastomotic. BSs in group 2 occurred between 1 and 12 months post-LT and were anastomotic, extrahepatic, intrahepatic, or combined intrahepatic and extrahepatic. There were no significant differences in the following factors between groups 1 and 2: donor age, local versus imported liver, split-liver or full-liver transplantation, incidence of multiple vessels in the donor liver, indications for LT, recipient age, T-tube versus no T-tube, post-LT peak aspartate aminotransferase level, and treatment for rejection. There was no hepatic artery thrombosis or primary nonfunction in either group. Interestingly, cold ischemia time (CIT) was longer in group 1, which had the least incidence of BSs (692 +/- 190 v 535 +/- 129 minutes in group 2; P =.001). Follow-up was longer in group 1 (28.9 +/- 8.

Topics: Adenosine; Adult; Allopurinol; Aorta; Biliary Tract; Cold Temperature; Constriction, Pathologic; Glutathione; Graft Survival; Humans; Hypertonic Solutions; Insulin; Ischemia; Liver Transplantation; Middle Aged; Organ Preservation; Organ Preservation Solutions; Raffinose; Retrospective Studies; Survival Rate; Time Factors; Tissue Donors; Viscosity

Functional irregularities due to damage after ischaemia-reperfusion vary depending upon the organs affected. High energy phosphates such as ATP and ADP are destroyed after ischaemia-reperfusion damage. Subsequently, protons and inorganic phosphates accumulate within the cells and the proton pumps such as adenosine triphosphatase (ATPase), which maintain intracellular ion balance are damaged. In the present study, malondialdehyde (MDA), a product of lipid peroxidation, was measured as an indicator of tissue damage. Additionally, we measured sodium-potassium-ATPase levels and determined the interactions between MDA and Na+-K+ ATPase levels. A total of 31 female guinea pigs were divided into four groups: sham operated guinea pigs (group 1), ischaemia-reperfusion (group 2), ischaemia-reperfusion + superoxide dismutase (SOD) (group 3), ischaemia-reperfusion + allopurinol (group 4). Following reperfusion, the livers of guinea pigs in each group were removed for histopathological examination and the levels of MDA and Na+-K+ ATPase were determined in homogenized tissue samples. There was a statistically significant (p < 0.05) reduction in tissue MDA levels in group 2 when compared with group 1. The level of tissue MDA in groups 3 and 4 was significantly lower than tissue MDA levels of group 2. However, there was a statistically significant (p < 0.05) reduction in tissue Na+-K+ ATPase levels of group 2 when compared with group 1. Similarly, the level of tissue Na+-K+ ATPase in groups 3 and 4 was significantly higher than the tissue Na+-K+ ATPase levels of group 2. The results of the histopathologic examination also revealed the beneficial effects of the use of SOD and allopurinol in preventing liver damage in cases of ischaemia-reperfusion. Although the levels of MDA and Na+-K+ ATP ase in group 2 were not equal to the level in group 1, antioxidant therapy significantly improved the tendency to reverse the effects of ischaemia-reperfusion and to protect the liver from damage due to ischaemia-reperfusion.

Topics: Adenosine Triphosphate; Allopurinol; Animals; Antimetabolites; Antioxidants; Disease Models, Animal; Female; Free Radical Scavengers; Guinea Pigs; Ischemia; Lipid Peroxidation; Liver; Malondialdehyde; Reactive Oxygen Species; Reperfusion Injury; Sodium-Potassium-Exchanging ATPase; Superoxide Dismutase

Prolonged cold ischemia has been shown to be an important factor in the development of posttransplant renal dysfunction. The exact mechanisms have not been completely defined. The expression of intercellular adhesion molecule-1 (ICAM-1) (CD 54) in rat kidneys stored in University of Wisconsin (UW) solution was studied in an attempt to correlate ischemia time with immunogenicity of the graft.. Kidneys from male Lewis rats were perfused with UW solution, removed, and bathed in UW solution at 4 degrees C for 4, 12, 24, and 48 h. For the evaluation of expression of ICAM-1, immunohistochemical staining, Western blotting, and semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR) were performed.. Immunohistochemical staining in normal, nonischemic kidneys revealed that glomerular capillaries expressed ICAM-1 but that tubular cells did not. The preserved kidneys were analyzed by immunohistochemistry, Western blotting, and semiquantitative RT-PCR and showed increased transcription and expression of ICAM-1 in the cortex of the kidney. Expression reached a maximum at 24 h and declined at 48 h. The ICAM-1 protein expression in the preserved kidney cortex relative to control kidneys was increased at 4 h (1.68 +/- 0.60-fold of control kidneys, P = 0.06), 12 h (2.38 +/- 0.90-fold, P = 0.02), 24 h (3.70 +/- 1.29-fold, P = 0.01), and 48 h (2.00 +/- 0.54-fold, P = 0.01). The messenger RNA expression (the ratio of ICAM-1 to glyceraldehyde-3-phosphate dehydrogenase) in preserved kidneys cortex relative to control kidneys was increased at 4 h (1.19 +/- 0.14-fold of control kidneys), 12 h (1.38 +/- 0.16-fold), 24 h (1.77 +/- 0.29-fold), and 48 h (1.19 +/- 0.12-fold) (P < 0.05 for all time points).. We conclude that cold preservation of rat kidneys in UW solution induces increasing levels of ICAM-1 cell surface expression and gene transcription. Further study is necessary to determine if this increase in adhesion molecule expression increases the immunogenicity of the allograft and contributes to the development of posttransplant renal dysfunction.

Topics: Adenosine; Allopurinol; Animals; Blotting, Western; Cryopreservation; Gene Expression; Glutathione; Immunohistochemistry; Insulin; Intercellular Adhesion Molecule-1; Ischemia; Kidney Cortex; Kidney Transplantation; Male; Organ Preservation Solutions; Raffinose; Rats; Rats, Inbred Lew; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger

Despite the established preservation method for major organs of perfusion followed by immersion at hypothermia, a standard preservation technique for skeletal muscle is still a matter of controversy. The purpose of this study is to examine the effect of perfusion on the preservation of skeletal muscle in amputated limbs.. The rat hindlimb was amputated for perfusion with Euro-Collins (EC) or University of Wisconsin (UW) solution at different perfusion pressures (40 or 100 cm-gravity). After certain ischemic periods (4 or 5 h), the skeletal muscle viability was determined by measuring the tissue content of adenosine triphosphate (ATP).. The UW solution perfusion group maintained better ATP levels than the EC solution group when the ischemic period was extended to 5 h. The perfusion pressure of 100 cm-gravity was more effective for preserving muscle viability than 40 cm-gravity with both EC and UW solutions.. UW solution might be adequate to preserve muscle viability and perfusion pressure is recommended at 100 cm-gravity rather than at minimal pressure (40 cm-gravity), which washes out stagnant blood.

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Glutathione; Hypertonic Solutions; Insulin; Ischemia; Male; Muscle, Skeletal; Organ Preservation Solutions; Perfusion; Raffinose; Rats; Rats, Inbred Lew; Tissue Preservation

The relative contribution of xanthine oxidase (XO) and leukocytes to tissue injury after short-term ischemia is unknown. In this study, we subjected three groups of rat spinotrapezius muscles to 30-min ischemia and 1-h reperfusion: 1) ischemia-reperfusion (I/R) + 0.9% saline, 2) I/R + superoxide dismutase, and 3) I/R + oxypurinol. A fourth group served as nonischemic control. We quantified the increase in resistance (%DeltaR) caused by leukocyte-capillary plugging concurrently with myocyte uptake of propidium iodide (PI) [expressed as no. of PI spots per total volume of perfused tissue (N(PI)/V)] and performed assays to quantify XO activity, thiobarbituric acid-reactive substances (TBARS), and myeloperoxidase (MPO). Groups 2 and 3 exhibited significant decreases in N(PI)/V relative to group 1. MPO levels and TBARS were similar among all groups, and mean %DeltaR was significantly reduced in groups 2 and 3 relative to group 1. However, elevated XO was observed in groups 1 and 2 relative to group 3 and nonischemic controls. These data are consistent with the hypothesis that XO, rather than toxic species produced by plugging or venule-adherent leukocytes, is responsible for postischemic damage in this model.

Topics: Animals; Capillaries; Cell Adhesion; Cell Movement; Female; Ischemia; Leukocytes; Lipid Peroxides; Muscle, Skeletal; Oxidants; Oxypurinol; Peroxidase; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Sodium Chloride; Superoxide Dismutase; Time Factors; Vascular Resistance; Xanthine Oxidase

Topics: Adenosine; Allopurinol; Cold Temperature; Diuresis; Glomerular Filtration Rate; Glutathione; Humans; Insulin; Ischemia; Kidney; Organ Preservation; Organ Preservation Solutions; Oxygen Consumption; Raffinose; Time Factors; Vascular Resistance

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Energy Metabolism; Glutathione; Insulin; Ischemia; Kidney; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Reperfusion; Trimetazidine

Acute lung reperfusion injury (ALI) frequently follows an ischemic event in another organ, such as organ transplantation. We recently demonstrated that lung priming with N-acetyl-L-cysteine (NAC) prevented liver ischemia-reperfusion (IR)-induced ALI pending on reduced glutathione (GSH) amount of replenishment. We now assessed the therapeutic effect of NAC-in preventing ALI caused by liver IR-if administered to the lung during liver reperfusion.. Rat isolated livers were stabilized (30 min) and then perfused with modified Krebs-Henseleit solution (control, n=20) or made globally ischemic (IR, n=20) for 2 hr. Rat lungs were isolated separately, ventilated, and stabilized (30 min) with Krebs plus 5% bovine albumin. Pairs of liver and lung were then reperfused together for 15 min, followed by only lung recirculation with the liver effluent for another 45 min. Three more controls (n=20 each) and three ischemic groups (n=20 each) included lungs which were treated with 100, 150 or 225 mg x kg(-1) NAC (0.5, 0.74, or 1.1 mmol, respectively) during the 15-min liver and lung reperfusion period.. Pulmonary artery and ventilatory pressures and vascular resistance increased by 60-80% of baseline, compliance decreased, and bronchoalveolar lavage volume and content were abnormally high in the IR-nontreated and the IR-100 lungs. Most parameters in IR-150 and IR-225 lungs remained almost similar to controls. Postinsult GSH content in IR-100, -150, and -225 lungs was at 20%, 110%, and 90% above the IR-nontreated lungs, respectively.. Lung treatment with NAC during its reperfusion with IR liver effluent prevented ALI. Lung GSH replenishment accounted for lung protection, but its content did not correlate directly with grade of protection; NAC itself seemingly afforded lung protection as well.

Topics: Acetylcysteine; Animals; Dose-Response Relationship, Drug; Free Radical Scavengers; Glutathione; Ischemia; Liver; Liver Circulation; Lung; Lung Diseases; Male; Perfusion; Pulmonary Circulation; Rats; Rats, Wistar; Reperfusion Injury; Respiration; Xanthine Oxidase

With increasing time of cold preservation, levels of high-energy nucleotides in the liver are reducing. The authors hypothesized that cold preservation sensitizes hepatocyte function to ischemic injury occurring during graft rewarming and that the injury can be prevented by short-term reperfusion. Rat livers were cold-preserved in University of Wisconsin solution for 0 to 18 hours and ischemically rewarmed for 0 to 45 minutes to simulate the implantation stage of transplantation. Hepatobiliary function was assessed using a blood-free perfusion model. In comparison with controls, neither 18-hour preservation nor 45-minute ischemic rewarming significantly influenced hepatocyte function. Compared with livers subjected to 45-minute ischemic rewarming, livers subjected to 9-hour preservation and 45-minute rewarming, and livers subjected to 18-hour preservation and 45-minute rewarming exhibited, respectively: 3.8 and 24 times reduced bile production, 4.3- and 116-fold decreased taurocholate excretion, and 3.1 and 42 times depressed bromosulfophthalein excretion. Thirty-minute oxygenated warm reperfusion after 9- and 18-hour preservation nearly completely blunted sensitization of hepatocyte function to rewarming ischemia. The authors found that short-term oxygenated reperfusion restored adenine nucleotides in liver tissue to the values found before organ preservation and that reperfusion with energy substrate containing solutions increased tissue adenosine triphosphate concentration to a higher level than that found before preservation. In conclusion, sensitization of hepatocyte function to rewarming ischemia increases disproportionally with storage time, suggesting that this phenomenon may play a role in graft dysfunctions with increasing liver preservation time. Short-term oxygenated reperfusion of the liver may protect hepatocyte functions against warm ischemic insult, even after extended preservation.

Topics: Adenosine; Allopurinol; Animals; Cold Temperature; Glutathione; Insulin; Ischemia; Liver; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Reperfusion; Time Factors

A brief period of liver ischemia decreases sinusoidal endothelial cell killing after cold liver storage and improves graft survival after liver transplantation, a phenomenon called ischemic preconditioning. In this study, we investigated the mechanism of sinusoidal endothelial cell protection after ischemic preconditioning. Livers were preconditioned by 5 minutes of ischemia and 5 minutes of reperfusion. Subsequently, livers were stored for 30 hours in cold University of Wisconsin (UW) solution and reperfused briefly with physiological buffer containing Trypan blue. Ischemic preconditioning decreased sinusoidal endothelial cell killing after storage/reperfusion, as assessed by Trypan blue staining of nonparenchymal cells. Adenosine A(2) receptor blockade prevented the protective effect of ischemic preconditioning. By contrast, adenosine A(1) receptor blockade did not prevent protective ischemic preconditioning. Other rat livers were treated with adenosine A(1) and A(2) receptor agonists or dibutyryl-cyclic adenosine monophosphate (DB-cAMP) before storage. The adenosine A(2) receptor agonist, CGS-21680, and DB-cAMP decreased sinusoidal endothelial cell killing to the same extent as ischemic preconditioning, but the adenosine A(1) receptor agonist, 2-chloro-N(6)-cyclopentyladenosine (CCPA), had no effect. The adenosine A(2) agonist and prostaglandin E(2), another agent that preconditions sinusoidal endothelial cells against storage/reperfusion injury, but not the adenosine A(1) agonist, increased cAMP levels in cultured sinusoidal endothelial cells. In conclusion, an adenosine A(2) receptor pathway coupled to increased cAMP mediates sinusoidal endothelial cell protection by ischemic preconditioning.

Topics: Adenosine; Allopurinol; Animals; Cyclic AMP; Endothelium, Vascular; Glutathione; Insulin; Ischemia; Ischemic Preconditioning; Liver; Male; Organ Preservation Solutions; Purinergic P1 Receptor Agonists; Raffinose; Rats; Rats, Sprague-Dawley; Receptors, Purinergic P1; Reperfusion Injury

Some studies have shown that postischemic hepatic dysfunction is mainly due to oxygen free radicals that are generated by xanthine oxidase. The present study was undertaken to determine the effect of allopurinol, an inhibitor of xanthine oxidase, on oxidative stress, liver injury and histologic alterations induced by hepatic ischemia-reperfusion in rats.. One hundred and sixty Wistar rats were used and divided into three groups. Group 1: sham operation; group 2: 50 min of ischemia followed by 1 h of reperfusion, and group 3: pretreatment with allopurinol and 50 min of ischemia followed by 1 h of reperfusion. The effect of allopurinol was evaluated by plasma levels of alanine aminotransferase and aspartate aminotransferase, histopathologic studies, and lipid peroxidation measured by the thiobarbituric acid reactive substances method and chemiluminescence initiated by tert-butyl hydroperoxide technique.. Ischemia followed by reperfusion promoted an increase in lipid peroxidation of the hepatic cells when compared to the sham-operated group (p<0.05). This increase was attenuated in the group treated with allopurinol (p< 0.05). Allopurinol also showed a protective effect on hepatocellular necrosis (p<0.05), and the plasma levels of liver enzymes returned earlier to the normal range in rats pretreated with allopurinol in comparison to those that did not receive the drug (p<0.05).. Allopurinol exerted a protective effect on hepatic ischemia and reperfusion in rats. The administration of this drug prior to liver operations should be considered to be submitted to trials in humans.

Topics: Alanine Transaminase; Allopurinol; Animals; Aspartate Aminotransferases; Enzyme Inhibitors; Ischemia; Lipid Peroxides; Liver; Liver Circulation; Male; Rats; Rats, Wistar; Reperfusion Injury; Time Factors

Hyperoxic reperfusion from global ischemia worsens functional outcome because of oxygen radical-mediated injury. This study tested the hypothesis that hyperoxic reperfusion would exacerbate postischemic renal dysfunction.. Twenty-nine healthy, uninephrectomized, male mongrel rabbits (Oryctolagus cuniculus) in 3 groups were subjected to 30 minutes of complete normothermic renal ischemia followed by reperfusion under hyperoxic or normoxic conditions. The groups were: hyperoxically reperfused (n = 8), normoxically reperfused (n = 8), hyperoxic sham (no ischemia, n = 5), and allopurinol-pretreated (50 mg/kg, intravenously), hyperoxically reperfused animals (n = 8). Plasma concentrations of creatinine, urea nitrogen and electrolytes were measured at 0, 24, 48, and 72 hours after ischemia and served as functional outcome markers. Histopathologic analysis of kidneys for injury was performed by an expert who was blinded to the procedures.. Plasma creatinine in hyperoxically reperfused rabbits was significantly elevated above normoxic (P =.02) and sham (P =.003) animals by 48 hours and remained elevated to 72 hours. Plasma urea nitrogen in hyperoxically reperfused rabbits was significantly elevated above the normoxic group (P = .01), the sham group (P = .02), and the allopurinol group (P = .04) by 72 hours. These coincided with a significantly elevated histopathologic injury score in hyperoxically reperfused rabbits compared with sham (P = .019), normoxic (P = .035), and allopurinol-pretreated hyperoxically reperfused animals (P = .037).. Hyperoxic reperfusion exacerbates renal dysfunction after 30 minutes of complete normothermic ischemia. This dysfunction may be mediated by oxygen radical-related injury.

Topics: Allopurinol; Animals; Antioxidants; Blood Urea Nitrogen; Creatinine; Hyperoxia; Ischemia; Kidney; Male; Rabbits; Reference Values; Renal Circulation; Reperfusion Injury

Our recent results indicate that pancreatic enzymes in the ischemic intestine are involved in the production of in vivo activators, which stimulate cells in the cardiovascular system and initiate multiple organ failure. Since the intestine is a rich source of xanthine oxidase (XO), we investigated whether XO may be involved in the production of circulating activators in shock. The small intestine was perfused with saline (SAL group), a broad acting pancreatic enzyme inhibitor, ANGD (ANGD group), allopurinol (ALLOP group), or a combination of ANGD and allopurinol (ANGD + ALLOP group). 100 min of splanchnic arterial occlusion was followed by 120 min of reperfusion. Leukocytes from asymptomatic volunteers were incubated with plasma from experimental animals, and the fractions of pseudopod positive cells were counted as an indicator for the activator. ANGD served to preserve the arterial blood pressure (MAP) close to its control values (96.6 +/- 6.2 % in ANGD versus 60.9 +/- 6.2 % in SAL, 120 min after reperfusion, P < 0.05). In line with our previous experiments, ANGD decreased the formation of activator (30.5 +/- 4.8% in SAL versus 7.3 +/- 1.6 % in ANGD, 120 min after reperfusion, P< 0.05). Although allopurinol inhibited the XO in the small intestine, no protection from early indicators of multi-organ injury was detected. The recovery of MAP and reduced levels of plasma activator achieved in the ANGD + ANGD group was similar to those in the ALLOP group. These results indicate that XO may not serve as a significant source for plasma derived activators in an acute phase of shock after severe intestinal ischemia.

Topics: Allopurinol; Animals; Benzamidines; Bile; Blood Pressure; Duodenum; Guanidines; Intestinal Mucosa; Ischemia; Leukocytes; Male; Multiple Organ Failure; Neutrophils; Protease Inhibitors; Rats; Rats, Wistar; Xanthine Dehydrogenase; Xanthine Oxidase

We have shown previously that rats subjected to tourniquet shock develop an acute form of remote organ injury of the liver that is both Kupffer cell (KC) and polymorphonuclear (PMN) leukocyte dependent. Circulating plasma xanthine oxidase (XO) has been shown to be responsible for the development of endothelial dysfunction and for remote organ injury of the lung and intestine after ischemia-reperfusion protocols. We now hypothesize that XO is released from rat hind limbs upon reperfusion and that it is responsible for KC and PMN leukocyte activation in this shock model. Our results show that about 30% of rat gastrocnemius muscle xanthine dehydrogenase (XD) is converted to XO during the 5-h tourniquet period and that it is released into the femoral vein within 10 min of reperfusion. Total muscle xanthine oxidoreductase activity (XO + XD) decreases within 30 min of reperfusion and is paralleled by a corresponding increase in femoral vein lactic dehydrogenase. In addition, liver tissue XO increases significantly within 30 min of reperfusion without a corresponding conversion of endogenous XD. Conversion of hepatic XD becomes evident 60 min after reperfusion is initiated, as does XO, and alanine aminotransferase (ALT) release into the hepatic vein, presumably from damaged hepatocytes as a consequence of oxidative stress. Tissue myeloperoxidase activity also increases significantly after the 60-min reperfusion period. That XO mediates KC and PMN activation is supported by the following observations: a) the close relationships between plasma XO and the time courses of tumor necrosis factor-alpha TNFalpha release into the hepatic vein and colloidal carbon clearance by KCs; b) that colloidal carbon clearance, TNFalpha and ALT release, loss of tissue free thiols, lipid peroxidation (TBARS), and liver infiltration by PMN neutrophils can also be induced by the administration of exogenous XO to normal rats; and c) pretreatment of rats with allopurinol inhibits KC activation and liver leukocyte infiltration. These results suggest that XO, released from the ischemic limb on reperfusion, is taken up by the liver were it mediates KC and PMN neutrophil activation and thus contributes to the development of multiple system organ failure after hind limb reperfusion.

Topics: Alanine Transaminase; Animals; Female; Hindlimb; Ischemia; Kupffer Cells; L-Lactate Dehydrogenase; Liver; Macrophage Activation; Muscle, Skeletal; Neutrophils; Oxidative Stress; Rats; Rats, Sprague-Dawley; Reperfusion; Shock; Time Factors; Tourniquets; Xanthine Dehydrogenase; Xanthine Oxidase

Questions as to the critical stress factor and primary targets of cold ischemia/reperfusion (CIR) injury were addressed by comparing mitochondrial defects caused by (1) CIR injury and (2) intracellular Ca2+ overload. CIR was simulated in transformed human umbilical vein endothelial cell cultures (tEC) by 8 h cold anoxia in University of Wisconsin solution and reoxygenation at 37 degrees C. Intracellular Ca2+ concentrations were changed by permeabilization of suspended cells with digitonin in culture medium (RPMI, 0.4 mM Ca2+). Binding of free Ca2+ by ethylene glycol-bis(beta-aminoethylether)-N,N,N',N'-tetraacetic acid in RPMI or mitochondrial incubation medium served as controls. Extracellular Ca2+ protected the cell membrane against permeabilization. Mitochondrial functions were determined before and after permeabilization of the cell membrane. After CIR, mitochondrial respiratory capacity declined, but oxygen consumption remained coupled to adenosine triphosphate (ATP) production. In contrast, Ca2+ overload caused uncoupling of mitochondrial respiration. High intracellular Ca2+ overload, therefore, does not reproduce cold ischemia/reperfusion injury in endothelial cells.

Topics: Adenosine; Allopurinol; Calcium; Cell Hypoxia; Cell Line, Transformed; Cell Membrane Permeability; Cells, Cultured; Cold Temperature; Egtazic Acid; Endothelium, Vascular; Glutathione; Humans; Insulin; Ischemia; Mitochondria; Organ Preservation Solutions; Oxygen Consumption; Raffinose; Reperfusion Injury; Umbilical Veins

Changes in cytosolic and mitochondrial calcium content were studied in an endothelial cell model after simulating cold ischemia reperfusion injury. Image analysis demonstrated that only a subpopulation of mitochondria in endothelial cells accumulate calcium. Observations led to the hypothesis that mitochondria which are in close contact with the plasma membrane are mainly affected by the Ca2+ efflux across that membrane, while those in other parts of the cell remain unaffected.

Topics: Adenosine; Allopurinol; Calcium; Cells, Cultured; Cytosol; Endothelium, Vascular; Glutathione; Humans; Insulin; Ischemia; Mitochondria; Organ Preservation Solutions; Raffinose; Reperfusion; Umbilical Veins

Topics: Adenosine; Allopurinol; Animals; Glutathione; Heart Arrest; Hepatic Veins; Insulin; Ischemia; Liver; Liver Circulation; Male; Organ Preservation; Organ Preservation Solutions; Oxygen; Raffinose; Rats; Rats, Wistar; Reperfusion; Reperfusion Injury; Superoxide Dismutase; Tissue Donors

Topics: Adenosine; Allopurinol; Animals; Catalase; Glutathione; Glutathione Peroxidase; Insulin; Ischemia; Isoenzymes; Kidney; Kidney Tubular Necrosis, Acute; Models, Animal; Organ Preservation; Organ Preservation Solutions; Perfusion; Raffinose; Rats; Rats, Sprague-Dawley; Reperfusion; Superoxide Dismutase; Temperature

The present study was carried out to elucidate the relationship between the generation of reactive oxygen species (ROS) and an activation of nuclear factor (NF) kappa B in a hepatic ischemia-reperfusion model. During the ischemic period, the contents of xanthine oxidase (XOD) metabolites and thiobarbituric acid-reactive substances were significantly increased, and NF-kappa B was activated in the liver of rats. The activation of NF-kappa B was inhibited by pretreatment of allopurinol (10-100 mg/kg, i.p.) in a dose-dependent manner. In conclusion, this suggests that the XOD-derived ROS may activate NF-kappa B during ischemia.

Topics: Animals; Ischemia; Liver; Male; NF-kappa B; Rats; Rats, Wistar; Reactive Oxygen Species; Thiobarbituric Acid Reactive Substances; Xanthine Oxidase

Applying the orthotopic rat liver transplantation (ORLT) model, postoperative survival has been shown to be mainly dependent on the portal vein clamping time (PVCT). It was hypothesized that prolonged intestinal congestion was responsible for the activation of Kupffer cells (KC) with overproduction of TNF, secondary to splanchnic endotoxin accumulation and release on reperfusion. The role of KCs was directly investigated in the context of long PVCTs by eliminating them (using liposome-encapsulated dichloromethylene diphosphonate), by preventing their activation (using a calcium channel blocker, nisoldipine) and by inhibiting TNF production (using thalidomide). Livers from different groups of rats were transplanted following 24-h cold preservation in the UW solution with long PVCTs (from 18-21 min). KCs depletion, preservation with nisoldipine and pretreatment with thalidomide significantly improved survival in conditions using long PVCTs. KC depletion and nisoldipine preservation had no effect on liver enzymes or pathological findings while lung injury was significantly improved. The present data confirm that, in the context of ORLT with long PVCTs, KCs are directly responsible for the systemic endotoxin-like shock syndrome and their effect is mediated through overproduction of TNF.

Topics: Adenosine; Adenosine-5'-(N-ethylcarboxamide); Allopurinol; Animals; Calcium Channel Blockers; Cell Count; Clodronic Acid; Cold Temperature; Constriction; Glutathione; Graft Survival; Hepatectomy; Immunosuppressive Agents; Insulin; Ischemia; Kupffer Cells; Liposomes; Liver; Liver Transplantation; Lung; Macrophage Activation; Male; Nisoldipine; Organ Preservation Solutions; Portal Vein; Postoperative Complications; Raffinose; Rats; Rats, Inbred Lew; Reactive Oxygen Species; Shock; Thalidomide; Time Factors; Tissue and Organ Procurement; Tumor Necrosis Factor-alpha

The effect of allopurinol (an inhibitor of xanthine oxidase) on oxidative stress, renal dysfunction, and histologic alterations was evaluated during the renal ischemia--reperfusion in uninephrectomized rats. Renal malondialdehyde and serum creatinine levels significantly increased after renal ischemia--reperfusion. However, the pretreatment with allopurinol demonstrated a protector effect in these parameters. Renal ischemia--reperfusion provoked a significant renal damage in the operated group. Tubular atrophy and interstitial fibrosis were attenuated by allopurinol when given prior to the surgery. In our study, allopurinol had a strong tendency to exert a beneficial effect during renal ischemia--reperfusion in uninephrectomized rats.

Topics: Allopurinol; Animals; Creatinine; Ischemia; Kidney; Lipid Peroxidation; Male; Nephrectomy; Rats; Rats, Wistar; Reactive Oxygen Species; Reperfusion; Xanthine Oxidase

A method is described for isolating human hepatocytes from tissue fragments after warm and cold ischemia as experienced during hepatic resections. Cells with a high trypan blue dye exclusion and good culture characteristics were isolated by employing an initial tissue perfusion with UW solution. The method could facilitate transfer of liver tissues between distant centers for cell isolation studies.

Topics: Adenosine; Adult; Aged; Allopurinol; Cell Separation; Cold Temperature; Female; Glutathione; Hepatectomy; Humans; In Vitro Techniques; Insulin; Ischemia; Liver; Male; Middle Aged; Organ Preservation; Organ Preservation Solutions; Raffinose; Temperature

Ischemia triggers secretion of proteins from the intestine, including type II secretory phospholipase A2 (sPLA2). This "secretory event" was studied in intestinal grafts during the first few hours of preservation by measuring total protein, sPLA2, and other enzymes in the UW preservation solution over time. The effect of PX-13, a PLA2 inhibitor, was also studied.. Twenty-five centimeter intestinal grafts were harvested from Lewis rats, flushed, and preserved in UW solution +/- PX-13 at 4 degrees C. UW samples from 0 to 48 h (n = 5 each) were analyzed for total protein, sPLA2, lactate dehydrogenase (LDH), N-acetylglucosamine (NAGA), and lysozyme. Nonpreserved grafts were homogenized in PBS as tissue controls. Standard biochemical methods were used for all assays.. Total protein increased rapidly by 5 min, continued to rise more slowly until 30 min, and then stabilized. The most significant increase in sPLA2 activity occurred between 90 and 180 min. NAGA increased most markedly between 30 and 180 min, while LDH increased in the first 30 min, although the level of both enzymes was negligible compared to tissue enzyme. Lysozyme levels were minimal at all times. PX-13 decreased sPLA2 activity markedly at all time points.. Total protein levels increased before sPLA2, suggesting that sPLA2 may be secreted in response to other proteins or enzymes released even earlier during preservation (e.g., cytokines). These elevations do not appear to be caused by cell death. Phospholipase A2 secretion may be blocked, and this may greatly improve the outcome of intestinal preservation.

Topics: Acetylglucosamine; Adenosine; Allopurinol; Animals; Cryopreservation; Glutathione; Insulin; Intestinal Mucosa; Intestines; Ischemia; L-Lactate Dehydrogenase; Male; Muramidase; Organ Preservation Solutions; Phospholipases A; Phospholipases A2; Proteins; Raffinose; Rats; Rats, Inbred Lew

In this study various methods for the prevention of oxidative stress due to tourniquet application were compared. An ischemia period of two hours followed by a reperfusion period of one hour was produced in the right posterior limb in 32 rats. In the first group no treatment was given. In the second group local cold application was performed before and after ischemia. In the third group allopurinol was given orally for 5 days before the procedure. In the fourth group both local hypothermia application and oral allopurinol treatment were given. Ultrastructural study of the gastrocnemius muscles in the various groups revealed that the least damage in the ultrastructure of the striated muscle was obtained using allopurinol alone and using a combination of allopurinol and local hypothermia. When tissue glutathione levels were measured, it was seen that a combination of allopurinol and local hypothermia was the best treatment for preventing oxidative stress.

Topics: Administration, Oral; Allopurinol; Animals; Free Radical Scavengers; Glutathione; Hindlimb; Hypothermia, Induced; Ischemia; Mitochondria, Muscle; Muscle Fibers, Skeletal; Muscle, Skeletal; Myofibrils; Oxidative Stress; Rats; Rats, Wistar; Sarcolemma; Tourniquets

Free radical scavengers have been utilized to prevent the consequences of ischemia, however, results do not seem conclusive. In our study we analyzed the blood flow, function, and histology of rat liver tissue after warm liver ischemia, in order to assess the effect of free radicals in liver reperfusion injury. N-acetyl cysteine (NAC), tocopherol, allopurinol, and superoxide dismutase (SOD), pharmacological agents expected to protect from injury mediated by free radicals, were investigated. Laser Doppler flowmetry and photometry were utilized to measure post-ischemic microcirculatory changes as an expression of ischemia-reperfusion injury in a model of segmental liver ischemia in the rat, with an ischemic time of 45 min. Galactose elimination capacity, ALT and histology were used to assess the functional and morphological consequences of ischemia after 24 h of reperfusion. The overall mean blood flow over 1 hour after reperfusion was of 33.9% (SD 11.2) of the normal, non-ischemic control. NAC (31.2% SD 10.9) did not show any protective effect and in some cases the effect seemed to be negative. Tocopherol (41.7% SD 5.1) marginally improved post ischemic liver tissue blood flow. Treatment with allopurinol did not show any beneficial effects (37.5% SD 14.2). Only animals treated with SOD showed an improvement of the post ischemic liver microcirculation (57.9% SD 14.4)(P < 0.001) and function. Only SOD produced statistically significant differences in galactose elimination capacity, compared with those of the ischemic control group. This moderately protective effect of SOD is encouraging, however, the relevance of all these compounds in a broader pathophysiological setting remains unproven.

Topics: Acetylcysteine; Allopurinol; Animals; Free Radical Scavengers; Galactose; Ischemia; Liver; Liver Function Tests; Male; Microcirculation; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Superoxide Dismutase; Vitamin E

Renal ischemia injures the renal tubular cell by disrupting the vital cellular metabolic machinery. Further cell damage is caused when the blood flow is restored by oxygen free radicals that are generated from xanthine oxidase. Oxygen radicals cause lipid peroxidation of cell and organelle membranes, disrupting the structural integrity and capacity for cell transport and energy metabolism. In the present study, the possible therapeutic usefulness of the adenosine deaminase inhibitor, 2'-deoxycoformycin (DCF), during renal ischemia and reperfusion injury was investigated. The effects of DCF on renal malondialdehyde (MDA) and ATP levels were studied after 45 min ischemia and 15 min subsequent reperfusion in rat kidneys. MDA levels remained unchanged during ischemia, but increased after the subsequent reperfusion. DCF pretreatment (2.0 mg/kg i.m.) decreased MDA and increased ATP levels during the ischemia-reperfusion period. DCF exerts a dual protective action by facilitating purine salvage for ATP synthesis and inhibiting oxygen radical-induced lipid peroxidation. These results suggest that DCF therapy could be beneficial in the treatment of ischemia-reperfusion renal injuries.

Topics: Adenosine; Adenosine Deaminase Inhibitors; Adenosine Triphosphate; Animals; Antioxidants; Enzyme Inhibitors; Ischemia; Kidney; Lipid Peroxidation; Male; Malondialdehyde; Oxidative Stress; Pentostatin; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Reperfusion Injury; Thiobarbituric Acid Reactive Substances; Xanthine Oxidase

Reperfusion injury following lung preservation has been associated with free radical formation and subsequent endothelial cell damage. Trolox is a water-soluble analogue of the free radical scavenger alpha-tocopherol. We hypothesized that addition of this form of vitamin E to University of Wisconsin (UW) solution would decrease reperfusion injury and improve lung function after cold ischemic preservation.. Bovine aortic endothelial cells were cultured and stored at 4 degrees C for 12, 24, and 48 h in UW or UW + Trolox (UWT). Endothelial cell viability after storage was assessed by dimethylthiazole tetrazolium cytotoxicity assay. An isolated rat perfused lung (IPL) model was used and lungs were flushed with the respective solutions with cold storage times of 6 and 12 h. Following storage, the lungs were reperfused with fresh blood and lung function was assessed by blood gas analysis, alveolar-arterial gradient, and compliance.. There was no difference in endothelial cell viability between UW and UWT after 12 or 24 h; however, UWT had higher endothelial cell viability than UW with 48 h of cold ischemic storage. Using the IPL model, the pO2 was higher with UWT than UW after 6 and 12 h of cold ischemia. The alveolar-arterial oxygen difference was significantly lower for UWT versus UW at 6 h. UWT provided increased compliance at 6 and 12 h of ischemia.. The addition of a water-soluble vitamin E analogue to UW solution resulted in increased endothelial cell viability after prolonged storage and improved whole lung preservation in the postreperfusion period as evidenced by higher oxygenation and increased compliance. These results are clinically relevant as the lung is extremely sensitive to reperfusion injury and UW solution is being increasingly used in lung transplantation and remains the predominant solution in abdominal organ transplantation.

Topics: Adenosine; Allopurinol; Animals; Cattle; Cells, Cultured; Child; Chromans; Endothelium, Vascular; Glutathione; Humans; In Vitro Techniques; Insulin; Ischemia; Lung; Organ Preservation Solutions; Pulmonary Circulation; Raffinose; Rats; Rats, Inbred Lew; Reperfusion Injury; Solubility; Vitamin E

In order to investigate locally produced mediators during the process of organ storage in liver transplantation, we collected the liver preservation solution effluent of 15 transplanted livers and compared it with serum samples taken preoperatively from donor and recipient, as well as 60 min after reperfusion. The mean ischemia time +/- SEM was 10 h 10 min +/- 53 min. Mean concentrations in University of Wisconsin preservation solution effluent were: interleukin-(IL-)1beta 154 +/- 77 pg/ml; IL-1 receptor antagonist (IL-1 ra) 1281 +/- 309 pg/ml; IL-6 412 +/- 90 pg/ml; and for tumor necrosis factor-(TNF-)alpha 74 +/- 21 pg/ml. Cytokine levels in the donors were lower than those detected in the effluent. All measured cytokines showed higher concentrations in the effluent compared to those of the recipient prior to the operation. With respect to a comparison of donor and recipient values, no correlation is evident. Likewise, the ischemic time does not correlate with effluent values. Further development of liver preservation concepts requires information about the state of the graft before reperfusion. Data on cytokine liberation may serve as a helpful tool for the further development of preservation concepts because they enable an estimation of cell activation during preservation.

Topics: Adenosine; Adult; Allopurinol; Cytokines; Female; Glutathione; Humans; Insulin; Interleukin 1 Receptor Antagonist Protein; Interleukin-1; Interleukin-6; Ischemia; Liver; Liver Transplantation; Male; Middle Aged; Organ Preservation; Organ Preservation Solutions; Raffinose; Sialoglycoproteins; Tissue Donors; Tumor Necrosis Factor-alpha

The purpose of this study was to investigate whether ischemia and subsequent reperfusion would affect xanthine oxidase activity in fetal rat brain capillaries.. We used rats on day 19 of pregnancy. Fetal ischemia was induced by bilateral occlusion of the utero-ovarian artery for 20 minutes. Reperfusion was achieved by releasing the occlusion to restore the circulation for 30 minutes. Control rats underwent a sham operation. Fetal brain capillaries were isolated for measurement of concentrations of hypoxanthine, xanthine, and uric acid, as well as of concentrations of thiobarbituric acid-reactive substances. The brain capillaries were incubated with hypoxanthine for 1-5 hours at 25 degrees C. The activity of xanthine oxidase was estimated by measuring the amount of xanthine converted from hypoxanthine.. Occlusion for 20 minutes markedly increased the concentration of hypoxanthine but had no effect on levels of xanthine, uric acid, and thiobarbituric acid-reactive substances. However, subsequent reperfusion led to significant increases in the levels of xanthine, uric acid, and thiobarbituric acid-reactive substances. Xanthine oxidase activity, as measured by the amount of xanthine produced, was significantly greater in the animals subjected to both ischemia and ischemia-reperfusion compared with the control group.. Ischemic insult led to the accumulation of hypoxanthine and stimulated xanthine oxidase activity in fetal brain capillaries. Subsequent reperfusion enhanced the degradation of hypoxanthine to uric acid, which may induce cerebral lipid peroxidation.

Topics: Animals; Arteries; Brain; Capillaries; Constriction; Female; Fetus; Hypoxanthine; Ischemia; Ovary; Pregnancy; Rats; Rats, Wistar; Reperfusion; Thiobarbituric Acid Reactive Substances; Uric Acid; Uterus; Xanthine; Xanthine Oxidase

1. This study examined the impact of allopurinol on the renal functional responses to a 30 min period of ischaemia in anaesthetized rats. 2. Immediately on reperfusion, blood pressure rose transiently, while renal blood flow remained stable throughout at control values. Glomerular filtration rate was decreased by some 90% over the first and 80% over the sixth hour (P<0.001). 3. Allopurinol, 50 or 100 mg kg-1, had no effect on the blood pressure or renal blood flow responses over the 6 h reperfusion period but glomerular filtration decreased by 60% initially, and to less than 30% of basal at 6 h. 4. Urine flow and absolute sodium excretion increased 2 - 3 fold in the first 2 h but decreased thereafter. Fractional sodium excretion was 30 times higher for the first 2 h but decreased reaching some 10 fold higher at 6 h. In the presence of allopurinol, urine flow and absolute sodium excretion increased by 5 - 6 fold in the first 2 h, and fell by half by 6 h which was greater than in the vehicle group (P<0.01). Fractional sodium excretion increased 20 fold in the allopurinol animals in the first 2 h period, but fell at a faster rate (P<0.01) than in untreated rats. 5. Potassium excretion decreased (P<0.05) by one half for the 6 h reperfusion period but in the allopurinol animals it was minimally altered. 6. Allopurinol largely ameliorated the decrease in kidney haemodynamic and excretory function following an ischeamic period for the initial few hours of reperfusion.

Topics: Acute Disease; Allopurinol; Anesthesia; Animals; Blood Pressure; Disease Models, Animal; Glomerular Filtration Rate; Ischemia; Kidney; Male; Potassium; Rats; Rats, Wistar; Renal Artery; Renal Circulation; Reperfusion Injury; Sodium; Time Factors; Xanthine Oxidase

Topics: Adenosine; Allopurinol; Animals; Glutathione; Heart Arrest; Insulin; Ischemia; Kidney; Kidney Transplantation; Organ Preservation; Organ Preservation Solutions; Oxidative Stress; Rabbits; Raffinose; Renal Artery; Renal Veins; Reperfusion; Time Factors; Tissue Donors

Topics: Acetylcysteine; Allopurinol; Animals; Free Radical Scavengers; Ischemia; Liver; Liver Circulation; Male; Microcirculation; Organ Preservation; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Superoxide Dismutase; Temperature; Time Factors; Vitamin E

Topics: Acetylcysteine; Adenosine Triphosphate; Allopurinol; Animals; Glutathione; Heart; Intestine, Small; Ischemia; Liver; Lung; Malondialdehyde; Mesenteric Arteries; Multiple Organ Failure; Myocardium; Oxidative Stress; Peroxidase; Rats; Rats, Wistar; Reperfusion Injury; Somatostatin

Pyruvate dehydrogenase has been thought to be involved in the improved recovery of livers, from fasted donors, reperfused with alanine after cold preservation. The aim of this work was to investigate the effect on perfused mouse liver of dichloroacetate, an activator of this enzyme. Livers from fed and fasted animals were perfused with oxygenated Krebs-Henseleit buffer for 30 min, then stored at 4 degrees C in University of Wisconsin solution for 48 h. Then reperfusion at 37 degrees C was performed with Krebs-Henseleit buffer containing 2 mM dichloroacetate for 1 h. (3-(13)C)Alanine (8 mM) was then added and perfusion was continued for a second hour. (31)P-NMR was used to measure nucleoside triphosphate recovery of the livers. At the end of reperfusion, (13)C-NMR spectra of perfusates were recorded. Dichloroacetate (DCA) was found to activate pyruvate dehydrogenase in all cases. However, it decreased the functional recovery of livers from both fed and fasted mice. In order to study the effect of alanine on this DCA deleterious effect, we reperfused the livers according to a modified protocol. The first hour of perfusion without alanine was omitted and the organs were reperfused directly for 1 h in the presence of 2 mM dichloroacetate and 8 mM (3-(13)C)alanine. In this protocol, the deleterious effect of DCA was completely suppressed for livers from fasted mice. These results led to the conclusion that the specific beneficial effect of alanine on livers from fasted livers persists in the presence of DCA and thus cannot be explained solely by the induction of a greater pyruvate dehydrogenase reaction rate.

Topics: Adenosine; Alanine; Allopurinol; Animals; Carbon Isotopes; Cold Temperature; Cryopreservation; Dichloroacetic Acid; Fasting; Glutamine; Glutathione; Insulin; Ischemia; Liver; Male; Mice; Nuclear Magnetic Resonance, Biomolecular; Organ Preservation; Organ Preservation Solutions; Phosphorus; Raffinose; Reperfusion Injury; Tissue Donors

The present study was devised to elucidate the influence of prolonged cold ischemia on the development of chronic transplant dysfunction (CTD) in kidney isografts (Brown Norway-->Brown Norway; BN-->BN) and in kidney allografts (BN-->Wistar Agouti/ Rij [WAG]) under temporary cyclosporine (CsA) therapy.. To induce ischemic injury, BN donor kidneys were preserved for 24 hr in 4 degrees C University of Wisconsin solution before transplantation. Renal function (proteinuria), histomorphology according to the BANFF criteria for CTD, and infiltrating cells were assessed. Grafts were examined both early at days 2, 3, 6, and 10, and late at week 26 (allografts) or at week 52 (isografts).. Nonischemic isografts preserved a normal function and morphology. Ischemic isografts developed a progressive proteinuria over time and demonstrated significantly more glomerulopathy with macrophage (Me) infiltration and intimal hyperplasia than nonischemic controls at week 52. During the initial 10 days, there was an increased infiltration of MHC class II+ cells, predominantly CD4+ cells and Mphi, coinciding with up-regulated intercellular adhesion molecule-1 expression. CsA treatment in ischemic isografts inhibited infiltration of MHC II+ cells in the early stage, which was accompanied by significantly less renal damage at week 52 compared with untreated controls (proteinuria: 59+/-8 vs. 134+/-19 mg/24 hr; BANFF score: 2.8+/-0.4 vs. 4.3+/-1.0). Under CsA therapy, 24-hr cold ischemia of the allograft affected neither the onset or progress of proteinuria, nor the histomorphology (BANFF score: 7.8+/-2.4 vs. 7.3+/-1.9). In both ischemic and nonischemic allografts, intercellular adhesion molecule-1 expression and mononuclear cell infiltration (CD4, CD8, Mphi was abundantly present during the first 10 days and function deteriorated rapidly.. Prolonged cold ischemia plays a role in the induction of CTD, but its deleterious effect can be successfully inhibited by CsA. Therefore, the alloantigeneic stimulus is the overriding component in the multifactorial pathogenesis of CTD.

Topics: Adenosine; Allopurinol; Animals; Cryopreservation; Cyclosporine; Glutathione; Graft Rejection; Immunohistochemistry; Immunosuppressive Agents; Insulin; Ischemia; Kidney; Kidney Transplantation; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Inbred BN; Rats, Wistar; Time Factors; Transplantation, Homologous; Transplantation, Isogeneic

Orthotopic rat liver transplantation (ORLT) following extended cold preservation in University of Wisconsin (UW) solution has been shown to induce alterations of the hepatic microcirculation, mainly characterized by areas of no-reflow. The present study was performed to determine whether these alterations were related to the portal vein clamping time (PVCT), shown to be the main determinant of survival after ORLT. The hepatic microcirculation was evaluated using the multiple-indicator dilution curve (MIDC) technique after ORLT following 24-hour cold ischemia in UW solution. Two groups of rats were studied: one with PVCTs of less than 14 min (survival conditions) and one with PVCTs of more than 18 min (nonsurvival conditions). Four hours after ORLT, only long PVCTs were associated with small, but significant, nonperfused areas, about 10% of the liver not being perfused by water; however, in both survival and nonsurvival conditions, the sinusoidal sieving function was well-maintained in perfused areas. In addition, liver viability parameters and hepatocyte function were similarly and minimally altered. The hepatic microcirculation is minimally altered 4 h after ORLT following extended cold preservation in UW solution, whatever the survival condition. Although only found after long PVCTs, the low magnitude of areas of no-reflow should not be associated with lethal injury of the transplanted liver, a finding further supporting the concept that survival after ORLT following 24-hour cold preservation in UW solution is mainly influenced by extrahepatic factors.

Topics: Adenosine; Allopurinol; Animals; Constriction; Cryopreservation; Glutathione; Graft Survival; Insulin; Ischemia; Liver; Liver Circulation; Liver Transplantation; Male; Microcirculation; Organ Preservation; Organ Preservation Solutions; Portal Vein; Raffinose; Rats; Rats, Inbred Lew; Reperfusion Injury; Time Factors; Tissue and Organ Harvesting

Ischemia-reperfusion to the liver results in increased microvascular permeability in a nonischemic lung. We hypothesized that a circulatory mediator released from ischemic liver contributed to endothelial cell (EC) damage. Isolated rat livers, made ischemic for 2 h, were reperfused for 10 min. Bovine ECs were incubated for 5 h with pooled liver effluent collected before ischemia (Baseline) or after 10 min of reperfusion (Reperfusion). In the Reperfusion group, there was increased endothelial cell injury, as determined by release of 8-[14C]adenine, (39 +/- 2%) compared to the Baseline group (22 +/- 2%). Permeability of ECs to rhodamine B-labeled dextran (70,000 Mr) was also increased in the Reperfusion group by 54 +/- 9%. There was no significant attenuation in EC injury following incubation with reperfusion effluent stored for 24 h, supplementation with antioxidants (superoxide dismutase + catalase), or inhibition of xanthine oxidase with allopurinol or tungstate. We conclude that the reperfused liver releases a long-lived circulatory mediator of EC injury, which may produce the clinical microvascular injury observed following hepatic ischemia. The mechanism of injury in our model is independent of oxidants or oxidants generated from the circulating xanthine oxidase released from reperfused ischemic liver.

Topics: Adenine; Allopurinol; Animals; Antioxidants; Catalase; Cattle; Cell Membrane Permeability; Dextrans; Endothelium, Vascular; Enzyme Inhibitors; Fluorescent Dyes; Free Radicals; Ischemia; Liver; Male; Protease Inhibitors; Rats; Rats, Sprague-Dawley; Reperfusion; Rhodamines; Superoxide Dismutase; Tungsten Compounds; Xanthine Oxidase

The aim of this study was to compare the effects of Euro-Collins and University of Wisconsin solutions on pulmonary mitochondrial function after cold ischemia and subsequent warm reperfusion.. Seventeen pigs underwent lung harvesting after classical lung flush with either University of Wisconsin or Euro-Collins solutions. The mitochondria were isolated from fresh swine lungs, from swine lungs subjected to 24 hr of cold ischemia, and from swine lungs subjected to 24 hr of ischemia followed by 30 min of subsequent ex vivo reperfusion at 37 degrees C with Krebs-Henseleit buffer solution and air ventilation. Mitochondrial oxidative phosphorylation parameters were determined in isolated mitochondria by in vitro measurement of oxygen consumption rates. During reperfusion, the lung function was assessed by the pulmonary aerodynamic parameters and the pulmonary vascular resistance.. Relative to controls, mitochondria submitted to cold ischemia showed an alteration in the oxidoreductase activities of the respiratory chain. However, the yield of oxidative phosphorylation was conserved. After reperfusion, pulmonary mitochondria underwent a significant worsening in the oxidoreductase activities of the respiratory chain, and a decrease in the respiratory control and the efficiency of oxidative phosphorylation. Meanwhile, the reperfused lungs showed evidence of early dysfunction, assessed by the aerodynamic parameters and pulmonary vascular resistance. In this model, there was no advantage of University of Wisconsin solution over Euro-Collins solution.. The mild mitochondrial alterations after cold ischemia were not sufficient to explain the limited tolerance of lung to ischemia. After reperfusion, the mitochondrial damage was more severe and could be involved in the posttransplant lung dysfunction.

Topics: Adenosine; Allopurinol; Analysis of Variance; Animals; Female; Glutathione; Hypertonic Solutions; In Vitro Techniques; Insulin; Ischemia; Lung; Male; Mitochondria; Organ Preservation Solutions; Oxidation-Reduction; Oxygen Consumption; Phosphorylation; Raffinose; Reperfusion; Swine; Vascular Resistance

An isocratic, reversed-phase HPLC method was developed for the determination of the rates of purine and pyrimidine efflux during early reperfusion of isolated organs after non-perfusion cold conservation. The method enables determination of uric acid, cytidine, xanthine, hypoxanthine, uridine, AMP, inosine, and adenosine in liver perfusate using a standard C-18 column (25 cm length). Peaks are resolved by elution with buffer containing 1% acetonitrile, 20 mM potassium citrate (pH 6.25), and 25-55 mM tetramethylammonium. The effects of pH and solvents on peak retention times are described. As an example of the application of the method, the effects of allopurinol on the rates of postischemic efflux of purines and pyrimidines during reperfusion of liver stored in the cold for 24 h in Euro-Collins solution was studied.

Topics: Allopurinol; Animals; Antimetabolites; Chromatography, High Pressure Liquid; Hydrogen-Ion Concentration; Ischemia; Liver; Purines; Pyrimidines; Rats; Reperfusion

50 Sprague-Dawley rats were used to study the effect of allopurinol and prostaglandin E1 (PGE1) on renal ischemia-reperfusion injury. They underwent left renal ischemia for 1 h and reperfusion. A right nephrectomy was performed, and 5 groups were made. Group AP received allopurinol 50 mg/kg and PGE1 20 micrograms/kg; group A, allopurinol; group P, PGE1; group C, control, and group S, sham group. Five animals from each group were used to study renal functions and 5 for renal histology. The serum creatinine values were lower in the treatment groups compared to the controls on days 1-3 and 7 (p < 0.05). The blood urea nitrogen values showed a similar trend. Maximum histological damage was seen in group C, followed by groups A, P and AP, in this order. We conclude that allopurinol and PGE1 attenuate renal ischemia-reperfusion injury in rats.

Topics: Allopurinol; Alprostadil; Animals; Blood Urea Nitrogen; Creatinine; Drug Therapy, Combination; Ischemia; Kidney; Male; Rats; Rats, Sprague-Dawley; Reperfusion Injury

To determine whether xanthine oxidase and dehydrogenase activities are altered during low flow ischemia and reperfusion of the small intestine of horses.. 5 clinically normal horses without histories of abdominal problems.. With the horse under general anesthesia, a laparotomy was performed and blood flow to a segment of the distal jejunum was reduced to 20% of baseline for 120 minutes and was then reperfused for 120 minutes. Biopsy specimens were obtained before, during, and after ischemia for determination of xanthine oxidase and dehydrogenase activities, and for histologic and morphometric analyses.. Percentage of xanthine oxidase activity (as a percentage of xanthine oxidase and dehydrogenase activity) was not altered during ischemia and reperfusion. An inflammatory response developed and progressed during ischemia and reperfusion. Mucosal lesions increased in severity after ischemia and reperfusion. Mucosal surface area and volume decreased during ischemia and continued to decrease during reperfusion. Submucosal volume increased slightly during ischemia, and continued to increase during reperfusion.. Evidence for conversion of xanthine dehydrogenase to xanthine oxidase during ischemia was not found. Factors other than production of reactive oxygen metabolites may be responsible for progressive epithelial loss, decrease in mucosal surface area and volume, and increase in submucosal volume observed in this study. Other methods of determining xanthine oxidase activity that detect the enzyme in sloughed epithelial cells should be used to better define the importance of this pathway in jejunal reperfusion injury in horses.

Topics: Animals; Female; Horses; Intestinal Mucosa; Ischemia; Jejunum; Male; Reperfusion; Time Factors; Xanthine Dehydrogenase; Xanthine Oxidase

Liver reperfusion following cold ischemia is frequently associated with diminished bile flow in patients undergoing liver transplantation. Glutathione is a major determinant of bile-acid independent bile flow, and the effects of cold ischemia on biliary glutathione excretion are unknown.. We examined the effects of cold ischemia (University of Wisconsin solution (4 degrees C), 24 h) with subsequent reperfusion (100 min) on biliary glutathione excretion in a recirculating system. Since glutathione might represent an important antioxidant within the biliary tract and oxidative stress in the biliary tract during reperfusion could contribute to the pathogenesis of bile duct injury after liver transplantation, we also assessed bile duct morphology in reperfused livers of mutant TR- -rats, in whom biliary excretion of glutathione is already impaired.. Hepatic bile formation was diminished in reperfused Wistar rat livers after cold ischemia. Biliary glutathione concentrations and output were significantly decreased and correlated with postischemic changes in bile secretion. An increased biliary oxidized glutathione/glutathione ratio, indicating oxidative stress, was detected only immediately after the onset of reperfusion. Basal bile flow rates in TR- -rat livers which were already markedly reduced in control-perfused livers, decreased further during the early but not the later reperfusion period. Reperfusion of both Wistar and TR- -rat livers was not associated with electron microscopic evidence of bile duct damage.. We conclude that impaired biliary excretion of glutathione contributes to decreased bile flow after cold ischemia. The absence of biliary glutathione does not appear to promote ultrastructural evidence of bile duct injury during reperfusion in the isolated perfused rat liver.

Topics: Adenosine; Allopurinol; Animals; Bile; Bile Ducts; Cold Temperature; Glutathione; In Vitro Techniques; Insulin; Ischemia; Liver; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Regression Analysis; Reperfusion; Time Factors

Xanthine oxidase (XO) is conventionally known as a generator of reactive oxygen species (ROS) which contribute to hypoxic-reperfusion injury in tissues. However, this role for human XO is disputed due to its distinctive lack of activity towards xanthine, and the failure of allopurinol to suppress reperfusion injury. In this paper, we have employed native gel electrophoresis together with activity staining to investigate the role human xanthine dehydrogenase (XD) and XO in hypoxic reperfusion injury. This approach has provided information which cannot be obtained by conventional spectrophotometric assays. We found that both XD and XO of human umbilical vein endothelial cells (HUVECs) and lymphoblastic leukaemic cells (CEMs) catalysed ROS generation by oxidising NADH, but not hypoxanthine. The conversion of XD to XO was observed in both HUVECs and CEMs in response to hypoxia, although the level of conversion varied. Purified human milk XD generated ROS more efficiently in the presence of NADH than in the presence of hypoxanthine. This NADH oxidising activity was blocked by the FAD site inhibitor, diphenyleneiodonium (DPI), but was not suppressible by the molybdenum site inhibitor, allopurinol. However, in the presence of both DPI and allopurinol the activities of XD/XO were completely blocked with either NADH or hypoxanthine as substrates. We conclude that both human XD and XO can oxidise NADH to generate ROS. Therefore, the conversion of XD to XO is not necessary for post-ischaemic ROS generation. The hypoxic-reperfusion injury hypothesis should be reappraised to take into account the important role played by XD and XO in oxidising NADH to yield ROS.

Topics: Allopurinol; Cell Hypoxia; Cells, Cultured; Electrophoresis, Polyacrylamide Gel; Endopeptidases; Endothelium, Vascular; Enzyme Inhibitors; Humans; Hypoxia; Ischemia; Lymphocytes; Milk, Human; NAD; Onium Compounds; Oxidation-Reduction; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Reactive Oxygen Species; Reperfusion Injury; Spectrophotometry; Substrate Specificity; Tumor Cells, Cultured; Umbilical Veins; Xanthine Dehydrogenase; Xanthine Oxidase

Iron may be important in catalyzing excessive production of reactive oxygen species (ROS). Cellular iron homeostasis is regulated by iron regulatory proteins (IRPs), which bind to iron-responsive elements (IRE) of mRNAs for ferritin and transferrin receptor (TfR) modulating iron uptake and sequestration, respectively. Although iron is the main regulator of IRP activity, IRP is also influenced by other factors, including the redox state. Therefore, IRP might be sensitive to pathophysiological alterations of redox state caused by ROS. However, previous studies have produced diverging evidence on the effect of oxidative injury on IRP. Results obtained in an animal model close to a pathophysiological condition, such as ischemia reperfusion of the liver as well as in a cell-free system involving an enzymatic source of O2 and H2O2, indicate that IRP is downregulated by oxidative stress. In fact, IRP activity is inhibited at early times of post-ischemic reperfusion. Moreover, the concerted action of O2 and H2O2 produced by xanthine oxidase in a cell-free system caused a remarkable inhibition of IRP activity. IRP seems a direct target of ROS; in fact, in vivo inhibition can be prevented by the antioxidant N-acetylcysteine and by interleukin-1 receptor antagonist. In addition, modulation of iron levels of the cell-free assay did not affect the downregulation imposed by xanthine oxidase. Conceivably, downregulation of IRP activity by O2 and H2O2 may facilitate iron sequestration into ferritin, thus limiting the pro-oxidant challenge of iron.

Topics: Acetylcysteine; Animals; Down-Regulation; Ferritins; Iron; Iron-Regulatory Proteins; Iron-Sulfur Proteins; Ischemia; Liver; Oxidation-Reduction; Oxidative Stress; Proto-Oncogene Proteins; Rats; Reactive Oxygen Species; RNA-Binding Proteins; Wnt2 Protein; Xanthine; Xanthine Oxidase

Topics: Adenosine; Allopurinol; Amino Acids; Cold Temperature; Glutathione; Insulin; Ischemia; Liver; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Temperature; Time Factors

Topics: Adenosine; Allopurinol; Animals; Aspartate Aminotransferases; Biomarkers; Cold Temperature; Endothelium; Glutathione; Hyaluronic Acid; Insulin; Ischemia; Liver; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Swine; Temperature; Time Factors

Topics: Adenosine; Allopurinol; Animals; Glutathione; Insulin; Intestine, Small; Ischemia; Male; Organ Preservation; Organ Preservation Solutions; Phospholipases A; Proteins; Raffinose; Rats; Rats, Inbred Lew; Reperfusion Injury; Time Factors

Topics: Acetylcysteine; Allopurinol; Animals; Glutathione; Intestine, Small; Ischemia; Lung; Malondialdehyde; Myocardium; Necrosis; Rats; Rats, Wistar; Reperfusion; Reperfusion Injury

The organ donor shortage has led to a reconsideration of the use of non-heart-beating donors (NHBDs). However, graft injury due to warm ischemia in NHBD livers strongly affects posttransplant outcome. The present study was aimed at investigating the role of the cellular cyclic (c)AMP second messenger signal with regard to hepatic viability after cold preservation of NHBD livers.. Cardiac arrest was induced in Wistar rats by frenotomy of the anesthetized nonheparinized animal. After 30 min, the livers were excised and flushed with 20 ml of heparinized saline solution, rinsed with 10 ml of University of Wisconsin (UW) solution, and stored submerged in UW solution at 4 degrees C for 24 hr. In half of the experiments, UW solution was supplemented with glucagon (0.5 microg/ml) to increase the cAMP signal in the liver. Reperfusion was carried out in vitro after all livers were incubated at 25 degrees C in saline solution to replicate the period of slow rewarming during surgical implantation in vivo.. Hepatic levels of cAMP (nmol/g dry weight) declined from 1.21+/-0.05 to 0.53+/-0.03 (P<0.01) at 30 min after cardiac arrest. Subsequent storage in UW solution resulted in a further decline to 0.35+/-0.04 after 24 hr in group A, whereas glucagon treatment enhanced cellular cAMP signal to 0.64+/-0.06 (P<0.01). Upon reperfusion, liver integrity was significantly improved after glucagon administration, with 66% reduction in alanine aminotransferase release and a threefold increase in hepatic bile production as compared with untreated livers. Moreover, liver ATP tissue levels were restored to only 2.19+/-0.51 micromol/g in the untreated group but reached 4.97+/-0.41 micromol/g (P<0.05) after treatment with glucagon.. Posthoc conditioning of predamaged livers by glucagon enhances cAMP tissue levels during ischemic preservation and improves hepatic integrity upon reperfusion. This may represent a promising approach for the use of livers from non-heart-beating donors in clinical transplantation.

Topics: Adenosine; Adenosine Triphosphate; Alanine Transaminase; Allopurinol; Animals; Bile; Cryopreservation; Cyclic AMP; Glucagon; Glutathione; Heart Arrest; Insulin; Ischemia; Liver; Liver Circulation; Male; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Reperfusion; Signal Transduction; Tissue Donors

We investigated the effects of the xanthine oxidase inhibitor, BOF-4272, on the production of cytokine-induced neutrophil chemoattractant (CINC) following reperfusion injury in rat liver. Ischemia was induced for 30 minutes by portal vein occlusion. Animals were pretreated with intravenous injection of BOF-4272 (1 mg/kg) or heparin (50 U/kg) 5 minutes before vascular clamp. Both BOF-4272 and heparin limited increases in the chemoattractant compared with nonpretreated rats. Pretreatment with BOF-4272 plus heparin resulted in an additive effect. Most cells immunostained for chemoattractant were macrophages in sinusoids. In vitro chemoattractant production by Kupffer cells isolated from animals pretreated with heparin or BOF-4272 was significantly lower than by Kupffer cells from nonpretreated animals. Expression of transcripts in liver for chemoattractant peaked 3 hours after reperfusion in nonpretreated animals, while pretreatment with heparin or BOF-4272 significantly decreased chemoattractant mRNA levels. In vitro chemoattractant transcription and production could be induced in naive Kupffer cells by hypoxanthine and xanthine oxidase, but BOF-4272 prevented these increases. We conclude that Kupffer cells release chemoattractant in response to oxygen radicals reducible by xanthine oxidase inhibition.

Topics: Animals; Chemokines, CXC; Chemotactic Factors; Enzyme Inhibitors; Growth Substances; Heparin; Intercellular Signaling Peptides and Proteins; Ischemia; Kupffer Cells; Liver; Liver Circulation; Male; Neutrophils; Peroxidase; Rats; Rats, Wistar; Reperfusion Injury; RNA, Messenger; Triazines; Xanthine Oxidase

Topics: Adenosine; Adolescent; Adult; Aged; Allopurinol; Aspartate Aminotransferases; Cold Temperature; Glutathione; Humans; Insulin; Ischemia; Liver; Liver Circulation; Liver Transplantation; Microcirculation; Middle Aged; Organ Preservation; Organ Preservation Solutions; Raffinose; Regression Analysis; Reperfusion Injury; Time Factors

Topics: Acetylcysteine; Adenosine; Allopurinol; Animals; Antibodies, Monoclonal; Choline Deficiency; Fatty Liver; Glutathione; Insulin; Intercellular Adhesion Molecule-1; Ischemia; Liver; Male; Methionine; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Reperfusion Injury

Topics: Adenosine; Aerobiosis; Allopurinol; Anaerobiosis; Animals; Glutathione; Hypoxia; Insulin; Ischemia; Liver; Male; Microscopy, Fluorescence; NAD; Organ Preservation Solutions; Oxidation-Reduction; Oxygen; Oxygen Consumption; Raffinose; Rats; Rats, Wistar

Triple therapy with S-adenosylmethionine (SAM) (given to the donor animal, included in University of Wisconsin solution [UW], and added to the reperfusing medium) has been shown to reduce the sequential cold and warm ischemia/reperfusion injuries characteristic of the liver transplantation procedure. To clarify the actions of SAM during different stages of ischemia/ reperfusion, we have compared its benefit in five dosage regimens, using perfused rat livers after sequential periods of 24 hr cold and 20 min rewarming ischemia. When added only to UW, the presence of SAM throughout ischemia improved hepatic blood flow by 26% after 15 min of reperfusion versus no treatment (2.32+/-0.18 vs. 1.84+/-0.11 ml/min/g liver, P<0.05). SAM also improved blood flow by 23% during the 3-hr perfusion overall (P<0.05). Oxygen consumption and the release of purine nucleoside phosphorylase (PNP) were decreased (both P<0.05). When added to both UW and the perfusate, SAM additionally increased bile production at 15 min (7.14+/-1.21 vs. 2.31+/-0.74 mg/h/g liver, P<0.01). By pretreating the liver donor with SAM in vivo, and including it in the preservation and reperfusing media, it was possible to prolong and amplify the benefits on blood flow (P<0.001) and bile production (P<0.05) and to sustain glucose uptake (P<0.01). An acute exposure to SAM, when used in saline to flush UW from the graft before reperfusion, increased blood flow at 15 min (by 68%) and over a 3-hr period (both P<0.001), but no indices of metabolic activity were improved. Oxygen consumption and PNP release were both decreased (P<0.05). When added to the perfusate (present throughout reperfusion), SAM increased blood flow at 15 min (58%) and over a 3-hr period (P<0.01 in both cases). Net glucose uptake was increased (P<0.05), whereas oxygen consumption (P<0.001) and PNP release fell (P<0.05). Actions of SAM achieved acutely and over the intermediate- and long-term all seem to underlie its benefits in reducing ischemia/reperfusion injuries.

Topics: Adenosine; Allopurinol; Animals; Bile; Glutathione; Insulin; Ischemia; Liver; Liver Transplantation; Male; Organ Preservation Solutions; Raffinose; Rats; Rats, Inbred Lew; Reperfusion Injury; S-Adenosylmethionine

Allopurinol (AP) protects skeletal muscle function against ischaemia-induced injury, but the mechanism is not yet clear. As AP acts as a competitive xanthine oxidase inhibitor, both a reduction of oxygen-derived free radicals and an enhancement of purine resynthesis (salvage pathway) might be involved. We investigated the in vivo kinetics of high-energy phosphates in skeletal muscle after AP pretreatment using 31P-magnetic resonance spectroscopy during 2 h of ischaemia and 3 h of reperfusion in rat hindlimbs. Three animals (group A) were pretreated with a total of 160 mg/kg AP i.p., 3 control animals (group B) received the same amount of 0.9% saline solution. ATP decreased to 18.6 +/- 1.3% of the pre-ischaemic value in group A and to 17.3 +/- 2.8% in group B after 2 h of ischaemia, and rose to only 47.7 +/- 1.5 and 50.5 +/- 1.8%, respectively, after 3 h of reperfusion. Phosphocreatine fell to 7.2 +/- 2.9 and 7.6 +/- 2.2% of pre-ischaemic values after 2 h of ischaemia and rose again to 36.5 +/- 12.9 and 45.4 +/- 20.4% after 3 h of reperfusion. Inorganic phosphate (Pi) increased 5-fold after 2 h of ischaemia, irrespective of the treatment. After 3 h of reperfusion, Pi was still 4 times the pre-ischaemic value. The kinetics of ATP, PCr, and Pi levels were not statistically different between the two groups. These results indicate that the ATP salvage pathway does not play an important role in AP-induced attenuation of ischaemia/reperfusion-induced muscle damage.

Topics: Adenosine Triphosphate; Allopurinol; Animals; Ischemia; Magnetic Resonance Spectroscopy; Male; Muscle, Skeletal; Phosphocreatine; Rats; Rats, Wistar; Reperfusion Injury

Intestinal ischemic injury is exacerbated by reperfusion in rodent and feline models because of xanthine oxidase-initiated reactive oxygen metabolite formation and neutrophil infiltration. Studies were conducted to determine the relevance of reperfusion injury in the juvenile pig, whose low levels of xanthine oxidase are similar to those of the human being.. Ischemia was induced by means of complete mesenteric arterial occlusion, volvulus, or hemorrhagic shock. Injury was assessed by means of histologic examination and measurement of lipid peroxidation. In addition, myeloperoxidase, as a marker of neutrophil infiltration, and xanthine oxidase-xanthine dehydrogenase were measured.. Significant ischemic injury was evident after 0.5 to 3 hours of complete mesenteric occlusion or 2 hours of shock or volvulus. In none of these models was the ischemic injury worsened by reperfusion. To maximize superoxide production, pigs were ventilated on 100% O2, but only limited reperfusion injury (1.2-fold increase in histologic grade) was noted. Xanthine oxidase-xanthine dehydrogenase levels were negligible (0.4 +/- 0.4 mU/gm).. Reperfusion injury may not play an important role in intestinal injury under conditions of complete mesenteric ischemia and low-flow states in the pig. This may result from low xanthine oxidase-xanthine dehydrogenase levels, which are similar to those found in the human being.

Topics: Animals; Female; Intestinal Mucosa; Intestines; Ischemia; Male; Peroxidases; Reperfusion Injury; Swine; Xanthine Dehydrogenase; Xanthine Oxidase

To determine if myocardial injury results from hepatoenteric ischemia-reperfusion. We also proposed to determine if this remote heart injury is mediated by a xanthine oxidase-dependent mechanism.. Randomized, controlled animal study.. University-based animal research facility.. Thirty-six New Zealand white male rabbits, weighing 1.8 to 3 kg.. Anesthetized rabbits were randomly assigned to one of four groups (n = 9 per group): a) a sham-operated group; b) a sham-operated group pretreated with sodium tungstate (xanthine oxidase inactivator); c) an aorta occlusion group; and d) an aorta occlusion group pretreated with sodium tungstate. Descending thoracic aorta occlusion was maintained for 40 mins with a 4-Fr Fogarty embolectomy catheter, followed by 2 hrs of reperfusion.. Myocardial injury, manifested by increased circulating creatine kinase-MB fraction activity, was significantly associated with aortic occlusion and reperfusion (p < .05). Sodium tungstate pretreatment significantly (p < .05) reduced circulating and myocardial xanthine oxidase activity. Xanthine oxidase inactivation by sodium tungstate significantly decreased circulating creatine kinase-MB fraction activity after hepatoenteric ischemia-reperfusion (p < .05). Finally, circulating creatine kinase-MB fraction activity was significantly associated with circulating xanthine oxidase activity (r2 = .85; p < .001).. We conclude that remote myocardial injury is caused by hepatoenteric ischemia-reperfusion. The pathoetiology of this myocardial injury involves a xanthine oxidase-dependent mechanism.

Topics: Animals; Creatine Kinase; Intestines; Ischemia; Isoenzymes; Liver Circulation; Male; Myocardial Reperfusion Injury; Rabbits; Random Allocation; Tungsten Compounds; Xanthine Oxidase

Recent evidence suggests that oxygen-derived free radicals are involved in mediating gastric microvascular and parenchymal cell injuries induced by ischaemia and reperfusion. Therefore, the effect of the locally acting anti-ulcer drug, sucralfate, was studied on ischaemia and reperfusion (e.g. induced gastric lesions, intraluminal bleeding, changes in vascular permeability and non-protein sulfhydryl levels in the rat stomach). Allopurinol was used as a known standard antioxidant drug. Rats were subjected to 30 min of gastric ischaemia in the presence of 100 mmol/L hydrochloric acid and reperfusion periods of 15, 30 or 60 min duration. The gastric lesions were assessed microscopically under an inverted microscope. The vascular permeability was quantified by measuring the extravasated Evans blue in the stomach. There were significantly greater numbers of gastric lesions, intraluminal bleeding and leakage of Evans blue during all reperfusion periods as compared with those of ischaemia, with maximum effects occurring at 60 min following reperfusion. Pretreatment with sucralfate (31.25-250 mg/kg, p.o.) or allopurinol (12.5-50 mg/kg, i.p.) 30 min before the procedure, dose-dependently reduced the gastric lesions, intraluminal bleeding, and decreased the vascular permeability induced by ischaemia and reperfusion. Furthermore, sucralfate dose-dependently reverses the ischaemia and reperfusion-induced depletion of mucosal non-protein sulfhydryl levels and inhibited the superoxide radical production in both cell-free xanthine-xanthine oxidase and in the stimulated polymorphonuclear cellular systems. These results suggest that the protection produced by sucralfate against gastric injury may be due to its antioxidant effects.

Topics: Allopurinol; Animals; Capillary Permeability; Coloring Agents; Dose-Response Relationship, Drug; Evans Blue; Gastric Mucosa; Ischemia; Male; Neutrophils; Rats; Rats, Wistar; Reperfusion Injury; Sucralfate; Sulfhydryl Compounds; Superoxide Dismutase; Tetradecanoylphorbol Acetate; Time Factors; Xanthine Oxidase; Xanthines

This study examines the hypothesis that intestinal ischemia-reperfusion (I/R) injury contributes to renal dysfunction by altered renal eicosanoid release. Anesthetized Sprague-Dawley rats underwent 60 min of sham or superior mesenteric artery (SMA) occlusion with 60 min of reperfusion. The I/R groups received either allopurinol, pentoxifylline, 1-benzylimidazole, or carrier before SMA occlusion. In vivo renal artery blood flow was measured by Transonic flow probes, the kidneys were then perfused in vitro for 30 min, and the effluent was analyzed for eicosanoid release and renal function. Intestinal I/R caused a twofold increase in the ratio of renal release of thromboxane B2 to prostaglandin E2 and to 6-ketoprostaglandin F1alpha compared with the sham level, with a corresponding 25% decrease in renal sodium and inulin clearance and renal blood flow. Pentoxifylline or allopurinol pretreatment restored renal eicosanoid release and renal sodium and inulin clearance to the sham level but did not alter renal blood flow. Pretreatment with 1-benzylimidazole restored renal function, eicosanoid release, and renal blood flow to sham levels. These data suggest that severe intestinal I/R contributes to the downregulation of renal function. The decrease in renal function is due in part to toxic oxygen metabolites, which occur in the milieu of altered renal eicosanoid release, reflecting a decrease in vasodilator and an increase in vasoconstrictor eicosanoids.

Topics: Allopurinol; Animals; Blood Pressure; Eicosanoids; Imidazoles; In Vitro Techniques; Inulin; Ischemia; Kidney; Male; Pentoxifylline; Rats; Rats, Sprague-Dawley; Renal Circulation; Reperfusion Injury; Sodium; Splanchnic Circulation

A method to reduce ischemia-reperfusion (I/R) injury can be an important criterion to improve the preservation solution. Although University of Wisconsin solution (UW) works as a lung preservation solution, its attenuation effect on I/R injury has not been investigated. We attempted to determine whether, by adding various protective agents, modified UW solutions will enhance the I/R attenuation by UW. We examined the I/R injury in an isolated rat lung model. Various solutions, e.g., physiological salt solution (PSS), UW, and modified UW solutions containing various protective agents such as prostaglandin E1, dexamethasone, U-74389G, or dibutyryl adenosine 3',5'-cyclic monophosphate were perfused individually to evaluate the I/R injury. Isolated rat lung experiments, with ischemia for 45 min, then reperfusion for 60 min, were conducted in a closed circulating system. Hemodynamic changes, lung weight gain (LWG), capillary filtration coefficient (Kfc), protein content of lavage fluid, concentration of cytokines, and lung histopathology were analyzed. Results showed that the acute I/R lung injury with immediate permeability pulmonary edema was associated with an increase in tumor necrosis factor-alpha (TNF-alpha) production. A significant correlation existed between TNF-alpha and Kfc (r = 0.8, P < 0.0001) and TNF-alpha and LWG (r = 0. 9, P < 0.0001), indicating that TNF-alpha is an important cytokine modulating early I/R injury. Significantly lower levels of Kfc, LWG, TNF-alpha, and protein concentration of lung lavage (P < 0.05) were found in the UW-perfused group than in the control group perfused with PSS. Modified UW promoted the protective effect of UW to further decrease Kfc, LWG, and TNF-alpha (P < 0.05). Histopathological observations also substantiated this evidence. In the UW+U-74389G group, bronchial alveolar lavage fluid contained lowest protein concentration. We conclude that the UW solution attenuates I/R injury of rat lung and that the modified UW solutions further enhance the effect of UW in reducing I/R injury. Among modified solutions, UW+U-74389G is the best. Further investigation of the improved effects of the modified UW solutions would be beneficial in lung transplantation.

Topics: Adenosine; Allopurinol; Alprostadil; Animals; Bucladesine; Dexamethasone; Drug Synergism; Glutathione; Hemodynamics; In Vitro Techniques; Insulin; Interleukin-1; Ischemia; Lung; Male; Organ Preservation Solutions; Pregnatrienes; Pulmonary Circulation; Raffinose; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Tumor Necrosis Factor-alpha

To investigate the role of allopurinol in the attenuation of ischaemia- and reperfusion-induced corporeal injury in a rat model of veno-occlusive priapism.. Placebo or allopurinol were given to eight groups of rats before priapism (ischaemia) was induced using a vacuum-constriction device for a duration of 6 or 12 h. Half of the groups of rats undergoing the same duration of priapism had 1 h of detumescence after the constriction band was removed (reperfusion). A ninth group was not treated and received no drug, serving as controls. Corporeal homogenates were then examined for malondialdehyde (MDA) accumulation, derived from lipid peroxidation, using a thiobarbituric acid assay.. The accumulation of MDA was significantly higher in the groups treated with placebo and undergoing ischaemia/reperfusion compared with the control group (P < 0.001), but was not significantly different between the placebo-treated ischaemic and reperfused groups (P > 0.05). Rats undergoing 6 and 12 h of ischaemia and reperfusion, and receiving allopurinol had significantly less accumulation of MDA compared with those receiving placebo (P < 0.005).. Lipid peroxidation, an indicator of injury induced by reactive oxygen metabolites, occurred in corporeal tissue during and after veno-occlusive priapism in this rat model; when assessed by lipid peroxidation, allopurinol appeared to protect rat corporeal tissue against this injury.

Topics: Allopurinol; Animals; Antimetabolites; Ischemia; Lipid Peroxidation; Male; Malondialdehyde; Penis; Priapism; Rats; Rats, Wistar; Reperfusion Injury

Multiple-organ injury often occurs after aortic occlusion-reperfusion. Oxidants derived from xanthine oxidase have been implicated as a source of injury after aortic occlusion-reperfusion. Halogenated anesthetics modify oxidant-mediated injury. The current study determined if halothane modifies hepatocellular enzyme release (e.g., alanine aminotransferase) and circulating lactate after aortic occlusion-reperfusion.. Rabbits were randomly assigned to one of four groups that underwent 40 min of thoracic aortic occlusion and 2 h of reperfusion: Two groups were given either halothane or fentanyl plus droperidol anesthesia and two groups were given either anesthetic and sodium tungstate (xanthine oxidase inactivator). Each of the four groups was then matched with a similarly treated group that did not undergo aortic occlusion.. Halothane anesthesia was associated with significantly (P < 0.05) increased release of alanine aminotransferase (34 +/- 9 U/l at baseline and 539 +/- 370 U/l at 120 min of reperfusion; mean +/- SD) and increased plasma lactate concentrations (2.8 +/- 2.0 mM at baseline and 12.1 +/- 9.7 mM at 120 min of reperfusion) after aortic occlusion-reperfusion compared with fentanyl plus droperidol anesthesia (alanine aminotransferase, 33 +/- 12 U/l and 148 +/- 109 U/l; lactate, 3.4 +/- 2.0 mM and 3.8 +/- 1.2 mM at baseline and 120 min of reperfusion, respectively). Inactivation of xanthine oxidase significantly decreased the release of hepatocellular enzymes (P < 0.05) and decreased circulating lactate in animals anesthetized with halothane after aortic occlusion-reperfusion.. Halothane increased hepatocellular enzyme release and circulating lactate after aortic occlusion-reperfusion compared with fentanyl plus droperidol anesthesia. Xanthine oxidase activity inactivation also decreased hepatocellular enzyme activity release during reperfusion. These findings justify further investigations to determine if halogenated anesthetics modify tissue injury in clinical settings involving oxidant stress.

Topics: Anesthetics, Inhalation; Animals; Aspartate Aminotransferases; Halothane; Ischemia; L-Lactate Dehydrogenase; Lactic Acid; Liver; Male; Rabbits; Reperfusion; Xanthine Oxidase

Topics: Adenine Nucleotides; Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Energy Metabolism; Glutathione; Hypoxanthine; Insulin; Ischemia; Jejunum; Mesenteric Artery, Superior; Organ Preservation; Organ Preservation Solutions; Oxygen; Phosphocreatine; Portal Vein; Raffinose; Rats; Rats, Wistar; Reperfusion; Reperfusion Injury

Oxygen free radicals are produced and play an important role in ischemic injury. We therefore wished to investigate the role of free radicals on ischemic skin wound healing. For this purpose, H-shaped flaps, where the test ischemic wound is the horizontal line in the H, were created on the dorsum of the rat. To inhibit the probable hazards of free radicals, allopurinol and superoxide dismutase (SOD) were given to the animals. Most of the studied wound-healing parameters were impaired in the ischemic group. In the allopurinol-treated group, breaking strength was increased by 52% by day 7 and by 109% by day 14 (p < 0.0002 and p < 0.001), and in the SOD-treated group the increase was 69% both by days 7 and 14 of healing when compared with the ischemic control group (p < 0.003 and p < 0.002). Hydroxyproline content was increased 75% with allopurinol and 113% with SOD in the wound by day 7 (p < 0.03 and p < 0.001 respectively). SOD treatment caused a significant decrease in wound edema by day 7 of healing (p < 0.05). Histopathological evaluation revealed that in the SOD- and allopurinol-treated groups, the amount of collagen and its organization were more prominent when compared with the ischemic controls. These results show that oxygen free radicals play an important role in the failure of ischemic wound healing, and antioxidants partly improve the healing in ischemic skin wounds.

Topics: Allopurinol; Animals; Body Water; Collagen; Free Radicals; Hydroxyproline; Ischemia; Rats; Rats, Wistar; Skin; Superoxide Dismutase; Surgical Flaps; Tensile Strength; Wound Healing

Ischemia caused by cold storage (CS) and reperfusion of the kidney is often responsible for delayed graft function after transplantation. Significant attention has been focused on the cascade of events involved in ischemia-reperfusion injury, with the objective of identifying drugs to ameliorate the functional damage that occurs.. The purpose of this study was to evaluate the renal function of isolated perfused pig kidneys after 48 hr of CS with Euro-Collins (EC) solution plus trimetazidine (EC+TMZ), standard EC solution, or University of Wisconsin (UW) solution. Normothermic isolated perfused pig kidneys were randomized into five experimental groups: (A) control group (cold flush with cold heparinized saline and immediately reperfused; n=6); (B) cold flush with cold heparinized saline with TMZ (10(-6) M), n=6; (C) 48 hr of CS with EC and reperfusion (n=8); (D) 48 hr of CS with EC+TMZ alone and reperfusion (n=8); (E) 48 hr of CS with UW and reperfusion (n=8). Proton nuclear magnetic resonance spectroscopy and biochemical studies were performed for the functional evaluation during reperfusion. Lipid peroxidation was also determined. Histological examination (optical and electron microscopy) was performed after CS and reperfusion.. Using TMZ, the renal perfusate flow rate as well as the glomerular filtration rate and proximal tubular function were significantly improved. This improvement of renal function during reperfusion was correlated with a less significant cellular and interstitial edema. In addition, tubular injury markers were significantly lower in the group preserved with EC+TMZ, and TMZ reduced lipid peroxidation dramatically during reperfusion.. The addition of TMZ to the EC solution increased the preservation quality and renal tubular function, and gave protection from reperfusion injury better than EC alone or UW. These results strongly suggest that TMZ has a cytoprotective effect and may therefore be useful for kidney preservation.

Topics: Adenosine; Allopurinol; Animals; Glutathione; Hypertonic Solutions; In Vitro Techniques; Insulin; Ischemia; Kidney; Lipid Peroxidation; Magnetic Resonance Spectroscopy; Organ Preservation; Organ Preservation Solutions; Perfusion; Raffinose; Renal Circulation; Reperfusion Injury; Swine; Trimetazidine

Topics: Adenosine; Allopurinol; Animals; Buffers; Carnosine; Cold Temperature; Glutathione; Glycolysis; Histidine; Insulin; Ischemia; Liver; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Sprague-Dawley

Topics: Anaerobiosis; Humans; Ischemia; Kinetics; Nitrate Reductase; Nitrate Reductases; Nitrates; Nitric Oxide; Nitrite Reductases; Oxidation-Reduction; Superoxides; Xanthine Oxidase

Oxidant generation in anoxia-reoxygenation and ischemia-reperfusion was compared in isolated rat lungs. Anoxia-reoxygenation was produced by N2 ventilation followed by O2 ventilation. After anoxia, lung ATP content was decreased by 59%. Oxygenated ischemia was produced by discontinuing perfusion while ventilation with O2 was maintained. With anoxia-reoxygenation, oxidant generation, evaluated by oxidation of dichlorodihydrofluorescein (H2DCF) to fluorescent dichlorofluorescein, increased 3.6-fold, lung thiobarbituric acid reactive substances (TBARS) increased 342%, conjugated dienes increased 285%, and protein carbonyl content increased 46%. Pretreatment of lungs with 100 microM allopurinol inhibited the reoxygenation-mediated increase in lung fluorescence by 75% and TBARS by 69%. Oxygenated ischemia resulted in an approximately eightfold increase in lung H2DCF oxidation and a fourfold increase in TBARS, but allopurinol had no effect. On the other hand, 100 microM diphenyliodonium (DPI) inhibited the ischemia-mediated increase in lung fluorescence by 69% and lung TBARS by 70%, but it had no effect on the increase with anoxia-reoxygenation. Therefore, both ischemia-reperfusion and anoxia-reoxygenation result in oxidant generation by the lung, but a comparison of results with a xanthine oxidase inhibitor (allopurinol) and a flavoprotein inhibitor (DPI) indicate that the pathways for oxidant generation are distinctly different.

Topics: Adenosine Triphosphate; Aerobiosis; Allopurinol; Animals; Hypoxia; In Vitro Techniques; Ischemia; Lipid Peroxidation; Lung; Male; Oxidants; Perfusion; Rats; Rats, Sprague-Dawley; Thiobarbituric Acid Reactive Substances

The impact of storage solution composition on graft performance was evaluated following perfusion with either Euro-Collins (EC), low potassium Euro-Collins (rEC), low potassium dextran (LPD) or University of Wisconsin solution (UW) after brief (2 h) and extended ischemia (16 h) in an acute double lung transplantation model in the rat.. Following flush perfusion and ischemia the lungs were implanted in recipient rats allowing serial assessment of graft pulmonary vascular resistance (PVR) and alveolar arterial oxygen difference (AaDO2) during 120 min of reperfusion. Graft dynamic lung compliance (DLC) was determined by separate ventilation. Final evaluation included weight gain and histology.. After extended ischemia LPD provided superior graft function in respect to DLC (repeated measures ANOVA; LPD versus rEC P < 0.05; versus EC P < 0.03; versus UW P < 0.05) and AaDO2 (LPD versus rEC P < 0.04; versus EC P < 0.006). The PVR was significantly lower in LPD versus UW (P < 0.05). At the end of reperfusion the weight increase amounted to 229 +/- 49% in rEC, 207 +/- 22% in EC, 115 +/- 22% in UW and 87 + 17% in LPD (LPD versus rEC P < 0.01, LPD versus EC P < 0.001). The type of preservation solution used had little impact on graft function after 2 h ischemia.. Low potassium dextran provides superior graft function after extended ischemia. After short ischemia the type of preservation solution used in this study had little impact on global lung function.

Topics: Adenosine; Allopurinol; Animals; Bronchoalveolar Lavage Fluid; Dextrans; Glutathione; Hypertonic Solutions; Insulin; Ischemia; Lung; Lung Transplantation; Male; Organ Preservation Solutions; Phospholipids; Potassium; Proteins; Raffinose; Rats; Rats, Inbred Lew; Time Factors

Topics: Adenosine; Allopurinol; Analysis of Variance; Animals; Anticoagulants; Bile; Cold Temperature; Gabexate; Glutathione; Insulin; Ischemia; L-Lactate Dehydrogenase; Liver; Liver Transplantation; Male; Microcirculation; Organ Preservation; Organ Preservation Solutions; Portal System; Raffinose; Rats; Rats, Inbred Lew; Regional Blood Flow; Reperfusion; Reperfusion Injury; Time Factors

Topics: Adenine Nucleotides; Adenosine; Allopurinol; Animals; Energy Metabolism; Glutathione; Heart; Heart Transplantation; Hemodynamics; Insulin; Ischemia; Myocardial Contraction; Organ Preservation; Organ Preservation Solutions; Phosphocreatine; Raffinose; Rats; Rats, Inbred Lew; Reperfusion; Time Factors; Transplantation, Heterotopic; Transplantation, Isogeneic

Topics: Adenosine; Allopurinol; Animals; Blood; Blood Pressure; Glutathione; Hypertonic Solutions; Insulin; Ischemia; Lung; Lung Transplantation; Male; Organ Preservation; Organ Preservation Solutions; Perfusion; Pneumonectomy; Pulmonary Artery; Raffinose; Rats; Rats, Inbred Lew; Reperfusion Injury; Trehalose

Topics: Acetylcysteine; Adenosine; Allopurinol; Analysis of Variance; Animals; Bucladesine; Dogs; Endothelium, Vascular; Gluconates; Glutathione; Hydroxyethyl Starch Derivatives; Insulin; Ischemia; Lung; Lung Transplantation; Microscopy, Electron, Scanning; Nitroglycerin; Organ Preservation; Organ Preservation Solutions; Oxygen; Phosphates; Raffinose; Time Factors; Trehalose

Topics: Adenosine; Allopurinol; Animals; Bile Ducts; Bilirubin; Cardiopulmonary Bypass; Dogs; Glucose; Glutathione; Heart Arrest; Humans; Insulin; Ischemia; Liver; Liver Transplantation; Mannitol; Organ Preservation; Organ Preservation Solutions; Potassium Chloride; Procaine; Raffinose; Swine; Temperature; Time Factors; Tissue Donors; Transplantation, Heterotopic

Topics: Adenosine; Alanine Transaminase; Allopurinol; Animals; Aspartate Aminotransferases; Glutathione; Graft Survival; Heart Arrest; Hepatectomy; Humans; Insulin; Ischemia; Liver; Liver Circulation; Liver Transplantation; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar; Reperfusion; Tissue Donors

Ischemic preconditioning has not been assessed in an experimental model for myocardial preservation during heart transplantation. Using isolated working rat hearts, ischemic preconditioning was investigated as an adjunct to isolated hypothermic (group 1), crystalloid (group 2: University of Wisconsin solution; group 3: St. Thomas' Hospital cardioplegic solution II; group 4: Bretschneiders' cardioplegic solution), and noncrystalloid (group 5: cold blood cardioplegia) preservation during a 10-hr period of global ischemia at 4 degrees C. After acquisition of functional baseline data, ischemic preconditioning was induced with one cycle of 5 min of normothermic ischemia and 5 min of reperfusion before induction of global hypothermic ischemia (n= 10/group). Nonpreconditioned hearts (n= 10/group) were assessed for control. Ischemic preconditioning improved postischemic: functional recovery. Thus, aortic flow after 60 min of reperfusion recovered to 0%, 8%, 0%, 1% and 0% in control groups 1 to 5 without ischemic preconditioning and 21%, 25%, 10%, 8%, and 3% in groups 1 to 5 with ischemic preconditioning. The same pattern of recovery was observed in regard to postischemic maximum developed left ventricular pressure, which recovered to 21%, 56%, 30%, 36%, and 19% in groups 1 to 5 without preconditioning and 46%, 75%, 49%, 40%, and 47% in the corresponding groups with ischemic preconditioning. High-energy phosphate contents were not significantly different between preconditioned hearts and corresponding nonpreconditioned control hearts. Creatine kinase leakage during early reperfusion was found to be reduced with ischemic preconditioning. Thus, we have demonstrated that ischemic preconditioning can improve contractile function after global hypothermic ischemia in the isolated rat heart and we have shown that this protection is additive to that of hypothermia-induced protection during global ischemia at 4 degrees C. This endogenous mechanism of cardioprotection was effective regardless of whether preservation was accomplished using cardioplegic solution or topical hypothermia alone. This may have clinical implications in myocardial preservation for heart transplantation.

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Cold Temperature; Coronary Circulation; Creatine Kinase; Energy Metabolism; Glutathione; Heart Transplantation; Insulin; Ischemia; Male; Myocardium; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Wistar

Xanthine oxidase activity in blood from the ipsilateral femoral vein, and the relationship between xanthine oxidase production and the products of lipid peroxidation, were studied before operation and for 60 min following release of clamps after successful revascularization in two groups of patients with claudication or critical ischaemia. Before revascularization, detectable levels of xanthine oxidase were found only in patients with critical ischaemia. Clamping during bypass surgery led to release of xanthine oxidase in claudicants, but this activity reduced after 60 min. There was no evidence of lipid peroxidation during this time. Xanthine oxidase activity in brachial vein blood was higher than in femoral vein blood in patients with critical ischaemia before revascularization.

Topics: Adult; Aged; Aged, 80 and over; Constriction; Female; Femoral Vein; Humans; Intermittent Claudication; Ischemia; Leg; Male; Middle Aged; Reperfusion; Xanthine Oxidase

To determine if gastric intramucosal pH is affected by hepatoneteric ischemia-reperfusion. We additionally proposed to determine if changes in gastric mucosal hydrogen ion concentration are associated with liver and lung injury following hepatoenteric ischemia-reperfusion. Finally, we hypothesized that gastric intramucosal pH is influenced by xanthine oxidase, an oxidant-generating enzyme released after hepatoenteric ischemia-reperfusion.. Randomized, controlled, animal study.. University-based animal research facility.. Thirty-six New Zealand white male rabbits (2 to 3 kg).. Anesthetized rabbits were randomly assigned to one of four groups (n = 9 per group): a) sham-operated group; b) sham-operated group pretreated with sodium tungstate (xanthine oxidase inactivator); c) aorta occlusion group; and d) aorta occlusion group pretreated with sodium tungstate. Descending thoracic aorta occlusion was maintained for 40 mins with a 4-Fr Fogarty embolectomy catheter, followed by 2 hrs of reperfusion.. Gastric tonometry was performed after completion of the surgical preparation (30-min equilibration) and at 30, 60, 90, and 120 mins of reperfusion. Plasma alanine aminotransferase activity was determined at 120 mins of reperfusion to assess hepatic injury. Bronchoalveolar lavage of the right lung was performed after 120 mins of reperfusion, and the protein content was determined as a measure of pulmonary alveolar-capillary membrane compromise. Descending thoracic aorta occlusion resulted in a significant decrease in gastric intramucosal pH as compared with sham-operated rabbits (p < .001). The change in gastric mucosal hydrogen ion concentration was significantly associated with plasma alanine aminotransferase activity (r2 = .48, p < .01) and bronchoalveolar protein content (r2 = .51, p < .01). Xanthine oxidase inactivation significantly improved gastric intramucosal pH after aortic occlusion and reperfusion (p < .001), with a concomitant attenuation of the release of plasma alanine aminotransferase (p < .05) and accumulation of bronchoalveolar protein (p < .05) during reperfusion.. Gastric intramucosal pH was significantly decreased after hepatoenteric ischemia-reperfusion. Furthermore, an increase in gastric intramucosal hydrogen ion concentration was associated with a concomitant increase in tissue injury, a presumed harbinger of multiple organ failure. Gastric intramucosal pH values improved during reperfusion after xanthine oxidase inactivation, concomitant with attenuation of hepatic and pulmonary injury. Gastric tonometry is an important clinical tool that can provide critical insight into the pathogenesis of multiple organ injury after hepatoenteric ischemia-reperfusion. Gastric tonometry may aid in the rapid assessment of pharmacologic interventions designed to attenuate multiple organ injury in similar clinical settings (e.g., trauma, shock, major vascular surgery).

Topics: Animals; Gastric Mucosa; Hydrogen-Ion Concentration; Ischemia; Liver; Lung; Male; Manometry; Phenylephrine; Rabbits; Random Allocation; Reperfusion Injury; Sodium Bicarbonate; Xanthine Oxidase

Hypothermia and preservative perfusates have been used to decrease ischemic renal injury. This study was performed to identify the preservative function of perfusates independent of the effects of hypothermia. Rats underwent 45 minutes of renal ischemia. Rectal and renal parenchyma temperatures were monitored and maintained within 1 degree C of normal. Perfusates were University of Wisconsin solution (UW), Euro-Collins solution, normal saline solution, and Ringer's lactate solution. A nonperfused ischemic control and a nonischemic control group were also evaluated. Parameters evaluated included serum creatinine and blood urea nitrogen levels, renal ischemic injury grade, renal weight, and gross appearance of the injured kidney. Rats treated with UW solution were found to have a significantly lower creatinine, blood urea nitrogen, and injury grade than the other three perfused groups. The external gross appearance of the UW-treated kidneys was normal, whereas that of the other groups demonstrated moderate to severe injury. Although the mean right/left renal weight difference of the UW-treated group was lower than that of the other three groups, this was not statistically significant. Under normothermic conditions in rats, UW solution affords significant renal protection from ischemia. Euro-Collins, normal saline, and Ringer's lactate solutions display no significant protective effect.

Topics: Adenosine; Allopurinol; Animals; Blood Urea Nitrogen; Body Temperature; Cardioplegic Solutions; Creatinine; Glutathione; Hypertonic Solutions; Hypothermia, Induced; Insulin; Ischemia; Isotonic Solutions; Kidney; Male; Monitoring, Physiologic; Organ Preservation Solutions; Organ Size; Perfusion; Raffinose; Rats; Rats, Sprague-Dawley; Rectum; Renal Artery; Ringer's Lactate; Sodium Chloride; Tissue Preservation

The University of Wisconsin solution has been proven to be effective for prolonged heart preservation. However, 24-hour heart preservation by simple cold immersion in University of Wisconsin solution has been disappointing. We have performed hypothermic low-pressure continuous coronary perfusion with oxygenated University of Wisconsin solution for experimental prolonged heart preservation. However, the high potassium concentration of University of Wisconsin solution combined with prolonged ischemia has detrimental effects on endothelial function, which increases coronary tone during preservation and after reperfusion. The severe vasoconstriction and tissue edema result in damage to the coronary microcirculation. The purpose of this study was to determine whether hypothermic low-pressure continuous coronary perfusion technique with oxygenated University of Wisconsin solution containing a selective endothelin-A receptor antagonist (FR139317) would increase the effectiveness of the perfusion technique and improve postischemic cardiac function, both minimizing tissue edema and suppressing vasoconstriction.. Preischemic and postischemic cardiac function of isolated rabbit hearts was evaluated with a Langendorff apparatus. The hearts were divided into three groups (n = 7 each): group I (hypothermic low-pressure continuous coronary perfusion with University of Wisconsin solution), group II (hypothermic low-pressure continuous coronary perfusion with oxygenated University of Wisconsin solution), and group III (hypothermic low-pressure continuous coronary perfusion with oxygenated University of Wisconsin solution containing 10 mg/L of FR139317). Preservation was performed for 24 hours. The initial perfusion pressure for continuous coronary perfusion was set at 5 mm Hg. Measurement of percentage of tissue water content and ultrastructural examination of the myocardium was then performed. In groups I, II, and III, the perfusion pressures at the end of the 24-hour preservation period increased from 5 mm Hg to 12.2 +/- 2.5, 8.1 +/- 1.3, and 5.4 +/- 0.8 mm Hg (p < 0.05), respectively. Percent recovery rate of cardiac output was 56.6 +/- 2.8, 82.3 +/- 8.2, and 93.3 +/- 6.0 (p < 0.05), respectively. And percent recovery rate of coronary flow was 55.5 +/- 8.1, 80.0 +/- 8.0, and 94.3 +/- 9.4 (p < 0.05), respectively. A significant inverse correlation was found between continuous coronary perfusion pressure at the end of preservation and the recovery rate of cardiac output (r = 0.85, p < 0.05). Tissue water content was significantly higher in group I than in groups II and III. These effects were inhibited by oxygenation of the University of Wisconsin solution (group II) and by the addition of the selective endothelin-A receptor antagonist (FR139317) (group III). Damage to coronary circulation was reduced by oxygenation and the addition of endothelin-A receptor antagonist during prolonged heart preservation.. We concluded that hypothermic low-pressure continuous coronary perfusion technique with oxygenated UW solution containing endothelin-A receptor antagonist (FR139317) maintained coronary circulation by suppressing tissue edema and vasoconstriction during preservation, which improved postischemic functional recovery.

Topics: Adenosine; Allopurinol; Animals; Azepines; Blood Pressure; Body Water; Cardiac Output; Cardioplegic Solutions; Coronary Circulation; Cryopreservation; Edema; Endothelin Receptor Antagonists; Glutathione; Heart Transplantation; Hypothermia, Induced; Indoles; Insulin; Ischemia; Microcirculation; Myocardial Contraction; Myocardium; Organ Preservation; Organ Preservation Solutions; Oxygen; Rabbits; Raffinose; Reperfusion; Time Factors; Vasoconstriction

We examined the potential protective effect of pretreatment with corticosteroids or antioxidants (ascorbic acid or allopurinol) in rabbits with reperfusion-induced damage to skeletal muscle after ischemia. 4 hours of limb ischemia induced by a pneumatic tourniquet, followed by reperfusion for 1 hour, caused a considerable amount of ultrastructural damage to the anterior tibialis muscles accompanied by a rise in circulating creatine kinase activity. Pretreatment of animals with depomedrone by a single 8 mg bolus injection led to a preservation of the anterior tibialis structure on both light and electron microscopy. High-dose continuous intravenous infusion with ascorbic acid (80 mg/hr) throughout the period of ischemia and reperfusion also preserved skeletal muscle structure, although allopurinol in various doses had no protective effect. These data are fully compatible with a mechanism of ischemia/reperfusion-induced injury to skeletal muscle, involving generation of oxygen radicals and neutrophil sequestration and activation. They also indicate that damage to human skeletal muscle caused by prolonged use of a tourniquet is likely to be reduced by simple pharmacological interventions.

Topics: Allopurinol; Animals; Anti-Inflammatory Agents; Antimetabolites; Antioxidants; Ascorbic Acid; Ischemia; Methylprednisolone; Methylprednisolone Acetate; Muscles; Rabbits; Reperfusion Injury

Retrograde oxygen persufflation (ROP) has been reported to be beneficial to kidney preservation. The purpose of this study was to investigate whether use of ROP during cold storage (CS) with Universita of Wisconsin (UW) solution could ameliorate energy metabolism and functional recovery of ischemically injured rat kidneys and, moreover, to study the particular role of adenosine (ADO) in CS with ROP. Kidneys subjected to 30 min of warm ischemia (WI) were preserved for 24 h in 4 degrees C UW solution with or without ROP and with or without ADO. Measurements of tissue high-energy phosphate levels showed that reduced total adenine nucleotides (TAN) after 30 min of WI further declined during the subsequent CS. In ROP kidneys, however, TAN were less reduced, suggesting that even during CS, TAN can still be regenerated in the injured kidneys when ROP is combined with UW solution. When UW did not contain ADO, regeneration of TAN by ROP was slightly less than in the case of UW with ADO. This indicates that the supply of molecular oxygen is a significant factor in TAN resynthesis during CS. There was no statistically significant difference in survival rate between the ROP and CS groups, indicating that an improved energy status is not the sole determinant of functional recovery. We conclude that the gaseous oxygen supply provided by ROP during CS in UW solution ameliorates the energy state of ischemically injured rat kidneys and that exogenous ADO from the UW solution contributes to the improvement of energy metabolism to a limited extent.

Topics: Adenine Nucleotides; Adenosine; Allopurinol; Animals; Energy Metabolism; Glutathione; Graft Survival; Hypothermia, Induced; Insulin; Ischemia; Kidney; Kidney Transplantation; Male; Organ Preservation; Organ Preservation Solutions; Oxygen; Raffinose; Rats; Rats, Inbred Lew; Solutions

The uptake of hyaluronic acid (HA) was used to assess preservation damage to sinusoidal endothelial cells (SEC) during cold storage and subsequent normothermic reperfusion of rat livers. After 8, 16, 24, and 48 h storage in University of Wisconsin (UW) solution, livers were gravity-flushed via the portal vein with a standard volume of cold UW solution containing 50 micrograms/l HA. The effluent was collected for analysis of HA, aspartate aminotransferase (AST), and lactate dehydrogenase (LDH). The mean uptake of HA at 0 h was 59.1% +/- 4.6% (mean +/- SEM). After 8 h of storage, HA uptake was similar (55.5% +/- 7.3%), whereas after 16 h of storage it was reduced to 34.7% +/- 5.8%. At 24 and 48 h of storage, no uptake of HA was found. In a second series of experiments, livers were stored in UW solution and subsequently reperfused for 90 min with a Krebs-Henseleit solution (37 degrees C) in a recirculating system containing 150 micrograms/l HA. Following 8 h of storage, 34.6% +/- 8.0% of the initial HA concentration was taken up from the perfusate. After 16 and 24 h of storage, no uptake of HA was found. The results of this study indicate that damage to SEC occurs progressively during storage, leading to zero uptake of HA by the rat livers at 24 h of cold ischemia time. Additional reperfusion injury to the SEC was demonstrated by the reduced ability of the SEC to take up HA following normothermic reperfusion. The uptake of exogenous HA in preserved livers, used as a tool to assess SEC injury, enables the detection of early preservation damage.

Topics: Adenosine; Allopurinol; Animals; Biomarkers; Cold Temperature; Endothelium; Female; Glucose; Glutathione; Hyaluronic Acid; Insulin; Ischemia; Liver; Organ Preservation; Organ Preservation Solutions; Oxygen; Raffinose; Rats; Rats, Wistar; Reperfusion Injury; Temperature; Tromethamine

We investigated the role of adhesion molecules in the early phase of reperfusion following cold ischemia. Livers of male Lewis rats were preserved for 0 h (group A) or 24 h in University of Wisconsin (UW) solution without additives (group B) or in UW solution with anti-ICAM-1 antibody (group C) or anti-E-selectin-1, SLe(x) and SLe(a) antibodies (group D). The livers were then reperfused with diluted rat whole blood (DWB; groups A and B). DWB containing anti-ICAM-1 and LFA-1 antibodies (group C) or DWB containing anti-L-selectin, SLe(x) and SLe(a) antibodies (group D). The reperfusion was performed at 37 degrees C for 1 h at 5 cm H2O of perfusion pressure. During reperfusion, hepatic microcirculation was assessed by monitoring portal and peripheral tissue blood flow. Bile production was significantly reduced in group B livers compared with those in group A. Anti-ICAM-1 and LFA-1 antibodies failed to improve hepatic microcirculation, whereas anti-LECAM-1, SLe(x) and SLe(a) antibodies significantly improved the microcirculation. Bile production in group C and D livers was comparable to that in group B livers. Preservation for 24 h significantly increased the release of TNF-alpha from 0.207 to 43.7 pg/g per hour during reperfusion. Monoclonal antibodies to the adhesion molecules did not suppress the release of TNF-alpha in groups C and D. Histological examination demonstrated a lack of leukocyte infiltration or thrombus in hetapic microvessels. The extent of hepatocyte necrosis did not differ among groups B, C, and D. We conclude that the microcirculatory disturbance in the early phase of reperfusion occurs as a result of the tethering of leukocytes through the interaction of the selectin family and their ligands, and that the ICAM-1-LFA-1 pathway is not involved in this step. The lack of improvement in bile production with antibodies to the selectin family and their ligands strongly suggests that other mechanisms participate in the deterioration of hepatic function.

Topics: Adenosine; Allopurinol; Animals; Antibodies, Monoclonal; Antibody Specificity; Bile; CA-19-9 Antigen; Cell Adhesion; Cold Temperature; E-Selectin; Glutathione; Insulin; Intercellular Adhesion Molecule-1; Ischemia; L-Lactate Dehydrogenase; L-Selectin; Leukocytes; Liver; Lymphocyte Function-Associated Antigen-1; Male; Microcirculation; Necrosis; Oligosaccharides; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Inbred Lew; Reperfusion; Reperfusion Injury; Sialyl Lewis X Antigen; Tumor Necrosis Factor-alpha

We have shown that 5-hr preservation using the two-layer (University of Wisconsin solution/perfluorochemical) method at 20 degrees C allows ATP synthesis and makes it possible to resuscitate a canine pancreas subjected to 90 min of warm ischemia. However, 8 hr of preservation using this method caused a disturbance of vascular microcirculation and did not resuscitate the grafts. The aim of this study was to examine the effect of thromboxane A2 synthesis inhibitor OKY046 on vascular endothelial cells and ATP tissue levels of canine pancreas during preservation using the two-layer (University of Wisconsin solution/perfluorochemical) method at 20 degrees C, and vascular microcirculation and pancreas viability after transplantation. Graft viability was judged by graft survival following autotransplantation. ATP tissue levels were measured by high-performance liquid chromatography at the end of preservation. Viability of the vascular endothelial cells was judged using nuclear trypan blue uptake of the graft after preservation. Pancreatic tissue perfusion was measured using an H2 clearance technique after reperfusion. Pancreas grafts subjected to 90 min of warm ischemia were not viable (0/5). However, 5-hr preservation made it possible to recover the pancreas (5/5); 8-hr preservation was not successful (0/3). ATP tissue levels after 5-hr and 8-hr preservation were 9.40+/-2.09 and 7.37+/-1.06 micromol/g dry weight, respectively, and OKY046 did not affect ATP synthesis during 8-hr preservation (8.44+/-0.92 micromol/g dry weight). The percentage of nuclear trypan blue uptake of endothelial cells in 8-hr-preserved grafts was 37.6+/-11.6% and was significantly higher than the value in 5-hr-preserved grafts (5.0+/-3.0%; P<0.01). However, OKY046 significantly reduced trypan blue uptake in 8-hr-preserved grafts (8.2+/-3.6%; P<0.01). Pancreatic tissue perfusion in 8-hr-preserved grafts after 2 hr of reperfusion was 28.5+/-7.5 ml/min/100 g, and was significantly lower than the value in 5-hr-preserved grafts (57.1+/-4.4 ml/ min/100 g; P<0.01), but OKY046 dramatically improved pancreatic tissue perfusion (97.1+/-14.6 ml/min/100 g; P<0.01). As a consequence, 8-hr-preserved grafts were resuscitated (4/5). We conclude that OKY046 protects the vascular endothelium during preservation by the two-layer method at 20 degrees C and consequently improves vascular microcirculation on reperfusion. Together with ATP synthesis, which is essential for repairing damaged cells, the canine p

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Dogs; Endothelium, Vascular; Enzyme Inhibitors; Female; Glutathione; Graft Survival; Insulin; Ischemia; Male; Methacrylates; Organ Preservation; Organ Preservation Solutions; Pancreas; Pancreas Transplantation; Perfusion; Raffinose; Temperature; Thromboxane A2; Time Factors; Trypan Blue

Activity of xanthine oxidoreductase (total xanthine dehydrogenase plus xanthine oxidase) and xanthine oxidase was determined cytophotometrically in periportal and pericentral areas of livers of rats under various (patho)physiological conditions that are known to affect the content of reduced glutathione. For this purpose, rats were either normally fed or fasted for 24 hours, fasted for 24 hours, and treated with diethylmaleate that depleted glutathione or treated by in vivo ischemia for 2 hours in the livers. Xanthine oxidoreductase activity was shown histochemically with the use of a tetrazolium salt procedure, and xanthine oxidase activity was localized with a cerium-diaminobenzidine-cobalt-hydrogen peroxide technique in unfixed cryostat sections of the livers. Cytophotometric measurements showed that total xanthine oxidoreductase activity was decreased after fasting and ischemia, whereas only ischemia caused reduced xanthine oxidase activity. Moreover, the percentage of xanthine oxidase of total xanthine oxidoreductase activity was constant in both periportal and pericentral areas at the level of approximately 4% in normally fed and 24-hour fasted and diethylmaleate-treated rats. Ischemia reduced this percentage in both areas of the liver to 2%. It was concluded that the amount of endogenous reduced glutathione did not affect the percentage of xanthine oxidase. The low percentage of xanthine oxidase as determined in the present in situ histochemical study indicates that in vivo the percentage oxidase in rat liver is lower than is assumed on the basis of biochemical assays in liver homogenates even after strictly controlled homogenization procedures. Apparently, conversion of xanthine dehydrogenase into xanthine oxidase may occur in vitro to yield percentages of xanthine oxidase of 10%-20% as are reported in the literature. The latter increase in the percentage of xanthine oxidase may be caused by changes in the local environment of the enzymes, which is left completely intact in histochemical assays. The finding of this low percentage of xanthine oxidase further stresses that the main function of xanthine oxidoreductase in the liver is not the production of superoxide anion radicals and/or hydrogen peroxide but rather the metabolism of xanthine to uric acid, which can act as a potent antioxidant.

Topics: Animals; Fasting; Glutathione; Ischemia; Liver; Male; Rats; Rats, Wistar; Xanthine Dehydrogenase; Xanthine Oxidase

Gut ischemia has been implicated in the pathogenesis of necrotizing enterocolitis. Cyclosporine A and rapamycin, both potent novel immunosuppressants which act on signal transduction pathways in CD4+ T-cells, could potentially modulate immune/inflammatory cellular reactions involved in tissue ischemia/reperfusion injury. We hypothesized that cyclosporine A and rapamycin would preserve mucosal cell function and attenuate inflammatory T-cell-mediated cellular changes associated with small bowel ischemic injury. Forty Sprague-Dawley rats underwent 60 min of gut ischemia by vascular occlusion of the superior mesenteric vessels. Animals were randomized to four groups (n = 10): cyclosporine A (CSA, 5 mg/kg/day SQ), rapamycin (RAP, 2 mg/kg/day SQ), cyclosporine A and rapamycin (C&R), and vehicle given to controls (CON). Following 1 hr of reperfusion, small bowel was harvested for xanthine oxidase (XO, units/mg protein) and maltase (MALT, mM substrate degraded/min/g protein) assays. Blood was obtained from the portal vein for tumor necrosis factor-alpha (TNF-alpha, pg/ml) assay. The results of the study are presented below (mean +/- SEM, *, P < 0.05 versus controls). (Table in text) The results indicate that cyclosporine and rapamycin each play a significant role in attenuating ischemia/reperfusion injury in the gut. These data suggest that there are cytoprotective and anti-inflammatory mechanisms of these drugs independent of T-cell signal transduction that provide some protective effect in small bowel ischemia. Furthermore, T-cell-mediated immune mechanisms may not be associated with the adverse effects of small bowel ischemia/reperfusion injury. Additional investigation will be necessary in order to define the role of T-cell-mediated immune injury in the gut and how this relates to the beneficial effect of immunosuppression in small bowel mucosal ischemic injury.

Topics: alpha-Glucosidases; Animals; Cyclosporine; Immunosuppressive Agents; Intestinal Mucosa; Intestine, Small; Ischemia; Male; Polyenes; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Sirolimus; Tumor Necrosis Factor-alpha; Xanthine Oxidase

Topics: Adenosine Triphosphate; Animals; Energy Metabolism; Intestinal Mucosa; Ischemia; Jejunum; Organ Preservation; Rats; Rats, Inbred Strains; Reperfusion; Reperfusion Injury; Xanthine Oxidase

Topics: Adenine Nucleotides; Adenosine; Adenosine Diphosphate; Adenosine Monophosphate; Adenosine Triphosphate; Allopurinol; Animals; Glutathione; Hypertonic Solutions; Insulin; Intestinal Mucosa; Intestine, Small; Ischemia; Isotonic Solutions; Male; Mesenteric Artery, Superior; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Inbred Lew; Reperfusion; Reperfusion Injury; Ringer's Lactate; Time Factors

Topics: Administration, Oral; Allopurinol; Animals; Dogs; Intestinal Mucosa; Ischemia; Jejunum; Reperfusion Injury; Time Factors

In this study, the changes of arachidonic acid metabolites after an ischemia-reperfusion (I/R) period are investigated. The cyclooxygenase and lipoxygenase metabolites were found to be significantly increased after a 45 min period of ischemia followed by 5 min of reperfusion. Prostaglandin E2 (PGE2)- and leukotriene C4 (LTC4)-like activities did not change in the ischemic period, but they both increased after reperfusion. A cyclooxygenase inhibitor indomethacin and lipoxygenase inhibitor nordehydroguaretic acid (NDGA) decreased PGE2- and LTC4-like activities, respectively, while allopurinol and superoxide dismutase (SOD) decreased both activities. According to our results, it can be assumed that free oxygen radicals are responsible for the elevation of PGE2- and LTC4-like activities and both of these arachidonic acid metabolites and free oxygen radicals are the main necrotizing agents in ischemia-reperfusion induced damage.

Topics: Alkaline Phosphatase; Allopurinol; Animals; Antioxidants; Creatine Kinase; Cyclooxygenase Inhibitors; Dinoprostone; Enzyme Inhibitors; Female; Guinea Pigs; Indomethacin; Ischemia; Leukotriene C4; Male; Masoprocol; Mesentery; Rats; Reperfusion Injury; Superoxide Dismutase; Tocolytic Agents

Topics: Allopurinol; Animals; Dinoprostone; Endothelins; Female; Ischemia; Leukotriene C4; Malondialdehyde; Mesenteric Artery, Superior; Rats; Rats, Sprague-Dawley; Reperfusion Injury

Topics: Allopurinol; Animals; Calcium; Endothelins; Female; In Vitro Techniques; Ischemia; Malondialdehyde; Mesenteric Artery, Superior; Muscle, Smooth, Vascular; Rats; Rats, Sprague-Dawley; Thiobarbituric Acid Reactive Substances; Verapamil

Topics: Adenosine Triphosphate; Allopurinol; Animals; Energy Metabolism; Ischemia; Male; Muscle Fatigue; Muscle, Skeletal; Phosphocreatine; Rats; Rats, Wistar; Reference Values; Reperfusion Injury

Topics: Animals; Ischemia; Liver; Male; Rats; Rats, Wistar; Reperfusion; Xanthine Dehydrogenase; Xanthine Oxidase

Topics: Adenosine; Adult; Allopurinol; Glutathione; Graft Rejection; Heart; Heart Transplantation; Heart-Lung Transplantation; Humans; Hypertonic Solutions; Insulin; Ischemia; Length of Stay; Organ Preservation; Organ Preservation Solutions; Raffinose; Retrospective Studies; Time Factors; Tissue Donors

Topics: Adenosine; Allopurinol; Animals; Glutathione; Insulin; Ischemia; Kidney Transplantation; Organ Preservation; Organ Preservation Solutions; Rabbits; Raffinose; Reperfusion; Temperature; Transplantation, Autologous

Topics: Adenosine; Allopurinol; Animals; Cell Adhesion; Cold Temperature; Endothelium, Vascular; Glutathione; Graft Survival; Insulin; Ischemia; Leukocytes; Liver Circulation; Liver Transplantation; Microcirculation; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Inbred ACI; Reperfusion Injury; Tacrolimus; Transplantation, Isogeneic

In the present study, using retinal ischemia as a model, we examined if different periods of ischemia and recirculation influenced the generation of reactive oxygen species, i.e. in hydrogen peroxide generation and nitroblue tetrazolium (NBT) reduction. Ischemia was induced for 30 and 90 min by ligation of the optic nerve with the vessels and recirculation was established by removing the ligature. The rats were sacrificed after 15 min or 3 days of recirculation. The retinas were separated from the pigment epithelium for measurements of catalase activity and examination of NBT staining. Compared to controls, the catalase activity was increased after 30 and 90 min of ischemia followed by 15 min of recirculation, and after 90 min of ischemia followed by 3 days of recirculation. As in controls, NBT staining was observed, both after 30 and 90 min of ischemia followed by 15 min of recirculation, in photoreceptors, in both plexiform layers, in some ganglion and glial cells, and, occasionally, in cells in the inner nuclear layer. Opposite to controls, addition of hypoxanthine to the NBT solution resulted in an increased staining in vessels in the inner nuclear layer in retinas subjected to 30 min of ischemia followed by 3 days of recirculation. The increased catalase activity suggests an increased amount of this free radical scavenger after ischemia followed by short-term and long-term recirculation. The hypoxanthine-enhanced NBT staining of blood vessel walls after ischemia followed by long-term recirculation indicates an activation of xanthine oxidase and an increased production of NBT reductants, some of which may represent oxygen free radicals.

Topics: Animals; Catalase; Endothelium, Vascular; Free Radicals; Hypoxanthine; Hypoxanthines; Ischemia; Male; Nitroblue Tetrazolium; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Reperfusion; Retina; Retinal Vessels; Staining and Labeling; Xanthine Oxidase

Serum concentration of thiobarbituric acid (TBA) reactants in the hepatic vein were measured before and after transient dearterialization of the liver in five human subjects bearing unresectable hepatocellular carcinoma (HCC). During 1 hour of the occlusion of the hepatic artery, change in TBA reactants level was slight. However, the mean value of TBA reactants in 1 hour after the reflow increased to 1.50 +/- 0.11 nmol/ml (mean +/- S.E.) and was significantly higher (p < 0.05) than those before hepatic dearterialization (1.28 +/- 0.11 nmol/ml) and just before the release of occlusion (1.32 +/- 0.09 nmol/ml). Further, two endogeneous scavenger enzymes, superoxide dismutase (SOD) and catalase (CAT), and one of the major sources of oxygen free radicals, xanthine oxidase (XOD) were measured in human untreated HCC and the corresponding adjacent liver tissue. The results demonstrated an increase in SOD in 81.8% (9/11) of HCC, and a decrease in CAT in 72.7% (8/11) of HCC when compared with the corresponding adjacent liver tissue. The mean value of SOD in HCC was significantly higher (66.8 +/- 6.5 vs 52.8 +/- 3.8 U/mg protein; p < 0.05), and that of CAT was significantly lower (22.6 +/- 2.4 vs 36.0 +/- 6.1 U/mg protein; p < 0.05) than those in liver tissue. All of nine HCC samples had a significantly lower activity of XOD (6.4 +/- 1.9 vs 20.3 +/- 3.4 pmol/minute/mg protein; p < 0.01) than the corresponding liver tissue. There was no obvious relation between the content of SOD and CAT in HCC, or in liver tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Carcinoma, Hepatocellular; Catalase; Female; Free Radicals; Humans; Ischemia; Liver; Liver Circulation; Liver Neoplasms; Male; Middle Aged; Oxygen; Reactive Oxygen Species; Reperfusion; Superoxide Dismutase; Thiobarbiturates; Xanthine Oxidase

The implication of different eicosanoids and oxygen free radicals in the development of pancreatic injury after an ischemia-reperfusion process has been evaluated. For this purpose we have compared the effect of allopurinol and indomethacin administration on the pancreatic levels of eicosanoids in a rat model of pancreatic ischemia-reperfusion. After 60 min of pancreatic ischemia and 2 h of reperfusion, significant increases in 6-keto-PGF1 alpha, PGE2, and LTB4 in pancreas tissue were detected. Allopurinol before the ischemic period reduced 6-keto-PGF1 alpha, PGE2, and LTB4 levels to the range of basal values, while prior indomethacin treatment significantly reduced 6-keto-PGF1 alpha and PGE2 levels, with LTB4 remaining unmodified. Increased postischemic plasma lipases were also significantly reduced by allopurinol to the range of sham-operated animals whereas indomethacin did not modify these levels. The data suggest a role for lipoxygenase metabolites in the development of pancreatic injury and the importance of the enzyme xanthine oxidase as an inductor of eicosanoid biosynthesis.

Topics: 6-Ketoprostaglandin F1 alpha; Allopurinol; Animals; Biomarkers; Cyclooxygenase Inhibitors; Dinoprostone; Free Radicals; Indomethacin; Ischemia; Leukotriene B4; Lipase; Lipoxygenase; Male; Oxidative Stress; Pancreas; Pancreatitis; Rats; Rats, Wistar; Reactive Oxygen Species; Reperfusion Injury; Xanthine Oxidase

Reactive oxygen species play an important role in pathogenesis of a variety of pathological processes, e.g., ischemia-reperfusion, acute viral infections, thermal injury, hepatic diseases, and acute lung injury. Xanthine oxidase (XO) may be a significant source of these cytotoxic oxygen species. We tested the hypothesis that hepatic ischemia-reperfusion releases xanthine dehydrogenase + XO (XDH + XO) into the circulation and that circulating XO damages isolated perfused lung. Isolated liver + lung preparation was perfused with Krebs-Henseleit buffer to minimize confounding effects of circulating neutrophils. In one group, livers were rendered globally ischemic for 2 h and then reperfused (I/R). In another group, livers were pretreated with allopurinol and perfused with buffer containing additional allopurinol (I/R + Allo). After 2 h of ischemia, an isolated lung was connected to liver, and liver + lung preparation was reperfused in series for 15 min. Liver reperfusion was terminated, and lung was recirculated with liver effluent for 45 min. Capillary filtration coefficient (ml.min-1.cmH2O-1.100 g lung dry wt-1) was 2.0 +/- 0.3 and 1.9 +/- 0.4 in control and I/R + Allo lungs, respectively, and 9.0 +/- 1.2 in I/R lungs (P < 0.001). Lung wet-to-dry weight ratio in control and I/R + Allo lungs was 8.6 +/- 0.3 and 9.1 +/- 0.5, respectively, and 14.9 +/- 1.1 in I/R lungs (P < 0.01). Control and I/R + Allo bronchoalveolar lavage protein content was < 1.0 mg/ml compared with 32.6 +/- 8.4 mg/ml in I/R group.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Allopurinol; Animals; Bronchoalveolar Lavage Fluid; In Vitro Techniques; Ischemia; L-Lactate Dehydrogenase; Liver; Liver Circulation; Lung; Male; Perfusion; Permeability; Proteins; Pulmonary Circulation; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Reperfusion; Xanthine Dehydrogenase; Xanthine Oxidase

Taurine (2-aminoethane sulfonic acid) is a physiologic amino acid involved in cellular osmoregulation in various species including man. This study was intended to compare the respective effects of cold storage and consecutive ischemic rewarming of the liver postischemic hepatic flow and hepatocellular outcome upon reperfusion with or without the addition of taurine to the preservation medium. Livers from male Wistar rats were rinsed free of blood via the portal vein and stored ischemically at 4 degrees C in UW solution. Livers from group 1 were then rinsed again with 10 ml Ringer's solution and reperfused with Krebs-Henseleit buffer at a constant pressure of 10 mmHg for 45 min at 37 degrees C in a nonrecirculating manner. Livers from groups 2 and 3 were subjected to 30 min of warm ischemia subsequent to cold storage and prior to reperfusion with 10 mM taurine added to the UW solution in group 3. While there were only very few signs of hepatic injury in group 1, the additional period of warm ischemia (group 2) led to a significant reduction in early perfusate flow and enhanced enzyme leakage from the livers during postischemic rinse and reperfusion. Livers in group 3 exhibited an amelioration in hepatic circulation and significantly reduced enzyme release as compared to group 2. The results clearly demonstrate a remarkable impact of postischemic rewarming on graft viability. Furthermore, the addition of taurine to the preservation medium was shown to improve hepatic circulation and enhance viability of the liver upon reperfusion.

Topics: Adenosine; Allopurinol; Animals; Glutathione; Insulin; Ischemia; Liver; Male; Organ Preservation Solutions; Perfusion; Raffinose; Rats; Rats, Wistar; Taurine; Temperature; Tissue Preservation

To ascertain whether surgery causes ischaemia-reperfusion (I-R) related injury, if this injury is augmented by preoperative shock, and reduced with low dose allopurinol.. Randomised blind placebo controlled trial.. Surgical laboratory.. 22 pigs were randomly allocated to four groups; OP = operation/placebo, OA = operation/ allopurinol, SOP = shock + operation/placebo, SOA = shock + operation/allopurinol. An aortic tube prosthesis was inserted in all. In groups SOP and SOA preoperative shock was induced by exsanguination. Allopurinol was administered in group OA on the preoperative day and peroperatively, in group SOA during shock and peroperatively.. Perioperative blood concentrations of thiobarbituric acid reactive species (TBARS), ascorbic acid (AA), albumin, 99mTc-albumin and creatine phosphokinase (CPK) as indicators of oxidative membrane damage, antioxidant activity, microvascular permeability changes and muscular cell damage respectively.. In the OP and OA groups TBARS gradually increased, while AA, 99mTc-albumin and CPK remained unchanged and albumin decreased. No effect of allopurinol was observed in these groups. In the SOP group TBARS and AA were not significantly different from groups OP and OA. Yet, albumin, 99mTc-albumin and CPK decreased significantly more in the SOP group. Compared with the SOP group, allopurinol treatment (SOA) produced lower TBARS and higher AA levels, and reduced the effect of shock on albumin, 99mTc-albumin and CPK concentrations.. Aortic surgery causes no I-R related damage. Pre-operative shock produces I-R related damage, which is reduced by allopurinol.

Topics: Allopurinol; Animals; Antioxidants; Aorta, Abdominal; Ascorbic Acid; Blood Vessel Prosthesis; Capillary Permeability; Creatine Kinase; Female; Granulocytes; Ischemia; Muscle, Skeletal; Oxidation-Reduction; Placebos; Random Allocation; Reperfusion Injury; Serum Albumin; Shock; Single-Blind Method; Swine; Technetium; Thiobarbituric Acid Reactive Substances

Warm and cold ischemia-reperfusion injuries to canine small intestine was compared. In the warm ischemic model, the superior mesenteric artery of mongrel dogs was clamped for 2 h and then released (group A). As a cold ischemia model, canine small intestines were harvested with cold lactated Ringer solution, preserved for 24 h in cold LR solution and then autotransplanted (group B). After ischemia and during reperfusion, activities of maltase (MAL), myeloperoxides (MPO), xanthine dehydrogenase (XD) and xanthine oxidase (XO) were measured as well as hypoxanthine (HX) concentration. MAL activities were not changed during warm or cold ischemia, whereas it was remarkably decreased after revascularization in both the groups. Neutrophil infiltration after reperfusion was shown by the increase of MPO activities to 8 and 1.5 U/mg protein in groups A and B respectively from a normal value of 0.35 U/mg protein. During warm ischemia, %XO (XO/XD + XO) was increased from 18.4 to 84.9% for 2 h. In contrast, %XO was not changed for 24 h of cold ischemia. Tissue accumulation of HX was increased 2.8 times from a normal value of 1.06, 2 h after warm ischemia, but there was almost neither accumulation of HX nor the conversion of XD to XO in 24 h cold ischemia. It was observed that warm and cold ischemia caused similar injury after reperfusion in spite of the striking difference in the conversion of XD to XO and accumulation of HX. Thus, it is suggested that the XO system is not always necessary for ischemia-reperfusion injury.

Topics: alpha-Glucosidases; Animals; Cold Temperature; Dogs; Female; Hot Temperature; Hypoxanthine; Hypoxanthines; Intestinal Mucosa; Intestine, Small; Ischemia; Male; Osmolar Concentration; Peroxidase; Reperfusion; Xanthine Dehydrogenase; Xanthine Oxidase

Topics: Adenosine; Adult; Allopurinol; Female; Glutathione; Humans; Insulin; Ischemia; Liver; Liver Transplantation; Male; Morbidity; Organ Preservation; Organ Preservation Solutions; Postoperative Complications; Raffinose; Retrospective Studies

Topics: Adenosine; Allopurinol; Elective Surgical Procedures; Emergencies; Female; Glutathione; Humans; Hypertonic Solutions; Insulin; Ischemia; Liver; Liver Transplantation; Male; Organ Preservation; Organ Preservation Solutions; Postoperative Complications; Probability; Prognosis; Raffinose; Renal Insufficiency; Retrospective Studies; Risk Factors; Time Factors

Topics: Adenosine; Allopurinol; Animals; Bacterial Physiological Phenomena; Glutathione; Insulin; Intestine, Small; Ischemia; Isotonic Solutions; Lipid Peroxidation; Male; Malondialdehyde; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Inbred Lew; Reperfusion Injury; Ringer's Lactate; Transplantation, Isogeneic

Topics: Adenosine; Allopurinol; Blood Loss, Surgical; Constriction; Embolism, Air; Follow-Up Studies; Glutathione; Hepatectomy; Hepatic Veins; Humans; Hypothermia, Induced; Insulin; Ischemia; Ligation; Liver Circulation; Liver Diseases; Liver Failure; Liver Neoplasms; Organ Preservation Solutions; Perfusion; Portal Vein; Raffinose; Survival Rate; Time Factors; Tissue Preservation; Vena Cava, Inferior

Reactive oxygen species (ROS) generated from xanthine oxidase (XO) play an important role in ischemia-induced injury. We hypothesize that XO and xanthine dehydrogenase (XDH) are released into the circulation with ischemia reperfusion to the human liver and intestine. Blood was drawn from a patient, before and at intervals after an aortic cross-clamp procedure. Plasma was incubated in the presence of xanthine, with NAD+ (for XD +XO) and without NAD+ (for XO). The amount of urate formed was quantified using a high-performance liquid chromatograph (HPLC). The calculated XDH+XO and XO activity increased from 1.88 and 1.66 microU/mg protein, respectively, before the cross clamp to 3.77 and 3.11 microU/mg, respectively, 7 minutes after reperfusion to the superior mesenteric, celiac, and right renal artery beds. The release of a significant biological source of ROS may explain the damage to lung or heart observed after ischemia to the human liver and intestine.

Topics: Aged; Anastomosis, Surgical; Aorta; Aortic Aneurysm; Chromatography, High Pressure Liquid; Constriction; Humans; Intestines; Ischemia; Liver; Male; Reactive Oxygen Species; Reperfusion Injury; Xanthine Dehydrogenase; Xanthine Oxidase

The standard preservation technique in lung transplantation is cold single pulmonary artery flush (PAF) with Eurocollins solution (ECS). We compared ECS with University of Wisconsin (UW) solution, with and without added indomethacin, in single PAF preservation in an in vivo rabbit model of warm ischemia-reperfusion lung injury. Six groups of four New Zealand white rabbits each underwent isolation and hilar stripping of the left lung. In the four experimental groups, the left lung was flushed with (15 ml/kg) of cold ECS or UW solution, with or without added indomethacin, before warm ischemia for 120 minutes and before reperfusion for 60 minutes. The remaining two groups were the nonischemic and the ischemic "no flush" controls. Transcapillary flux of 99mTechnitium-labeled albumin and electron microscopy were used to demonstrate lung injury. Pulmonary vascular resistance (PVR) and thromboxane B2 (TXB2) concentrations were measured. There was a significant rise in PVR after ischemia/reperfusion in the ischemic control group (54.7 +/- 13.9 to 117.8 +/- 20.7 mm Hg/L.min-1, P < 0.05). The net rise in PVR after ischemia-reperfusion was significantly smaller in the two groups in which indomethacin was added (16.8 +/- 17.5 and 4.5 +/- 10.6 mm Hg/L.min-1 for UW and ECS, respectively) compared with the ischemic control (63.1 +/- 24.6 mm Hg/L.min-1, P < 0.05). Post-reperfusion TXB2 levels tended to be lower in the nonischemic control group and in the indomethacin-flush groups. We conclude that the increase in PVR produced by unilateral ischemia-reperfusion lung injury in this model was improved by single PAF perfusion. There was no significant difference between UW solution and ECS in this regard. The addition of indomethacin to the flush solution was associated with lower PVRs as well as morphologic improvement by electron microscopy. These findings may indicate a prominent role for the provision of PG synthesis inhibition during preservation for lung transplantation.

Topics: Adenosine; Allopurinol; Animals; Blood Pressure; Glutathione; Hypertonic Solutions; Indomethacin; Insulin; Ischemia; Lung; Organ Preservation; Organ Preservation Solutions; Oxygen; Partial Pressure; Pulmonary Artery; Rabbits; Raffinose; Reperfusion; Thromboxane B2; Vascular Resistance

1. The role of allopurinol in the protection of kidney function following ischaemia-reperfusion injury has been investigated using the novel technique of near-infrared spectroscopy. 2. An in vivo model of rat kidney ischaemia was used, with the expected falls in blood and tissue oxygenation seen and confirmed by near-infrared spectroscopy. 3. Allopurinol infusion increased the rate of reperfusion of oxygenated blood seen in control rats (P < 0.05). 4. Allopurinol enhanced the rate of tissue oxygenation during early reperfusion (P < 0.01). 5. This study provides further evidence for the proposed benefits of allopurinol in ischaemia-reperfusion injury. Furthermore, the potential of near-infrared spectroscopy as a technique of value in interventional studies of this nature is confirmed.

Topics: Allopurinol; Animals; Hemoglobins; Ischemia; Kidney; Male; Oxyhemoglobins; Random Allocation; Rats; Rats, Sprague-Dawley; Reperfusion Injury

We investigated the effects of allopurinol on renal damage following renal ischemia. Male Wistar rats weighing 250-300 g were classified into enflurane and allopurinol groups and anesthetized for 5 minutes using 1.7 MAC of enflurane in 30% oxygen. Then the left renal artery was dissected and clamped. Arterial occlusion was performed under 1.3 MAC enflurane for 30 minutes. Anesthesia was maintained for an additional 90 minutes after releasing the clip. In the allopurinol group, the rats were administered with allopurinol 3 mg.kg-1 intravenously prior to renal ischemia. At the end of anesthesia and 24 hours after the discontinuation of anesthesia, the necrotic areas, kidney weight/body weight ratios, gamma-GTP and NAG activities of the kidney which had been clamped were examined. Urinary gamma-GTP and NAG activities and serum inorganic fluoride concentrations were also measured. The necrotic area was significantly smaller in the allopurinol group than in the enflurane group. The activity of gamma-GTP in the kidney was higher in the allopurinol group than in the enflurane group. The kidney weight/body weight ratio was lower in the allopurinol group than in the enflurane group. There was no difference in serum inorganic fluoride concentration between the allopurinol and enflurane groups. These results suggest that allopurinol decreases renal damage following renal ischemia under enflurane anesthesia.

Topics: Allopurinol; Anesthesia, Inhalation; Animals; Constriction; Enflurane; Ischemia; Kidney; Male; Premedication; Rats; Rats, Wistar; Reperfusion Injury

Topics: Animals; Fasting; Ischemia; Liver; Rats; Reperfusion Injury; Xanthine Dehydrogenase; Xanthine Oxidase

The present paper shows that cultured bovine endothelial cells can be labeled with 3H-carnitine by incubation. This process is slow and is uphill, requiring Na+/K+ ATPase activity. After 3 days incubation isotopic equilibrium is reached, when the cells contain about 0.5 mM (total) carnitine at a medium concentration of about 3 microM. The plasmamembrane barrier is rather resistant to acidosis and oxygen free radicals (OFR). The rate of carnitine release increases significantly only at pH below 5.8. At pH 6.0 the release of stored carnitine can be initiated by the addition of D- or L-lactate. OFR, generated by the addition of xanthine and xanthine oxidase, did not affect carnitine release. Both mild acidosis and OFR left plasmamembranes of endothelial cells intact as judged by the absence of lactate dehydrogenase loss from the cells. Therefore, the known increase of capillary permeability during ischemia and reperfusion may not be due to plasmalemmal disruption of individual endothelial cells, but to increase of inter-endothelial spaces.

Topics: Acidosis; Animals; Carnitine; Cattle; Cell Membrane; Cells, Cultured; Endothelium, Vascular; Female; Free Radicals; Hydrogen-Ion Concentration; Ischemia; Kinetics; L-Lactate Dehydrogenase; Lactates; Mitochondria; Ouabain; Reactive Oxygen Species; Xanthine; Xanthine Oxidase; Xanthines

Liver regeneration plays a key role in restoring the liver/body ratio after partial liver transplantation. However, hepatic ischemia hinders the proliferative response of the hepatocytes. In this study, different ways of improving the regenerating capacity of ischemic hepatocytes are tested. Following 70% hepatectomy and 15 min of normothermic liver ischemia, the percentage of regenerating hepatocytes and the regenerative gradient are assessed. Cyclosporine A (hepatotrophic agent), superoxide dismutase and folinic acid (antioxidants), administered during the ischemic period, have significantly increased these indices. The later drug has restored the regenerative response to the levels of normoperfused livers.

Topics: Allopurinol; Animals; Cyclosporine; Ischemia; Leucovorin; Liver; Liver Regeneration; Male; Rats; Rats, Sprague-Dawley; Superoxide Dismutase

Kupffer cell activation is hypothesized to play an etiopathogenic role in storage-related graft failure after liver transplantation. The aim of this study was to verify whether the elimination of Kupffer cells modifies the magnitude of cold ischemia/reperfusion injury of the liver.. Rat Kupffer cells were eliminated by an intravenous injection of liposome-encapsulated dichloromethylene diphosphonate. Livers from control and treated rats were isolated and perfused before and after 24-hour cold ischemia in the University of Wisconsin solution (4 degrees C). Hepatocyte and sinusoidal endothelial cell functions were evaluated by taurocholate and hyaluronic acid elimination, respectively. Liver transplantation was also performed using control and treated donor livers stored under identical conditions.. Compared with baseline values, similar alterations were found in both groups after cold ischemia for hepatocyte function (intrahepatic resistance, bile secretion, lactate dehydrogenase release, oxygen consumption, and taurocholate intrinsic clearance) and for sinusoidal endothelial cell function (hyaluronic acid intrinsic clearance). The 10-day survival rate of animals undergoing transplantation was not different between the groups (6 of 15 vs. 4 of 15, control vs. treated donor livers, respectively).. The presence or absence of Kupffer cells does not modify the effect of 24-hour cold ischemia/reperfusion on the rat liver.

Topics: Adenosine; Allopurinol; Analysis of Variance; Animals; Bile; Glutathione; Hyaluronic Acid; Hypothermia, Induced; In Vitro Techniques; Insulin; Ischemia; Kupffer Cells; L-Lactate Dehydrogenase; Liver; Liver Transplantation; Macrophage Activation; Male; Metabolic Clearance Rate; Organ Preservation; Organ Preservation Solutions; Oxygen Consumption; Raffinose; Rats; Reperfusion Injury; Taurocholic Acid; Tissue Survival

With the ex vivo perfused canine pancreas preparation, the infusion of acetaldehyde, the primary metabolite of ethanol oxidation, plus a short period of ischemia to convert xanthine dehydrogenase to xanthine oxidase, results in the physiologic injury response of acute pancreatitis (edema, weight gain, hyperamylasemia). The free radical scavengers superoxide dismutase and catalase and a xanthine oxidase inhibitor, allopurinol, ameliorate this injury response, suggesting that toxic oxygen metabolites generated by xanthine oxidase play an intermediary role.. The isolated ex vivo canine pancreas preparation was perfused for 4 hours, and weight gain of the preparation and amylase activity in the perfusate were monitored. Changes in pancreatic acinar cell architecture were characterized by light and electron microscopy, and intracellular phosphate metabolism was followed by magnetic resonance spectroscopy in control preparations and in glands simulating alcoholic pancreatitis.. Control preparations and preparations with a 1-hour period of ischemia before perfusion gained little weight (7 +/- 3 gm and 8 +/- 1 gm), amylase activity in the perfusate remained normal (933 +/- 513 units/dl and 1537 +/- 553 units/dl), and no changes in architecture were observed. Weight gain (5 +/- 6 gm) and amylase activity (1188 +/- 173 units/dl) were also normal in the preparations receiving acetaldehyde without preceding ischemia, but mild vascular and islet cell injury were observed on electron microscopy. One hour of ischemia followed by acetaldehyde infusion resulted in edema, increased weight gain (21 +/- 12 gm [p < 0.05]), and amylase activity (2487 +/- 1484 units/dl [p < 0.05]). Microscopy showed mild acinar cell damage and greater injury to the capillaries and the islets. The capillary and islet cell changes were reduced by superoxide dismutase and catalase. Intracellular adenosine triphosphate levels remained at baseline levels in the control preparations. Adenosine triphosphate decreased during ischemia but quickly recovered during perfusion without a significant difference whether acetaldehyde was infused after ischemia. An iron chelator desferoxamine ameliorated the injury response in the preparations simulating acute pancreatitis (weight gain, 13 +/- 6 gm [p = 0.09] and amylase activity, 1198 +/- 471 units/dl [p = 0.08]), but a cholecystokinin receptor antagonist L364,718 did not have an effect. A sulfhydryl group protector, dithiothreitol, decreased weight gain (10 +/- 7 gm [p = 0.06]), and amylase activity was not significantly increased over that of the control group (1582 +/- 641 units/dl), but a serine protease inhibitor phenylmethylsulphonylfluoride was ineffective.. In this model simulating acute alcoholic pancreatitis, both the early physiologic injury response and the early morphologic changes are mediated at least in part by free radicals, which are generated by xanthine oxidase converted reversibly from xanthine dehydrogenase. In addition to the superoxide radical, the hydroxyl radical may also be an important early intermediate step, but the cholecystokinin receptor is not.

Topics: Acetaldehyde; Acute Disease; Alcoholism; Animals; Disease Models, Animal; Dogs; Free Radicals; Ischemia; Pancreas; Pancreatitis; Receptors, Cholecystokinin; Xanthine Oxidase

As adenine nucleotide content has been shown to correlate with post-transplant function of livers and hearts, it was the aim of our study to investigate the regeneration of rat small bowel tissue high-energy phosphates after 7 hr of cold storage followed by incubation of everted small bowel sacs in normothermic oxygenated KHB for 1 hr. We compared the University of Wisconsin (UW) and the Eurocollins (EC) solutions. Krebs-Henseleit-bicarbonate buffer (KHB) was used to point out the effect of simple cold ischemic storage. After 7 hr of cold storage only small bowel stored in UW and EC solutions retained the capacity for almost total regeneration of ATP necessary for optimal posttransplant function, whereas in the KHB group we found only minimal regeneration. A similar pattern was found for the energy charge. These data support the superiority of UW and EC solutions over simple cold storage in KHB for preservation of small bowel.

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Cold Temperature; Glutathione; Hypertonic Solutions; Insulin; Intestine, Small; Ischemia; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Sprague-Dawley

Topics: Adenine Nucleotides; Adenosine; Allopurinol; Animals; Energy Metabolism; Glutathione; Hypertonic Solutions; Insulin; Intestinal Mucosa; Intestine, Small; Ischemia; Isotonic Solutions; Male; Organ Preservation Solutions; Raffinose; Rats; Rats, Inbred Lew; Reperfusion; Ringer's Lactate; Time Factors

Topics: Adenosine; Adolescent; Adult; Allopurinol; Cadaver; Female; Glutathione; Graft Rejection; Humans; Insulin; Ischemia; Isotonic Solutions; Kidney; Kidney Transplantation; Male; Middle Aged; Organ Preservation; Organ Preservation Solutions; Pancreas; Pancreas Transplantation; Perfusion; Raffinose; Ringer's Solution; Therapeutic Irrigation; Thrombosis; Tissue and Organ Procurement; Tissue Donors

New Zealand rabbits were assigned randomly to three groups: sham operation, intestinal simple obstruction, and strangulation obstruction. To relate possible changes in the body fluid content of biochemical markers to the strangulation process, subsequent samples of blood and peritoneal fluid, for the determination of levels of creatine kinase (CK), lactic acid (LA), xanthine oxidase (XO), and inorganic phosphate (IP), were obtained at 1-, 2-, 4-, and 6-hour intervals, and intestinal histological specimens were graded blindly. Significant increases in plasma LA (3.93 +/- 0.26 v 2.99 +/- 0.37; P < .05), peritoneal LA (5.03 +/- 1.14 V 3.33 +/- 0.86; P < .05), and CK (940 +/- 146 v 772 +/- 165, P < .05) occurred after 1 hour of ischemic injury. Except for serum CK, all parameters in the blood and peritoneal fluid in group 3 were markedly elevated within 4 hours. The serum CK remained almost unchanged throughout the 6-hour study period. The results suggest that plasma LA, peritoneal LA, and CK are sensitive indicators in the early diagnosis of bowel ischemia; the determination of both serum and peritoneal XO and IP was also helpful for early diagnosis; in contrast, serum CK was not a useful indicator. The value of any biochemical marker as an early diagnostic tool for intestinal ischemia depends not only on its quantity but also on its location and mechanism of release.

Topics: Animals; Ascitic Fluid; Biomarkers; Creatine Kinase; Intestinal Obstruction; Intestines; Ischemia; Lactates; Lactic Acid; Phosphates; Rabbits; Xanthine Oxidase

The role of true cold ischemia times (CIT) and rewarming ischemia times (WIT) in determining outcome after liver transplantation was investigated in 230 adult recipients. Using multivariate analysis, WIT (time from the start of implantation until restoration of arterial and portal blood supply) and donor intensive care stay (P = .04 and .0004, respectively) but not CIT (the time from donor portal vein flushing until the graft was removed from University of Wisconsin solution; P > .30) emerged as independent determinants of graft survival. In the small number of patients with a WIT of greater than 180 minutes, there were reductions in graft survival (58% v 80% for WIT greater than 180 minutes) but these just failed to reach significance (P = .055). CIT had no influence on graft survival using cut-offs of 12 or 18 hours. A WIT of greater than 180 minutes was associated with an increased median area under the curve of day 1 through 7 serum bilirubin (1,370 v 915 mumol/L.day; P = .048) and trends towards an increased incidence of primary graft nonfunction or dysfunction (22.2% v 6.2% for WIT of less than 180 minutes; P = .065) and the day 1 through 7 area under the curve of serum aspartate aminotransferase (3,310 v 1,440 IU/L.day; P = .092). A prolonged CIT (greater than 18 hours) led to a prolonged hospital stay (69 v 31 days; P = .03), an increased area under the curve of day 8 through 14 serum bilirubin (2,500 v 995 mumol/L.day; P = .003), and a trend towards an increased incidence of initial poor graft function (33.3% v 6.3% for less than 18 hours; P = .092). The incidence of acute rejection increased (to 64.3% from 53.4%; P = .04) in patients with preservation injury (serum aspartate aminotransferase greater than 1,500 IU/L during the first 2 postoperative days). True CIT and WIT are important determinants of outcome after liver transplantation.

Topics: Adenosine; Adolescent; Adult; Aged; Allopurinol; Cold Temperature; Female; Follow-Up Studies; Glutathione; Graft Survival; Humans; Insulin; Ischemia; Liver; Liver Function Tests; Liver Transplantation; Male; Middle Aged; Multivariate Analysis; Organ Preservation; Organ Preservation Solutions; Raffinose; Retrospective Studies; Rewarming; Time Factors; Transplantation, Homologous; Treatment Outcome

Enzyme histochemical activity of catalase, a peroxisomal enzyme involved in cellular antioxidant systems, was studied in proximal tubular cells of human renal transplants as a marker of ischemia-reperfusion injury in the prediction of the evolution of renal transplants. A low enzymatic activity was observed in all renal biopsies performed at 30 min. reperfusion with no difference between the several evolution types of renal transplants. Reduced catalase activity due to ischemia-reperfusion injury could not be correlated with renal function or used as an index of renal function recovery.

Topics: Adenosine; Adolescent; Adult; Allopurinol; Biomarkers; Catalase; Creatinine; Follow-Up Studies; Glutathione; Histocytochemistry; Humans; Hypertonic Solutions; Insulin; Ischemia; Kidney; Kidney Transplantation; Kidney Tubules, Proximal; Middle Aged; Organ Preservation; Organ Preservation Solutions; Raffinose; Reperfusion; Time Factors; Tissue Donors

Although leukocyte adhesion and capillary plugging are postulated to play a role in postischemic tissue injury, there is only limited evidence demonstrating the relationship between tissue leukocyte accumulation and cell injury in terms of their temporal sequence and spatial distribution.. This study was designed to study in vivo neutrophil behavior and its correlation with cell injury in postischemic skeletal muscle microcirculation. The microcirculation of the rat spinotrapezius muscle was observed in vivo using dual-color digital microfluorography to simultaneously visualize leukocyte traffic and cell death (irreversible nuclear damage) on the basis of carboxyfluorescein diacetate succinimidyl ester and propidium iodide, respectively. A 1-hour period of hemorrhagic hypotension (40 mm Hg) followed by reperfusion was carried out to induce muscle injury.. Hypotension was followed by an increase in leukocyte recruitment in two different ways: capillary obstruction and venular adhesion. Upon reperfusion, a majority of the leukocytes were initially dispersed from the muscle capillaries and venules, but then the number of leukocytes plugging capillaries and adherent to venules increased again in a time-dependent manner. The number of leukocytes obstructing capillaries was closely correlated with the postischemic systemic blood pressure. The cell injury became detectable initially at the end of the hypotensive period and then increased explosively after reperfusion before a significant leukocyte accumulation. Reperfusion-induced early nuclear injury was seen predominantly in reperfused capillaries without plugging leukocytes. A majority of the initially damaged nuclei were those of myocytes in the pericapillary space, but no nuclei of capillary endothelium was involved. Sodium (-)-8-(3-methoxy-4-phenylsulfinylphenyl) pyrazolo [1,5-a]-1,3,5-triazine-4-olate monohydrate, a novel inhibitor of xanthine oxidase, significantly attenuated the early increase in muscle injury and subsequent venular leukocyte adhesion after reperfusion.. These results suggest the involvement of an endothelium-dependent mechanism involving xanthine oxidase in postischemic irreversible myocyte injury. It is conceivable that leukocytes adherent to venules as well as those plugging capillaries play only minor roles in the initial mechanism of reperfusion injury.

Topics: Animals; Antibodies, Monoclonal; Antigens, CD; Blood Pressure; Capillaries; CD18 Antigens; Ischemia; Leukocytes; Male; Microcirculation; Microscopy, Fluorescence; Muscles; Rats; Rats, Wistar; Reperfusion; Time Factors; Triazines; Venules; Xanthine Oxidase

Xanthine oxidase (XO) activity and hydroxyl radical (.OH) formation are widely proposed mediators of renal reperfusion injury, potentially altering the severity of, and recovery from, postischemic acute renal failure. The goal of this study was to ascertain whether combination XO inhibitor (oxypurinol) and .OH scavenger (Na benzoate) therapy, given at the time of renal ischemia, alters the extent of: (1) tubular necrosis and filtration failure; (2) DNA fragmentation/apoptosis (assessed in situ by terminal deoxynucleotidyl transferase reactivity); (3) early tubular regenerative responses (proliferating cell nuclear antigen expression; (3H)thymidine incorporation); and (4) the rate and/or degree of functional and morphologic repair. The effects of XO inhibition, .OH scavengers, and "catalytic" iron (FeSO4) on human proximal tubular cell proliferation in vitro were also assessed with a newly established cell line (HK-2). Male Sprague-Dawley rats were subjected to 35 min of bilateral renal arterial occlusion with or without oxypurinol/benzoate therapy. These agents did not alter the extent of tubular necrosis or filtration failure, proliferating cell nuclear antigen expression or thymidine incorporation, or the rate/extent of renal functional/morphologic repair. DNA fragmentation did not precede tubular necrosis, and it was unaffected by antioxidant therapy. By 5 days postischemia, both treatment groups demonstrated regenerating epithelial fronds that protruded into the lumina. These structures contained terminal deoxynucleotidyl transferase-reactive, but morphologically intact, cells, suggesting the presence of apoptosis. Oxypurinol and .OH scavengers (benzoate; dimethylthiourea) suppressed in vitro tubular cell proliferation; conversely, catalytic Fe had a growth-stimulatory effect. These results suggest that: (1) XO inhibition/.OH scavenger therapy has no discernible net effect on postischemic acute renal failure; (2) DNA fragmentation does not precede tubular necrosis, suggesting that it is not a primary mediator of ischemic cell death; and (3) antioxidants can be antiproliferative for human tubular cells, possibly mitigating their potential beneficial effects.

Topics: Acute Kidney Injury; Animals; Antioxidants; Apoptosis; Benzoates; Benzoic Acid; Cell Division; Cells, Cultured; DNA Damage; DNA Nucleotidylexotransferase; Free Radical Scavengers; Humans; Ischemia; Kidney; Kidney Tubular Necrosis, Acute; Male; Nuclear Proteins; Oxypurinol; Proliferating Cell Nuclear Antigen; Rats; Rats, Sprague-Dawley; Regeneration; Reperfusion Injury; Xanthine Oxidase

1. The preventive effect of allopurinol on reduced glutathione and lipid peroxide levels of the liver and the accompanying ultrastructural changes during liver ischemia was investigated in guinea pigs. 2. Liver glutathione levels decreased significantly while lipid peroxide levels increased slightly in the ischemic group. 3. Allopurinol administered before ischemia resulted in a reverse significant increase in liver glutathione levels and a significant decrease in lipid peroxide levels indicating a protective effect upon cell membrane during ischemia. 4. On the other hand, electron microscopic changes in the liver associated with ischemia could not be altered by allopurinol.

Topics: Allopurinol; Animals; Female; Glutathione; Guinea Pigs; Ischemia; Lipid Peroxides; Liver; Male; Microscopy, Electron

The current shortage of transplantable organs has renewed interest in kidneys obtained from non-heart-beating donors. Kidneys from these donors have suffered warm ischemia (WI). The effectiveness of two preservation solutions, i.e., the University of Wisconsin (UW) and the histidine tryptophan ketoglutarate (HTK) solutions, for preservation of kidneys that have been subjected to WI was tested in dogs. The left kidney was autotransplanted after 30 min of WI, and subsequent 24-hr cold storage (CS) in either UW (n = 6) or HTK (n = 6), with immediate contralateral nephrectomy. Surgical biopsies from the cortex were taken before WI, after 30 min of WI, after 24 hr of CS, and after 1 hr of reperfusion for electron microscopy and for analysis of energy metabolites. At 2 weeks after transplantation in the UW group, 4 out of 6 and, in the HTK group, 1 out of 6 dogs survived. As from day 2, serum creatinine was lower in the UW group as compared with the HTK group (P < 0.05). After 24 hr of CS, in the HTK group the luminal membranes of proximal tubular cells were partly denuded of microvilli. Moreover, the tubular lumen was filled with blebs and debris. In the UW group, the brush borders remained intact, although microvilli were swollen. Energy metabolites were analyzed with HPLC. Thirty minutes of WI resulted in a +/- 45% reduction of total adenine nucleotide (TAN) content. During CS, TAN levels further decreased in both groups; however, after 24 hr of CS, the levels of adenosine, inosine, hypoxanthine, and xanthine were significantly higher in the UW group as compared with the HTK group (P < 0.05, P < 0.01, P < 0.01, P < 0.01). At 1 hr of reperfusion, TAN levels were higher in the UW group as compared with the HTK group (4.66 +/- 0.16 vs. 4.02 +/- 0.28, P < 0.05). Our results show that UW is a superior solution compared with HTK in the preservation of ischemically damaged kidneys, demonstrating better survival, better recovery of kidney function, better protection against ischemia-induced ultrastructural damage, and better preservation of energy metabolism indicated by (a faster) regeneration of TAN levels after reperfusion.

Topics: Adenine Nucleotides; Adenosine; Allopurinol; Animals; Cardioplegic Solutions; Cold Temperature; Creatinine; Dogs; Female; Glucose; Glutathione; Insulin; Ischemia; Kidney; Kidney Transplantation; Kidney Tubules; Mannitol; Organ Preservation; Organ Preservation Solutions; Organ Size; Potassium Chloride; Procaine; Raffinose; Reperfusion

1. Na+K+ATPase is a membrane bound enzyme whose activity is essential for maintenance of cell viability. Lipid peroxidation changes membrane fluidity and enzyme activity. 2. The purpose of this study was to investigate the effect of allopurinol (free radical scavenger) on Na+K+ATPase activity in rabbit kidney cortex membrane. In this in vivo study we created ischemia and reperfusion in rabbit kidneys. 3. Enzyme activity were low in ischemic and reperfused kidneys, compared to the controls. In allopurinol treated ischemic and reperfused groups, the levels of Na+K+ATPase activity were high compared to the untreated group. 4. It has been concluded that allopurinol may protect this enzyme activity.

Topics: Allopurinol; Animals; In Vitro Techniques; Ischemia; Kidney; Lipid Peroxidation; Male; Malondialdehyde; Phosphates; Rabbits; Renal Circulation; Reperfusion; Sodium-Potassium-Exchanging ATPase

Topics: Adenosine; Allopurinol; Animals; Antioxidants; Cold Temperature; Edetic Acid; Glutathione; Graft Survival; Hypertonic Solutions; Insulin; Intestine, Small; Ischemia; Lipid Peroxidation; Male; Organ Preservation Solutions; Pregnatrienes; Raffinose; Rats; Rats, Inbred WF; Reperfusion Injury; Temperature; Tissue Preservation

Topics: Animals; Free Radicals; Glutathione; Ischemia; Liver; Liver Diseases; Mitochondria, Liver; Rats; Reperfusion Injury; Ubiquinone; Vitamin E; Xanthine Dehydrogenase; Xanthine Oxidase

Topics: Adenine Nucleotides; Allopurinol; Animals; Energy Metabolism; Ischemia; Muscle Contraction; Muscles; Phosphocreatine; Rats; Rats, Wistar

Topics: Adenosine; Allopurinol; Cadaver; Cyclosporine; Glutathione; Graft Survival; Humans; Hypertonic Solutions; Insulin; Ischemia; Kidney; Kidney Transplantation; Kidney Tubular Necrosis, Acute; Organ Preservation; Organ Preservation Solutions; Raffinose; Time Factors; Tissue Donors

Topics: Adenosine; Allopurinol; Animals; Cold Temperature; Female; Glutathione; Hypertonic Solutions; In Vitro Techniques; Insulin; Ischemia; Kidney; Kidney Transplantation; Microscopy, Electron; Mitochondria; Models, Biological; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Reperfusion Injury

In a rat model, the left kidney was subjected to 60 min of normothermic ischemia followed by 15 min of reperfusion, whereas the right kidney, serving as a paired control, was not rendered ischemic. Both kidneys were then perfused in situ with either Euro-Collins (EC) solution (n = 12) or University of Wisconsin (UW) solution (n = 6) for 10 min. Each kidney was then harvested and stored at 4 degrees C in its respective solution. After 24 and 48 h of cold storage, the following vasoactive substances were measured in the preservation media: endothelin (ET), angiotensin II (A-II), thromboxane (B2) (TxB2), and prostaglandin I2 (PGI2). After 24 h in EC solution, left kidneys uniformly produced significantly higher concentrations of each vasoactive substance than right kidneys: ET 1.64 +/- 0.3 pg/ml vs 0.82 +/- 0.1 pg/ml (P < or = 0.009); A-II 20.8 +/- 6.2 pg/ml vs 7.75 + 2.3 pg/ml (P < or = 0.007); TxB2 100.8 +/- 17.7 pg/ml vs 40.1 +/- 11.7 pg/ml (P < or = 0.04); PGI2 638.3 +/- 41.1 pg/ml vs 318.3 +/- 36.4 pg/ml (P < or = 0.001), respectively. At 48 h, a similar pattern of results was obtained as the kidney continued to produce TxB2 and prostacyclins during the 24-48 h period. In the UW solution, basal levels of ET and A-II were lower than those in EC solution, but similarly increased after initial ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adenosine; Allopurinol; Angiotensin II; Animals; Cryopreservation; Endothelins; Glutathione; Humans; Hypertonic Solutions; Insulin; Ischemia; Kidney; Kidney Transplantation; Male; Organ Preservation; Organ Preservation Solutions; Radioimmunoassay; Raffinose; Rats; Rats, Wistar; Thromboxane B2

In spite of the interest in free radicals as mediators of ischemic damage, most information on these species in biological systems is derived from indirect measurements. Our aim was to obtain more direct information concerning sources of free radical production during ischemia and reperfusion.. We have performed simultaneous measurement of radical generation, purine metabolites, reduced glutathione, neutrophil infiltration and morphological appearance in the cat small intestine in vivo during 60 minutes of ischemia followed by 60 minutes of reperfusion.. Radical formation increased abruptly on reperfusion and remained elevated in untreated animals. Inhibition by a monoclonal antibody (IB4) against the neutrophil and by allopurinol treatment was paralleled by improvement of biochemical and morphological parameters. The radicals detected during reperfusion could be divided into one component arising directly from the neutrophils, one due to the xanthine oxidase reaction, and one unknown source.. Neutrophils are a major source of radical production during reperfusion after ischemia. Radicals formed in the xanthine oxidase reaction seem to function as a primer for the neutrophils. The nonsignificant linear correlation between radical formation and morphological appearance suggests that factors other than free radicals are important for the development of intestinal damage after a period of ischemia.

Topics: Allopurinol; Animals; Antibodies, Monoclonal; Biopsy; Cats; Female; Hypoxanthine; Hypoxanthines; Intestinal Mucosa; Intestine, Small; Ischemia; Male; Neutrophils; Peroxidase; Reactive Oxygen Species; Reperfusion Injury; Xanthine Oxidase

The importance of sequential events which lead to skin necrosis has significant implications in trauma, vascular injury, and wound healing. In this series of experiments, we tested the hypothesis that xanthine oxidase (XO) activity was increased along an ischemic gradient of a skin flap and that the XO enzyme activity correlated with an increase in neutrophils. There were two animal groups in which the skin flaps were raised and assayed at 0, 1, or 6 hr. In the other group, they were created as bipedicle flaps for 7 days, before the distal attachment was divided and the tissue assayed. In the acutely raised flaps, some animals were treated with the XO inhibitor, allopurinol. Xanthine dehydrogenase (XD) and XO activity was measured with a fluorometric pterin assay and neutrophil concentration was measured using a myeloperoxidase marker. In this model, there was consistent skin necrosis in the distal end of the skin flap (48 +/- 8%). The data showed that both XD and XO activity in the distal ends was statistically significantly increased over the sham control or proximal ends of the skin flaps at 1 hr (P < 0.05). XO activity remained elevated in the distal ends at 6 hr. Allopurinol significantly reduced the neutrophil concentrations in the distal ends of the skin flaps when compared to untreated animals (P < 0.05). Moreover, allopurinol reduced skin necrosis to 12 +/- 1%. Preconditioning of the skin flap reduced the XO activity to sham control levels. The observations implicate XO activity as source of free radical injury in skin necrosis seen in random skin flaps.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Allopurinol; Animals; Dose-Response Relationship, Drug; Histological Techniques; Ischemia; Peroxidase; Rats; Rats, Sprague-Dawley; Skin; Surgical Flaps; Time Factors; Xanthine Dehydrogenase; Xanthine Oxidase

Rewarming ischemia during implantation severely compromises posttransplant pancreas graft survival because the graft has already been subjected to warm and cold ischemia before implantation. The purpose of this study was to examine whether preservation of the pancreas graft by the two-layer method ameliorates rewarming ischemic injury of the graft during implantation using a canine model. After flushing with cold University of Wisconsin solution (UW), the pancreas grafts were preserved by the two-layer (UW/perfluorochemical [PFC]) method (group 1) or simple cold storage in UW (group 2) for 24 hr and then autotransplanted. In control, the pancreas grafts were flushed out with cold UW and immediately autotransplanted without preservation (group 3). After completion of vascular anastomosis, vascular clamp was not released until 90, 120, or 150 min of rewarming ischemia, including anastomosis time, had elapsed. After 90 min of rewarming ischemia, graft survival rates were 5/5, 100%, 5/5, 100%, and 5/5, 100%, in groups 1, 2, and 3, respectively. After 120 min, all the grafts in groups 2 and 3 failed (0/5, 0%, and 0/5, 0%, respectively); however, all the grafts in group 1 survived (5/5, 100%). Even after 150 min, 1 of 3 grafts in group 1 survived (1/3, 33%). After 24 hr preservation, tissue ATP levels of the grafts in group 1 were about 2-fold the reference values before harvesting (8.23 +/- 0.72 vs. 4.44 +/- 0.49 mumol/g dry weight, P < 0.05) and significantly higher compared with group 2 (8.23 +/- 0.72 vs. 1.76 +/- 0.52 mumol/g dry weight, P < 0.01). After 120 min of rewarming ischemia, tissue ATP levels in group 1 were 84% of the reference values and significantly higher compared with group 2 (3.75 +/- 0.25 vs. 1.57 +/- 0.48 mumol/g dry weight, P < 0.05). Two hours after reperfusion, ATP levels in group 1 were 42% of reference values but significantly higher compared with group 2 (1.86 +/- 0.36 vs. 1.03 +/- 0.18 mumol/g dry weight, P < 0.05). We conclude that the two-layer (UW/PFC) method ameliorates rewarming ischemic injury of the pancreas graft during implantation by increasing tissue ATP contents during preservation and consequently maintaining tissue ATP levels during implantation.

Topics: Adenosine; Allopurinol; Animals; Dogs; Female; Fluorocarbons; Glutathione; Graft Survival; Hot Temperature; Insulin; Ischemia; Male; Methods; Organ Preservation; Organ Preservation Solutions; Pancreas; Pancreas Transplantation; Raffinose

Topics: Adenosine; Allopurinol; Animals; Biopsy; Blood Glucose; Dogs; Female; Fluorocarbons; Glucose Tolerance Test; Glutathione; Insulin; Ischemia; Male; Organ Preservation; Organ Preservation Solutions; Pancreas; Pancreas Transplantation; Raffinose; Time Factors; Transplantation, Autologous

Topics: Adenosine; Allopurinol; Animals; Dogs; Glutathione; Graft Survival; Insulin; Ischemia; Lung; Lung Transplantation; Organ Preservation; Organ Preservation Solutions; Pulmonary Circulation; Raffinose; Reperfusion; Time Factors; Transplantation, Homologous; Vascular Resistance

The aim of this study was to assess the effect of allopurinol on rat groin flaps rendered ischaemic by selectively occluding the feeding femoral artery and reperfused by means of microsurgical anastomosis. For the establishment of the critical arterial ischaemia time, the femoral artery of 29 rat groin flaps isolated on the inferior epigastric pedicle was occluded for 10, 12 and 14 h. Following 12 h or more of ischaemia, 5.25% of the flaps survived, compared to 40% survival after 10 h (p = 0.04). In the second stage of the study, 34 rat groin flaps were subjected to arterial ischaemia for 12 h. Of these, 12 rats received allopurinol solution I.V. 30 min prior to reperfusion, 10 received the vehicle solution (control) and 12 underwent no treatment (control). After 7 days, survival of the groin flaps was observed in 41.7%, 0 and 8.3% of the groups, respectively (p = 0.0164). This study suggests that systemic administration of allopurinol has a beneficial effect on rat arterial ischaemic groin flaps and may prolong their critical ischaemia time.

Topics: Allopurinol; Animals; Arterial Occlusive Diseases; Female; Graft Survival; Ischemia; Rats; Skin; Surgical Flaps; Time Factors

Intestinal ischaemia and reperfusion cause changes in cardiovascular and pulmonary function. In a rat model, the plasma concentrations of atrial natriuretic peptide (ANP) and pancreatic glucagon rose on reperfusion after 20 min of intestinal ischaemia, coinciding with significant arterial hypotension: mean(s.e.m.) ANP 79(13) versus control 36(4) fmol ml-1 (P < 0.01); and mean(s.e.m.) glucagon 22(2) versus control 10(1) fmol ml-1 (P < 0.001). Glucagon was also released on reperfusion after 5 min of ischaemia: mean(s.e.m.) 18(2) fmol ml-1 (P < 0.001 versus control). In a second experiment, pretreatment of rats with allopurinol did not prevent arterial hypotension but abolished ANP release (mean(s.e.m.) 36(2)fmol ml-1 versus no pretreatment 70(7) fmol ml-1, P < 0.05), while glucagon release was unaffected. The release of ANP, but not that of glucagon, is therefore mediated by oxygen free radicals and may signify cardiac and/or pulmonary injury or dysfunction. The actions of these peptides may be relevant in the pathophysiological perturbation of intestinal ischaemia-reperfusion.

Topics: Allopurinol; Animals; Atrial Natriuretic Factor; Blood Pressure; Free Radicals; Glucagon; Intestines; Ischemia; Male; Quinacrine; Rats; Rats, Wistar; Reperfusion; Time Factors

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Chromatography, High Pressure Liquid; Cryopreservation; Fluorocarbons; Glutathione; Humans; Insulin; Ischemia; Organ Preservation; Organ Preservation Solutions; Pancreas; Pancreas Transplantation; Raffinose; Temperature

In order to evaluate the protective effect of University of Wisconsin (UW) solution in heart transplantation, a retrospective comparative study with histidine-tryptophane-ketoglutarate (HTK) solution was initiated. In group I, we included 160 patients with HTK preservation, while group II consisted of 50 patients who had their transplant protected with UW solution. All patients received standard quadruple drug therapy for immunosuppression. The average ischaemic time of the donor hearts in group I was 142+/-44 min, ranging from 83 to 235 min. Acute immediate perioperative graft failure occurred in six cases (3.8%). Statistical analysis including the chi-square test, revealed a significant increase in the incidence of acute perioperative graft failure when compared with duration of ischaemic time (P < 0.01). Within the first 30 postoperative days, 24 patients died (15% early mortality). The same statistical correlation was evident between the incidence of early mortality and duration of graft ischaemic time. The 30-day and 6-month survival rates were 81% and 78%, respectively. The average ischemic time of the donor hearts in group II was 193+/-50 min ranging from 100 to 360 min, which was significantly longer in comparison with the group I (P < 0.05). Acute perioperative graft failure occurred once (2%); the patient was retransplanted successfully. Five patients died within the first 30 postoperative days (10% early mortality). There was no correlation between length of ischaemic time and incidence of acute graft failure or early mortality. The 30-day and 6-month survival rates were 90% and 88%, respectively and, thus, better when compared with group I. In both groups similar results were achieved with regard to postoperative NYHA status of the patients and incidence of cardiac arrhythmias. Myocardial preservation with HTK solution showed satisfying results as long as the ischaemic time did not exceed 4 h. The early functional results achieved with UW graft protection were excellent, even with ischaemic times longer than 4 h and not depending on lenght of ischaemic period.

Topics: Adenosine; Allopurinol; Arrhythmias, Cardiac; Chi-Square Distribution; Female; Glucose; Glutathione; Graft Survival; Heart; Heart Transplantation; Humans; Insulin; Ischemia; Male; Mannitol; Middle Aged; Organ Preservation Solutions; Postoperative Complications; Postoperative Period; Potassium Chloride; Procaine; Raffinose; Reoperation; Retrospective Studies; Survival Rate; Time Factors; Treatment Failure

Frozen section examination was performed on 385 donor livers before transplantation. Exclusion criteria were applied to the donor livers examined to exclude potentially dysfunctional livers. The exclusion criteria included the following: severe macrovesicular steatosis, ischemic necrosis, prominent chronic portal inflammation, prominent periductular fibrosis, granulomatous inflammation, bridging fibrosis, and malignancy. Twenty-seven of the 385 donor livers examined were excluded before transplantation. The following histologic features were present in the excluded livers: severe steatosis (22), ischemic necrosis (2), portal inflammation (1), and periductular fibrosis (2). Steatosis was present in 51 of the 385 (13.25%) organs examined, including 22 of the donor organs excluded before transplantation. Twenty-nine livers with mild to moderate steatosis were implanted into size and blood type-matched recipients. Indicators of allograft function (prothrombin time and bilirubin) and damage (aspartate aminotransferase and alanine aminotransferase) were measured daily for the first 10 days after transplant. There was no statistically significant difference between the group of nonfat livers and donor livers containing mild steatosis. Statistically significant higher posttransplant serum alanine aminotransferase and prothrombin time levels were present in the patients with livers implanted with mild versus moderate steatosis. The 1-year survival rate for patients receiving fatty versus nonfatty donor livers was not statistically different (Kaplan-Meier, P = 0.592). No significant differences were found in the clinical and laboratory characteristics of donors whose organs were implanted compared with the clinical and laboratory characteristics of donors whose organs were excluded. The primary nonfunction rate after applying the exclusion criteria was 1.4%, which is a significant decrease compared with our primary nonfunction rate of 8.5% before using frozen section examination. Frozen section examination is useful in excluding donor organs which may become dysfunctional after transplantation.

Topics: Adenosine; Adult; Allopurinol; Azo Compounds; Child; Fatty Liver; Female; Fibrosis; Frozen Sections; Glutathione; Hepatitis; Humans; Hypertonic Solutions; Insulin; Ischemia; Liver; Liver Transplantation; Male; Necrosis; Organ Preservation; Organ Preservation Solutions; Raffinose; Staining and Labeling; Survival Rate; Tissue Donors

The enhancement of blood flow in experimental skin flaps following postischemic perfusion washout was investigated in rats. Unilateral island skin flaps based on the superficial epigastric vessels were raised and subjected to 6 hr of primary ischemia. Group 1 was designated as a control and did not undergo postischemic perfusion washout. In the remaining rats, postischemic washout was performed with one of five agents: Group 2--lactated Ringer's solution; Group 3--University of Wisconsin solution, an organ preservation medium; Group 4--verapamil, a calcium channel blocker; Group 5--urokinase, a thrombolytic agent; Group 6--iloprost, a stable prostacyclin analog. Two hours following perfusion washout, fluorometric analysis revealed a statistically significant enhancement of blood flow in Groups 4, 5, and 6, compared to Groups 2 and 3 (p < 0.05). Furthermore, a significant increase in skin surface fluorescence was demonstrated in all the flaps that underwent perfusion washout, compared to the control flaps (p < 0.05). By analyzing skin surface fluorescence, the enhancement of nutritive blood flow in flaps, following postischemic perfusion washout, was evaluated. This is the first study in which the above pharmacologic agents were compared in a quantitative manner.

Topics: Adenosine; Allopurinol; Animals; Female; Fluorescein; Fluoresceins; Glutathione; Iloprost; Insulin; Ischemia; Organ Preservation Solutions; Perfusion; Raffinose; Rats; Rats, Sprague-Dawley; Skin; Surgical Flaps; Tissue Preservation; Urokinase-Type Plasminogen Activator; Verapamil

The aim of this study was to clarify the role of oxygen-derived free radicals and the effect of free radical scavengers on skeletal muscle ischemia/reperfusion injury. Male Wistar rats were divided into a complete ischemia group (C-group) and an incomplete ischemia group (IC-group) and each animal was subjected to 2 h of ischemia and 1 h of reperfusion. In an attempt to decrease reperfusion injury, the rats were given free radical scavengers either as allopurinol 50 mg/kg for 2 days or as superoxide dismutase 60,000 units/kg plus catalase 500,000 units/kg. Tissue malondialdehyde, a product of lipid peroxidation, was measured as an indicator of free radicals, with higher levels indicating higher concentrations of free radicals. The malondialdehyde level in the gastrocnemius muscle after 1 h of reperfusion increased significantly in both groups when compared to the levels before and 2 h after ischemia, although there was no significant difference between the two groups. The water content of the gastrocnemius muscle and serum creatinine phosphokinase MM isoenzyme (CPK-MM) in both groups, and GOT in the C-group, increased significantly after 1 h of reperfusion when compared the values before and 2 h after ischemia. In the C-group, these values were significantly higher than in the IC-group. The administration of free radical scavengers suppressed the increase in malondialdehyde in the gastrocnemius muscle after reperfusion in both groups. The increase in water content and CPK-MM after reperfusion was also suppressed by free radical scavengers in the IC-group, but not in the C-group.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Allopurinol; Animals; Aspartate Aminotransferases; Blood Flow Velocity; Blood Pressure; Body Water; Catalase; Creatine Kinase; Free Radical Scavengers; Free Radicals; Fructose-Bisphosphate Aldolase; Ischemia; Isoenzymes; Lipid Peroxidation; Male; Malondialdehyde; Muscles; Oxygen; Rats; Rats, Wistar; Reperfusion Injury; Superoxide Dismutase

The two-layer cold storage method using the University of Wisconsin solution (UW) allows continuous tissue adenosine triphosphate (ATP) production during the preservation period. UW contains 5mM of adenosine which has several mechanisms of action, however, its efficacy is controversial. In this study, at first, we investigated the metabolism of exogenous adenosine during preservation by the two-layer method in the canine pancreas graft subjected to 60 min warm ischemia. High concentration (> 5 mM) of adenosine in Euro-Collins' solution (EC) remarkably increased ATP and total adenine nucleotide (TAN) levels during 24 hr preservation by the two-layer method using EC. Furthermore, experiments with 5 mM of [2-3H] adenosine demonstrated that adenosine was metabolized and incorporated into adenine nucleotides (ANs). However, neither 5 mM of inosine, hypoxanthine nor adenine substituted for adenosine. It was clear that adenosine was directly phosphorylated and converted into ANs. Secondly, the effect of adenosine on the viability of the ischemically damaged pancreas graft was evaluated by graft survival following autotransplantation. The ischemically damaged pancreas grafts were preserved for 24 hours by simple cold storage in EC (group 1), EC with 5 mM of adenosine (group 2), the two-layer method using EC (group 3), EC with 5 mM of adenosine (group 4). Graft survival rates were 0/5 (0%), 1/5 (20%), 0/3 (0%) and 4/5 (80%) in groups 1, 2, 3 and 4 respectively. Adenosine was clearly effective on graft survival via recovering high tissue ATP and TAN levels only in case of the preservation by the two-layer method. We conclude that exogenous adenosine works as a substrate for ANs synthesis and is directly phosphorylated to ANs during preservation by the two-layer method. This is essential to repair damaged cells and maintain cellular integrity, making it possible to preserve ischemically damaged pancreas.

Topics: Adenine Nucleotides; Adenosine; Allopurinol; Animals; Cryopreservation; Dogs; Female; Glutathione; Graft Survival; Insulin; Ischemia; Male; Organ Preservation Solutions; Pancreas; Raffinose

To assess the effects of oxygen free radicals on liver regeneration in rats after 80% hepatectomy.. Open laboratory study.. Institute of Biomedical Sciences, University of Milan, Italy.. Female Sprague-Dawley rats.. After laparotomy 122 rats had ischaemia induced by clamping of the portal vein and hepatic artery, and 93 rats had manipulation of the vessels only. They were then allowed to recover before 80% hepatectomy was done. Absolute controls (n = 16) did not have a laparotomy. Mortality was recorded, and surviving rats were killed one, three, five, and seven days after operation. A further 10 rats had 80% hepatectomies and then underwent a 10 minute period of ischaemia 24 hours later. These animals were killed after three days. In yet more experiments 38 rats underwent 80% hepatectomies and were then divided into four groups: 8 were given allopurinol 50 mg/kg/day starting three days before operation; 8 were given superoxide dismutase 4.16 mg/kg intraperitoneally 30 minutes before induction of ischaemia; 12 were given verapamil 0.1 mg/kg 30 minutes before induction of ischaemia; and 10 were given saline (controls).. Incorporation of tritiated thymidine into DNA, differences in liver weights, and lipid peroxide concentrations.. 43 rats died after ischaemia/reperfusion and 19 after hepatectomy alone. Ischaemia/reperfusion caused a significant reduction in the incorporation of tritiated thymidine into DNA 24 hours after hepatectomy (p < 0.01), and significant inhibition of recovery of liver weight three (p < 0.01) and five (p < 0.05) days after hepatectomy. These effects were associated with high lipid peroxide concentrations at three days. Allopurinol (p < 0.01, p < 0.05), superoxide dismutase (p < 0.01, p < 0.01) and verapamil (p < 0.01, N.S.) reduced the effects of ischaemia/reperfusion on liver weights or lipid peroxide concentrations three days after hepatectomy.. A 10 minute period of ischaemia followed by reperfusion temporarily reduces liver regeneration after 80% hepatectomy in rats.

Topics: Allopurinol; Animals; Female; Free Radicals; Hepatectomy; Ischemia; Lipid Peroxidation; Lipid Peroxides; Liver; Liver Regeneration; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Reperfusion; Reperfusion Injury; Superoxide Dismutase; Verapamil

Reactive oxygen metabolites generated from xanthine oxidase play an important role in the pathogenesis of ischemia-induced tissue injury. In a hemorrhagic shock model of ischemia-reperfusion, the intracellular enzyme xanthine oxidase was released into the vasculature. This intravascular source of superoxide (O2.-) and hydrogen peroxide (H2O2) interacted reversibly with glycosaminoglycans of vascular endothelium and markedly concentrated xanthine oxidase at cell surfaces, enhancing its ability to produce extensive damage to remote tissues. Rats were made hypotensive by hemorrhage, maintained for 2h, and reinfused with shed blood. Blood samples were obtained prior to hemorrhage and 15, 30, 60, and 90 min after reperfusion for determination of xanthine oxidase (XO), lactate dehydrogenase (LDH), and alanine transaminase (AST). These enzymes were not significantly elevated in control animals. Reperfusion after hemorrhage-induced ischemia resulted in significantly elevated AST and LDH in both low heparin (100 U/h) and high heparin (1000 U/h) groups. Xanthine oxidase was detected in the circulation only after 90 min reperfusion in the low heparin group and was elevated during the entire reperfusion period in the high heparin group. Studies with cultured vascular endothelium showed significant heparin-reversible binding of XO to cellular glycosaminoglycans. These results suggest that XO can gain access to the circulation following ischemia, where it then binds to the vascular endothelial cells to produce site-specific oxidant injury to organs remote from the site of XO release.

Topics: Alanine Transaminase; Animals; Endothelium, Vascular; Free Radicals; Glycosaminoglycans; Heparin; Hydrogen Peroxide; Ischemia; L-Lactate Dehydrogenase; Male; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Shock, Hemorrhagic; Superoxides; Xanthine Oxidase

The perfused rat hindlimb preparation was used with a blood cell-free perfusate to investigate alterations in the purine nucleotide metabolism, flow rate, perfusion pressure, and venous excretion in response to ischemia and ischemia followed by reperfusion in skeletal muscle. The development of a physical hindrance during postischemic reperfusion, indicated by an increase in reperfusion pressure and a decrease in flow rate, coincided with a 90% decrease in phosphocreatine and a 50-70% reduction in total adenine nucleotide pool. The reflow impairment could not be explained by blood cell plugging of the capillaries. Washout of several metabolites was demonstrated during reperfusion. Hypoxanthine accumulated intracellularly during ischemia, and a substantial amount of uric acid was excreted into the venous effluent during reperfusion. The experimental data were fitted into a computer simulation model of the purine pathways. The model indicated that AMP deaminase was the predominant enzymatic pathway for the AMP degradation. It was demonstrated that ATP preferably accumulated as inosine-5'-monophosphate during ischemia and that xanthine oxidase was undetectable in skeletal muscle tissue homogenates. However, vascular endothelial cell xanthine oxidase activity responsible for a free radical-induced reperfusion injury could not be excluded.

Topics: Adenine Nucleotides; Animals; Computer Simulation; Female; Hindlimb; Inosine Monophosphate; Ischemia; Models, Biological; Muscles; Perfusion; Phosphocreatine; Purine Nucleotides; Rats; Rats, Sprague-Dawley; Reperfusion; Xanthine Oxidase

Premature infants are susceptible to intestinal ischemia during the newborn period when their intestinal tracts are functionally and structurally immature. Studies have shown that exogenous glucocorticoids hasten intestinal maturation. We investigated the effects of hydrocortisone on platelet activating factor (PAF)-induced intestinal ischemia in the neonatal rat. On Postnatal Days 7-11, Sprague-Dawley rats were given intraperitoneal (ip) injections of either saline (SAL) or hydrocortisone (HC; 50 mg/kg total). On Day 12, rats were injected with either PAF (2 micrograms/kg) or an equal volume of saline. After 2 hr the rats were sacrificed and sections were taken for histology. The remaining intestine was analyzed for maltase, lactase, myeloperoxidase (MPO), and xanthine oxidase (XO). Experimental groups were as follows: SAL (N = 8), received saline only; SAL+PAF (N = 8), received saline plus PAF; HC (N = 3), received hydrocortisone+saline; and HC+PAF (N = 5), received hydrocortisone plus PAF. XO was significantly decreased (P < 0.001) in the hydrocortisone-treated groups (HC + SAL = 16.36 +/- 18.42 units/g protein, HC + PAF = 17.33 +/- 9.06 units/g protein) vs the controls (SAL only = 108.90 +/- 20.24 units g/protein, SAL + PAF = 145.77 21.28 units/g protein). MPO was not significantly elevated in SAL + PAF (4.60 +/- 0.95 units/g protein) vs HC + PAF (2.18 +/- 0.80 units/g protein) in this study. Maltase was significantly elevated (P < 0.001) in the HC + PAF (241.46 +/- 40.6 mole/min/g protein) and HC + SAL (152.78 +/- 16.35 mole/min/g protein) vs saline only (28.35 +/- 5.77 mole/min/g protein and SAL + PAF (37.29 +/- 8.70 mole/min/g protein. Animals (7/8) in the SAL + PAF group developed ischemia by inspection and histologic exam.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: alpha-Glucosidases; Animals; Animals, Newborn; Hydrocortisone; Intestines; Ischemia; Platelet Activating Factor; Rats; Rats, Sprague-Dawley; Xanthine Oxidase

We have demonstrated that a two-layer (University of Wisconsin solution [UW]/perfluorochemical [PFC]) cold storage method restores the function of ischemically damaged pancreas during 24-hr preservation in canine autotransplantation model. The purpose of this study was to examine the possibility of a long-term preservation of the ischemically damaged pancreas by the two-layer (UW/PFC) method. After 60 or 90 min of warm ischemic time, pancreas grafts were preserved by the two-layer (UW/PFC) method or a simple cold storage in UW alone for up to 96 hr. A K value of i.v. glucose tolerance test more than 1.0 2 weeks after autotransplantation was considered successful preservation. After 60 min warm ischemia, limitation of preservation time by the simple cold storage in UW was 24 hr (5/5 100% and 0/5 0%; 24- and 48-hr preservation, respectively). However, the two-layer method made it possible to extend the preservation time up to 48 hr (5/5 100%, 5/5 100%, 2/5 40%, and 0/5 0%; 24-, 48-, 72-, and 96-hr preservation, respectively). After 90 min warm ischemia, the simple cold storage in UW was not effective even for 24-hr preservation (0/5 0%). However, 48-hr preservation was successful by the two-layer (UW/PFC) method (5/5 100%, 5/5 100%, and 0/5 0%; 24-, 48-, and 72-hr-preservation, respectively). After preservation by the two-layer (UW/PFC) method, ATP tissue concentrations of viable grafts were significantly higher compared with nonviable grafts (9.11 +/- 3.05 (n = 22) versus 5.22 +/- 1.02 (n = 13) mumol/g dry wt, P < 0.001). Based on analysis of individual ATP for each graft, if an ATP concentration of 6.0 mumol/g dry weight was determined as a critical value for doing the transplant, sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 84.6%, 91.7%, and 94.3%, respectively. This study clearly demonstrated that 48-hr preservation of the canine pancreas subjected to either 60 or 90 min warm ischemia was successfully achieved by the two-layer (UW/PFC) cold storage method, and ATP tissue concentration at the end of preservation by this method would predict the post-transplant outcome of the ischemically damaged pancreas just prior to transplantation.

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Cold Temperature; Dogs; Female; Fluorocarbons; Glutathione; Insulin; Ischemia; Male; Organ Preservation; Organ Preservation Solutions; Pancreas; Pancreas Transplantation; Raffinose; Time Factors

Using isolated perfusion rat lung model, we studied the effect of continuous ventilation without perfusion and allopurinol on the development of ischaemia-reperfusion lung injury. Ischaemia was induced by stopping the perfusion. Normothermic ischaemia for 90 min without ventilation caused significant lung oedema. Continuous ventilation during ischaemia with 21% O2 decreased lung oedema significantly after 60 min of reperfusion. The same protection could be achieved by 100% N2 ventilation during 90 min of ischaemia, suggesting that xanthine oxidase (XO) is unlikely to cause the ischaemia-reperfusion lung injury. On the other hand allopurinol, XO inhibitor, equally inhibited lung oedema after 90 min of ischaemia and 60 min of reperfusion. These results indicate that mechanical movement of alveoli provides successful preservation of ischaemic lung, and allopurinol has some protective effect other than XO inhibition.

Topics: Allopurinol; Animals; Body Water; Ischemia; Lung; Male; Oxygen; Pulmonary Edema; Rats; Rats, Wistar; Reperfusion Injury; Respiration, Artificial; Xanthine Oxidase

Topics: Adenosine; Alanine Transaminase; Allopurinol; Animals; Aspartate Aminotransferases; Ischemia; L-Lactate Dehydrogenase; Liver; Liver Function Tests; Male; Rats; Rats, Wistar; Reperfusion; Time Factors

Topics: Adenosine; Allopurinol; Cold Temperature; Glutathione; Humans; Insulin; Ischemia; Liver; Liver Function Tests; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Retrospective Studies; Time Factors

Topics: Adenosine; Allopurinol; Animals; Blood Urea Nitrogen; Creatinine; Glutathione; Hypertonic Solutions; Insulin; Ischemia; Kidney; Kidney Transplantation; Kidney Tubular Necrosis, Acute; Kidney Tubules, Proximal; Microscopy, Electron; Microvilli; Organ Preservation; Organ Preservation Solutions; Raffinose; Swine; Transplantation, Autologous

UW solution has been found to be an effective organ perfusate for transplantation. Initial studies in experimental pedicle skin flaps have also demonstrated its unique effectiveness in prolonged ischemia. To understand better the limits of its preservation properties without the influence of endothelial clamp damage, we have undertaken to study the properties of UW solution in experimental microvascular free flaps. Control, lactated Ringer's, and UW solutions were utilized in pedicle and microvascular free flaps in Sprague-Dawley rats over varying periods of ischemia. UW solution demonstrated a clear superiority over all other solutions in both flap models. In addition there also was a significant prolongation of critical ischemia time in UW-treated free flaps compared to pedicle flaps.

Topics: Adenosine; Allopurinol; Animals; Female; Glutathione; Insulin; Ischemia; Isotonic Solutions; Microcirculation; Organ Preservation Solutions; Perfusion; Raffinose; Rats; Rats, Sprague-Dawley; Regression Analysis; Ringer's Lactate; Skin; Skin Transplantation; Surgical Flaps; Tissue Preservation

The effects of ischemia and reperfusion with and without oxygen radical scavengers and xanthine oxidase inhibitors on Ca(2+)-ATPase activity were examined in the rat liver of 5 min ischemia followed by 5 and 10 min reperfusion. Ischemia was produced by the ligation of right hepatic artery and right portal vein. Superoxide dismutase, catalase and allopurinol were administered by subcutaneous injection of 60,000U/kg, 90,000U/kg and 200mg/kg, respectively before ligation. Reaction products of Ca(2+)-ATPase were morphometrically analyzed by RUZEX IIIU. Histochemically, Ca(2+)-ATPase activities were demonstrated on plasma membrane of liver cells, bile canaliculi and Kupffer cells involving mitochondria in liver cells of control rats. Ca(2+)-ATPase activities were depressed in the central lobes of liver after 5 min ischemia followed by 5 and 10min reperfusion. However, the activities of Ca(2+)-ATPase were not depressed by addition of oxygen radical scavengers and xanthine oxidase inhibitor before ischemia. These results suggest that oxygen free radicals may influence Ca(2+)-ATPase activity and contribute to liver cell damage due to ischemia-reperfusion.

Topics: Animals; Calcium-Transporting ATPases; Catalase; Free Radicals; Ischemia; Liver; Male; Oxygen; Rats; Rats, Wistar; Reperfusion Injury; Superoxide Dismutase; Xanthine Oxidase

We studied the effect of allopurinol (ALL) on the activity of xanthine dehydrogenase (XDH), xanthine oxidase (XOX), superoxide dismutase (SOD), and catalase (CAT) in rat liver during ischemia followed by 60 min of reperfusion. We induced 60-min ischemia in the median and left lobes by clamping the hepatic artery and portal branches. The percentage XOX relative to total oxidase activity increased significantly in the control group, from 10% during the stabilization period to 18% after 60 min of reperfusion. The XDH activity decreased during reperfusion. Activity of both XDH and XOX was almost completely blocked by ALL. The activity of SOD and CAT did not differ significantly between the ALL group and controls after 60 min of reperfusion. ALL treatment did not affect liver injury parameters, as concentrations of lactate dehydrogenase (LDH) and alanine transferase (ALT) increased in plasma after ischemia, both in controls and in the ALL-treated group. We concluded that ischemia promotes conversion of XDH to XOX during reperfusion. XOX may not be the main source of free radical production, since intracellular scavengers (SOD and CAT) did not differ significantly between controls and the ALL-treated group, despite the fact that ALL blocked XOX activity completely.

Topics: Allopurinol; Animals; Catalase; Free Radicals; Hyperthermia, Induced; Ischemia; Liver; Male; Rats; Rats, Wistar; Reperfusion; Superoxide Dismutase; Superoxides; Xanthine Dehydrogenase; Xanthine Oxidase

Hepatic artery thrombosis (HAT) after liver transplantation (LTx) usually mandates retransplantation. Prolonged preservation with Eurocollins solution has been associated with HAT. We reviewed our experience with 359 LTx patients to identify risk factors for HAT. All grafts were preserved in University of Wisconsin solution. HAT developed in 12 patients (3%) within 50 days. Seven patients were asymptomatic; four presented with biliary sepsis and 1 with poor graft function. Two patients had suffered acute rejection; another 2 had severe preservation injury. Technical problems accounted for 4 cases; in the remaining 8, no etiology was found. Diagnosis was at a mean 14.7 days after LTx. One patient maintains normal graft function 3 years after LTx without intervention. Eight underwent re-LTx, 3 of whom died. Routine surveillance via duplex enabled early diagnosis and revascularization in 3 patients; in all 3, no biliary complications occurred between 6 and 20 months. Overall graft and patient survival after HAT were 33.3% and 75%, respectively. Cold ischemic time (CIT) averaged 813 min in patients with HAT and 669 min in those without HAT (P < .05). HAT occurred in 7/165 patients with CIT > 12 hr, and in 3/234 patients with CIT < 12 hr (P = 0.0699). By avoiding CIT > 12 hr, we have recently avoided HAT in 78 consecutive patients. We conclude that CIT > 12 hr may increase the risk of HAT. When HAT is diagnosed before biliary sepsis develops, flow can often be restored and retransplantation averted.

Topics: Adenosine; Adult; Aged; Allopurinol; Child, Preschool; Cold Temperature; Glutathione; Hepatic Artery; Humans; Insulin; Ischemia; Liver; Liver Transplantation; Middle Aged; Organ Preservation; Organ Preservation Solutions; Raffinose; Thrombosis; Time Factors; Ultrasonography

This study was designed to observe the effect of perfusion with University of Wisconsin (UW) preservation solution on skin flap survival following secondary ischaemia caused by venous obstruction in rats. An epigastric flap model was used. Saline-perfused flaps exhibited no significant improvement in survival compared to untreated animals (NS). Skin flaps perfused with UW solution, however, had a significant increase in survival to 40% (8/20) (p < 0.01) when perfused before the onset of primary ischaemia and 30% (p < 0.05) when given before the onset of secondary ischaemia. These results show that UW solution improves skin flap survival, presumably through preservation of the microvasculature.

Topics: Adenosine; Allopurinol; Animals; Glutathione; Graft Survival; Insulin; Ischemia; Male; Organ Preservation Solutions; Raffinose; Rats; Rats, Sprague-Dawley; Skin; Skin Transplantation; Solutions; Surgical Flaps; Time Factors; Tissue Preservation

Topics: Adenosine; Allopurinol; Cold Temperature; Endothelins; Glutathione; Humans; Insulin; Ischemia; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Reperfusion Injury

Ischemia is a common situation, not always desirable, in liver surgery. In any case, it implies cellular damage that would be worth avoiding. In the present study, different antioxidant drugs (superoxide-dismutase, allopurinol and folinic acid) are administered prior to liver reperfusion in order to reduce ischemic damage. Liver regeneration, following a 70% hepatectomy and 15 minutes of normothermic hepatic ischemia, serves as an indirect functional test of the reperfused liver. SOD (6 mg/kg) and allopurinol (50 mg/kg) have accelerated hepatocytic DNA synthesis without increasing the number or percentage of activated hepatocytes. However, the folinic acid has proved to be very effective, counteracting the deleterious effect of liver ischemia on hepatocytic regeneration.

Topics: Allopurinol; Animals; Hepatectomy; Ischemia; Leucovorin; Liver; Liver Regeneration; Male; Rats; Rats, Sprague-Dawley; Superoxide Dismutase

Topics: Adenosine; Allopurinol; Animals; Aspartate Aminotransferases; Bile; Glutathione; Hepatic Artery; Insulin; Ischemia; Liver Function Tests; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Organ Size; Pressure; Raffinose; Reperfusion Injury; Swine

Recent evidence has suggested that the immaturity of the neonatal intestine may play a key role in the development of ischemic injury. However, relatively little data exist on the susceptibility of the neonatal intestine to ischemic injury at various ages especially in the fed versus fasted states. In this study, the levels of xanthine oxidase ([XO] an enzyme which is a known, major source of free radicals in postischemic tissue) and myeloperoxidase ([MPO] an index of tissue neutrophil infiltration) were measured in 1-, 5-, 10-, 15-, and 20-day-old Sprague-Dawley rats. Rats were divided into fed (n = 8/day) and fasted (n = 8/day) groups 4 hours prior to sacrifice. The entire small intestine was removed and divided into five segments: the duodenum, proximal jejunum, distal jejunum, proximal ileum, and distal ileum. The specimens were homogenized and assayed for XO and MPO levels. A significant increase in XO was observed in the fasted animals compared to the fed animals on all days. Peak levels in XO were observed in both groups from day 5 to 10. MPO levels were significantly higher in the fasted versus fed animals on day 1. MPO levels decreased as the animals aged. These data demonstrate dramatic differences in the levels of inflammatory enzymes of the newborn rat in the fed versus fasted states. Also, marked variations with age are seen in both XO and MPO. Whether the XO and MPO levels present at the time of ischemic insult affect severity of injury remains to be seen.

Topics: Animals; Animals, Newborn; Enterocolitis, Pseudomembranous; Fasting; Intestine, Small; Ischemia; Peroxidase; Rats; Rats, Sprague-Dawley; Xanthine Oxidase

Neutrophils (PMNs) are believed to play a key role in the pathogenesis of postinjury adult respiratory distress syndrome. We have previously shown that gut ischemia/reperfusion (I/R) produces lung injury by a process that requires PMNs. More recently, we have shown that xanthine oxidase (XO) plays a role. The purpose of this study was to characterize the mechanistic sequencing of XO activity versus the PMN in this model of gut I/R-induced lung injury. Normal and XO-inactivated (tungsten enriched, molybdenum depleted diet) rats underwent 45 min of superior mesenteric artery occlusion. After 6 hr reperfusion, blood was sampled and gut and lungs harvested. Myeloperoxidase (MPO) was used to quantitate PMN presence in the gut and lungs, while circulating PMN priming was measured as the difference in superoxide production with and without the activating stimulus, fMLP. 125I-labeled albumin leak was used as a marker for lung endothelial permeability. We observed that the gut I/R increased gut MPO levels, primed circulating PMNs, increased lung MPO levels, and provoked distant lung leak. XO inactivation abolished gut MPO activity, attenuated circulating PMN priming, and blocked lung leak. In conclusion, XO plays a proximal role in the pathogenesis of remote organ injury following splanchnic hypoperfusion.

Topics: Animals; Intestines; Ischemia; Lung; Lung Diseases; Male; Neutrophils; Peroxidase; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Superoxides; Xanthine Oxidase

This study was aimed at examining the vulnerability of the liver to oxygen-free radicals upon reoxygenation after prolonged ischemia. Livers from male Wistar rats were first flushed with Ringer's and Euro-Collins solutions. After ischemic storage in Krebs-Henseleit solution at 37 degrees C for 60 min and in Euro-Collins solution at 4 degrees C for another 60 min, they were then persufflated with either gaseous O2 or N2 for 30 min at 37 degrees C, and rinsed again with Ringer's solution. Enzyme concentrations and calcium ion activities were measured in the effluent rinsing solution after passage through the liver. Treatment with superoxide dismutase (SOD) or allopurinol resulted in a significant reduction of tissue injury, determined by the enzyme loss, calcium uptake, and lipid peroxidation upon persufflation with O2. Allopurinol also improved the tissue levels of ATP and the sum of adenine nucleotides after aerobic persufflation, whereas SOD did not. Notwithstanding, neither treatment had any effect on anoxic persufflation with N2. Thus, we conclude that the postischemic liver is susceptible to oxygen-induced free radical injury and that allopurinol and SOD promote specific antioxidative protection of the liver, with the exclusion of side effects related to substrates or perfusion modalities.

Topics: Adenine Nucleotides; Adenosine Triphosphate; Alanine Transaminase; Allopurinol; Animals; Calcium; Energy Metabolism; Free Radicals; Glutamate Dehydrogenase; In Vitro Techniques; Ischemia; Lipid Peroxidation; Liver; Male; Rats; Rats, Wistar; Superoxide Dismutase

Four models of acute pancreatitis have been previously developed that use the ex vivo perfused isolated canine pancreas preparation. The four models include the intraarterial infusion of oleic acid (FFA) that mimics hyperlipemic pancreatitis, partial obstruction of the pancreatic duct with secretin stimulation (POSS) that mimics gallstone pancreatitis, a 2-hour period of ischemia before perfusion (ISCH 2) that mimics shock pancreatitis, and the infusion of cerulein at supramaximal stimulatory doses (CER), which lacks an obvious clinical counterpart. In the FFA, POSS, and ISCH 2 pancreatitis, but not in the CER pancreatitis, toxic oxygen metabolites, generated by the enzyme xanthine oxidase (XO), have been shown to be important mediators in the early pathogenesis. Ordinarily XO primarily occurs as xanthine dehydrogenase (XD) but can be converted to XO, which is the form that generates toxic oxygen metabolites. This conversion of XD to XO may take place either reversibly by way of sulfhydryl group oxidation or irreversibly by means of proteolytic cleavage of XD. This study was undertaken to investigate the mechanism of conversion of XD to XO in the FFA-, POSS-, and ISCH 2-induced pancreatitis models. CER pancreatitis was studied for comparison. After 4 hours of perfusion, pancreatitis was manifest by edema, weight gain, and hyperamylasemia in all four models. Dithiothreitol, a sulfhydryl group protector, ameliorated the weight gain in the FFA (40 +/- 14 gm to 18 +/- 13 gm; p < 0.05), POSS (28 +/- 10 gm to 9 +/- 3 gm; p < 0.05), and ISCH 2 pancreatitis (30 +/- 13 gm to 15 +/- 3 gm; p < 0.05), and ameliorated the hyperamylasemia in the POSS pancreatitis (12,062 +/- 4304 units/dl to 5877 +/- 2659 units/dl; p < 0.05). The CER pancreatitis was not ameliorated with dithiothreitol. A serine protease inhibitor of low molecular weight, phenylmethylsulfonyl fluoride, ameliorated only the CER pancreatitis (weight gain from 28 +/- 10 gm to 17 +/- 10 gm, p < 0.05; amylase activity from 38,116 +/- 6491 units/dl to 23,372 +/- 11,654 units/dl, p < 0.05), and not the FFA, POSS, or ISCH 2 pancreatitis. We conclude that in the three models of pancreatitis (FFA, POSS, and ISCH 2) that are mediated by toxic oxygen metabolites, XD is converted to XO reversibly by way of sulfhydryl group oxidation rather than irreversibly by way of proteolysis. In the CER pancreatitis, where XO does not play a role in the pathogenesis, proteolytic enzymes may be important mediators in the injury.

Topics: Acute Disease; Animals; Ceruletide; Dithiothreitol; Dogs; In Vitro Techniques; Ischemia; Oleic Acid; Oleic Acids; Pancreas; Pancreatitis; Phenylmethylsulfonyl Fluoride; Secretin; Time Factors; Xanthine Dehydrogenase; Xanthine Oxidase

Topics: Adenosine; Allopurinol; Animals; Blood Glucose; Dogs; Female; Fluorocarbons; Glutathione; Hyperglycemia; Insulin; Ischemia; Male; Organ Preservation; Organ Preservation Solutions; Pancreas; Pancreas Transplantation; Raffinose; Solutions; Temperature; Transplantation, Autologous

This study sought to examine the acute effects of ocular ischemia and reperfusion on retinal function and determine the extent to which recovery during reperfusion is improved by allopurinol (AP), a blocker of xanthine oxidase (XO). The latter is presumed to be a major factor in the formation of free radicals associated with reperfusion of ischemic tissue.. Electroretinographic (ERG) responses were recorded simultaneously from the two isolated, arterially perfused eyes obtained from the same cat. One eye served as the control and received only the standard perfusate; the other eye was infused with AP before and after a 3 hr period of total ischemia.. After the prolonged period of nonperfusion, recovery of the electroretinographic components was incomplete to varying degrees. Maximum b-wave amplitudes recovered only to 17 +/- 5% (mean +/- SEM) of baseline, whereas the a-wave grew to 60 +/- 10% of its baseline value. For both measures, the recovery of electroretinographic amplitude was significantly greater in AP-treated eyes than in the control eyes.. Generation of free radicals by XO contributes to the retinal damage and loss of function that occurs after a period of ischemia and subsequent reperfusion.

Topics: Allopurinol; Animals; Cats; Dark Adaptation; Electroretinography; Female; Free Radicals; Ischemia; Light; Perfusion; Reperfusion Injury; Retina; Retinal Artery; Xanthine Oxidase

In a recent study, reperfusion mucosal injury was demonstrated in a rat model of total ischemia if venous congestion was avoided. The aims were to examine the possibility of reperfusion damage in a canine model involving 2 hours of complete segmental ischemia and to investigate the effects of antioxidant therapy or pretreatment with nonspecific phospholipase A2 inhibitors on postocclusive mucosal changes. Tissue samples were evaluated histologically in a blind manner, according to a 0 to V grade scale. The degree of mucosal damage was statistically significantly increased during the 30-minute reperfusion period. Similarly, 2 hours of total ischemia followed by 30 minutes of reperfusion produced significantly more tissue lesions than did 2 1/2 hours of ischemia without reperfusion. Oral allopurinol pretreatment supplemented by an intravenous dose, or oral allopurinol in combination with a superoxide radical scavenger, resulted in a significant amelioration of postischemic histologic changes. Pretreatment with a nonspecific phospholipase A2 inhibitor (methylprednisolone, dexamethasone, or quinacrine) was ineffective in diminishing the reperfusion injury in either case. The results suggest that reperfusion injury may develop even after complete intestinal ischemia, and this damage can be attenuated by inhibiting the capacity of xanthine oxidase to generate reactive oxygen intermediates.

Topics: Allopurinol; Animals; Antioxidants; Dexamethasone; Dogs; Female; Ileum; Intestinal Mucosa; Ischemia; Male; Methylprednisolone; Phospholipases A; Phospholipases A2; Quinacrine; Quinolines; Reperfusion Injury

The time course of oxidative stress and tissue damage in zonal liver ischemia-reperfusion in rat liver in vivo was evaluated. After 180 min of ischemia, surface chemiluminescence decreased to zero, state 3 mitochondrial respiration decreased by 70-80%, and xanthine oxidase activity increased by 26% without change in the water content and in the activities of superoxide dismutase, catalase, and glutathione peroxidase. After reperfusion, marked increases in oxyradical production and tissue damage were detected. Mitochondrial oxygen uptake in state 3 and respiratory control as well as the activities of superoxide dismutase, catalase, and glutathione peroxidase and the level of nonenzymatic antioxidants (evaluated by the hydroperoxide-initiated chemiluminescence) were decreased. The severity of the post-reperfusion changes correlated with the time of ischemia. Morphologically, hepatocytes appeared swollen with zonal cord disarrangement which ranged from mild to severe for the tissue reperfused after 60-180 min of ischemia. Neutrophil infiltration was observed after 180 min of ischemia and 30 min of reperfusion. Mitochondria appear as the major source of hydrogen peroxide in control and in reperfused liver, as indicated by the almost complete inhibition of hydrogen peroxide production exerted by the uncoupler carbonylcyanide p-(trifluoromethoxy) phenylhydrazone. Additionally, inhibition of mitochondrial electron transfer by antimycin in liver slices reproduced the inhibition of state 3 mitochondrial respiration and the increase in hydrogen peroxide steady-state concentration found in reperfused liver. Increased rates of oxyradical production by inhibited mitochondria appear as the initial cause of oxidative stress and liver damage during early reperfusion in rat liver.

Topics: Animals; Free Radicals; Hydrogen Peroxide; Ischemia; Liver; Luminescent Measurements; Male; Mitochondria, Liver; Oxygen Consumption; Phenobarbital; Rats; Rats, Wistar; Reperfusion Injury; Xanthine Dehydrogenase; Xanthine Oxidase

A myriad of investigations have been published on the pharmacologic manipulation of flaps to enhance tolerance to ischemia. We recently reported a threefold increase in ischemic tolerance of the rat abdominal skin flap pedicle after 6 hours of primary ischemia and 12 hours of reperfusion. Flaps underwent normothermic perfusion washout with lactated Ringer's or U.W. solution, a newly developed organ preservation medium. Perfusion washouts were performed at one of three different points in the protocol: (1) onset of primary ischemia; (2) onset of secondary ischemia; or (3) 2 hours after onset of secondary ischemia. The last group was used to simulate the clinical situation in which flaps are discovered and salvage procedures instituted at a delayed time interval. This is the longest normothermic ischemic interval reported. We undertook the present study to determine the utility of the U.W solution in prolonging the tolerance of the flap to a second ischemic insult after a period of reperfusion. Seventy-five unilateral rat abdominal skin flaps were raised. Secondary ischemia was produced by placing a microvascular clamp across the inferior epigastric pedicle. Flap survival was assessed at 1 week postoperatively. While none of the nonperfused flaps survived 8 hours of secondary ischemia, at least 50% of the U.W. perfused flaps survived an average of 14 hours of secondary ischemia. Lactated Ringer's perfusion washout only modestly increased the ischemic tolerance. Perfusion washout in the secondary ischemic phase improved the ischemic tolerance to a significantly greater degree than in the primary ischemic interval.

Topics: Adenosine; Allopurinol; Animals; Female; Glutathione; Graft Survival; Insulin; Ischemia; Organ Preservation Solutions; Perfusion; Raffinose; Rats; Rats, Sprague-Dawley; Reperfusion; Skin; Solutions; Surgical Flaps; Time Factors; Tissue Preservation

The activity and localization of the plasma membrane-bound enzyme 5'-nucleotidase (5'-NT) in liver tissue are sensitive parameters of ischemic damage. The value of 5'-NT as a marker of liver graft viability was studied in relation to liver preservation. In six mongrel dogs, the main right and left branches of the portal vein were cannulated and flushed separately in situ with cold University of Wisconsin (UW) solution and Euro-Collins (EC) solution, respectively. After hepatectomy, the right and left liver lobes were split and stored at 5 degrees C in either of the two solutions. 5'-NT activity was demonstrated in cryostat sections of liver tissue using the lead salt method. After 48 h of storage in EC solution, the 5'-NT score had decreased to 31% +/- 16% (n = 6), whereas in UW solution the 5'-NT score was 76% +/- 10% (n = 6). Significantly (P < 0.05) higher 5'-NT scores were also found after 24-h and 72-h preservation times in UW versus EC solutions. This result is in keeping with the higher preservation tolerance of liver grafts preserved in UW solution. The 5'-NT assay was studied in relation to graft function in orthotopic liver transplantation experiments in dogs. All dogs with liver grafts preserved in UW solution for 24 h (n = 4) and 48 h (n = 3) survived (> 5 days). Pretransplant 5'-NT scores ranged from 61% to 100%. The 72-h-preserved livers (n = 5) did not show life-supporting function.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: 5'-Nucleotidase; Adenosine; Allopurinol; Animals; Aspartate Aminotransferases; Dogs; Female; Glutathione; Graft Survival; Hypertonic Solutions; Insulin; Ischemia; Liver; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Raffinose; Solutions

Topics: Adenine Nucleotides; Adenosine; Allopurinol; Animals; Blood Glucose; Dogs; Female; Fluorocarbons; Furans; Glutathione; Graft Survival; Hot Temperature; Insulin; Ischemia; Male; Neck; Organ Preservation; Organ Preservation Solutions; Pancreas; Pancreas Transplantation; Raffinose; Solutions; Transplantation, Autologous; Transplantation, Heterotopic

The current study was done to evaluate the effects of short term (60 minutes) pancreatic biliary duct obstruction (PBDO) with intraductal hypertension (IDH) stimulated by secretin (0.2 clinical unit per kilogram per hour) and caerulein (0.2 microgram per kilogram per hour) plus 30 minutes of temporary pancreatic ischemia (ISCH) produced by ligation of celiac and superior mesenteric artery on the exocrine pancreas and protective effects of a new potent protease inhibitor, ONO3307 in combination with xanthine oxidase inhibitor, allopurinol, in this multifactor related model of acute pancreatitis in rats. Twelve hours after PBDO with IDH plus ISCH, we observed hyperamylasemia (23 +/- 3 units per milliliter) (p < 0.01); moderate pancreatic histologic changes; pancreatic edema (water content--81 +/- 2 percent) (p < 0.02), as well as the impaired amylase (2,889 +/- 328 units per kilogram per hour) (p < 0.01) and cathepsin B output (7 +/- 3 units per kilogram per hour) (p < 0.01) into the pancreatic juice of rats stimulated by caerulein (control group--serum amylase levels, 6 +/- 1 units per milliliter; pancreatic water content, 74 +/- 1 percent. Furthermore, PBDO with IDH plus ISCH caused the redistribution of lysosomal enzyme from lysosomal fraction (12 kilo times gravity pellet; 40 +/- 3 percent; p < 0.01) to zymogen fraction (1.3 kilo times gravity pellet; 38 +/- 3 percent; p < 0.01) (control group--12 kilo times gravity pellet, 59 +/- 2 percent; 1.3 kilo times gravity pellet, 24 +/- 2 percent) and the impaired pancreatic adenylate energy metabolism (0.79 +/- 0.02, p < 0.02) (control group--energy charge equals 0.88 +/- 0.01). Only PBDO with IDH caused no significant changes. Although only ONO3307 or allopurinol therapy showed the partial significant protective effects against pancreatic injuries, improving serum amylase levels, the administration of ONO3307 in combination therapy with allopurinol showed almost complete protective effects against the pancreatic injuries induced by PBDO with IDH plus ISCH (serum amylase levels, 9 +/- 2 units per milliliter; pancreatic water content, 76 +/- 2 percent; amylase and cathepsin B output, 7,127 +/- 946 and 18 +/- 3 units per kilogram per hour; 1.3 kilo times gravity pellet, 28 +/- 2 percent; 12 kilo times gravity pellet, 54 +/- 2 percent, and energy charge equals 0.85 +/- 0.02).(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Acute Disease; Allopurinol; Animals; Ceruletide; Cholestasis, Extrahepatic; Drug Therapy, Combination; Guanidines; Ischemia; Male; Pancreas; Pancreatic Ducts; Pancreatitis; Rats; Rats, Wistar; Secretin; Serine Proteinase Inhibitors

Topics: Adenosine; Allopurinol; Animals; Body Water; Cold Temperature; Energy Metabolism; Glutathione; Hot Temperature; Hydrogen; Insulin; Ischemia; Liver; Magnetic Resonance Spectroscopy; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Solutions

Topics: Adenosine; Adult; Allopurinol; Brain Death; Glutathione; Humans; Indocyanine Green; Insulin; Ischemia; Liver; Liver Function Tests; Liver Transplantation; Metabolic Clearance Rate; Organ Preservation; Organ Preservation Solutions; Raffinose; Regression Analysis; Solutions; Tissue Donors

Topics: Adenosine; Adenosine Diphosphate; Adenosine Monophosphate; Adenosine Triphosphate; Allopurinol; Animals; Energy Metabolism; Glucose; Glutathione; Insulin; Ischemia; Liver; Male; Mannitol; Organ Preservation Solutions; Potassium Chloride; Procaine; Raffinose; Rats; Rats, Sprague-Dawley; Solutions; Temperature

Effects of 60 and 120 minutes of in-vitro ischaemia on the localization of xanthine oxidase activity were studied in rat intestine and liver. A histochemical method was applied on unfixed cryostat sections using a semipermeable membrane. The incubation medium contained hypoxanthine as substrate, cerium ions which capture the enzyme product, hydrogen peroxide, and sodium azide to inhibit catalase and peroxidase activities. In a second step reaction diaminobenzidine was polymerized in the presence of cobalt ions and hydrogen peroxide by decomposition of cerium perhydroxide. Large amounts of final reaction product were found in the cytoplasm of enterocytes and goblet cells of control small intestine. When the incubation was performed in the absence of substrate or in the presence of substrate and allopurinol, a specific inhibitor of xanthine oxidase activity, no reaction product was found. After 60 and 120 minutes of storage of tissue blocks at 37 degrees C enzyme activity was significantly reduced in the apical region of epithelial cells, whereas a high activity was present in the basal region of these cells. A very low xanthine oxidase activity was found in rat liver. Highest activity was present in endothelial cells, whereas in liver parenchymal cells, a more pronounced activity was found in pericentral than in periportal hepatocytes. Ischaemia up to 120 minutes did not affect the enzyme activity in livers. It was concluded that increased xanthine oxidase activity during ischaemia may not be responsible for cell damage during reperfusion in contrast with assumptions in the literature.

Topics: Animals; Culture Techniques; Intestine, Small; Ischemia; Liver; Male; Rats; Rats, Wistar; Reperfusion Injury; Xanthine Oxidase

Successful liver transplantation is dependent upon many factors, one of which is the quality of the donor organ. Previous studies have suggested that the donor nutritional status may affect the outcome of liver transplantation and starvation, due to prolonged stay in the intensive care unit, may adversely affect the liver. In this study we have used the orthotopic rat liver transplant model to measure how fasting the donor affects the outcome of liver transplantation. Rat livers were preserved with UW solution either at 37 degrees C (warm ischemia for 45-60 min) or at 4 degrees C (cold ischemia for 30 or 44 hr). After preservation the livers were orthotopically transplanted and survival (for 7 days) was measured, as well as liver functions 6 hr after transplantation. After 45 min of warm ischemia 50% (3 of 6) animals survived when the liver was obtained from a fed donor about 80% (4 of 5) survived when the liver was obtained from a three-day-fasted donor. After 60 min warm ischemia no animal survived (0 of 8, fed group). However, if the donor was fasted for 3 days 89% (8 of 9) of the animals survived for 7 days. Livers cold-stored for 30 hr were 50% viable (3 of 6) and fasting for 1-3 days did not affect this outcome. However, if the donor was fasted for 4 days 100% (9 of 9) survival was obtained. After 44-hr preservation only 29% (2/7) of the recipients survived for 7 days. If the donor was fasted for 4 days, survival increased to 83% (5/6). Liver functions, bile production, and serum enzymes were better in livers from the fasted rats than from the fed rats. Fasting caused a 95% decrease in liver glycogen content. Even with this low concentration of glycogen, liver viability (animal survival) after warm or cold ischemia was not affected, and livers with a low glycogen content were fully viable. Thus liver glycogen does not appear to be important in liver preservation. This study shows that fasting the donor does not cause injury to the liver after warm or cold ischemia. In fact, the livers appeared to be better able to tolerate ischemia when obtained from fasted rats. Thus donor nutritional status may be an important factor for outcome of liver transplantation. Livers from fasted donors may be capable of tolerating long-term preservation better than livers from fed donors.

Topics: Adenosine; Allopurinol; Animals; Bile; Body Water; Cold Temperature; Fasting; Glutathione; Graft Survival; Hot Temperature; Immunity, Innate; Insulin; Ischemia; Liver; Liver Glycogen; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Organ Size; Raffinose; Rats; Rats, Inbred BN; Solutions; Time Factors; Tissue Donors

The conversion from xanthine dehydrogenase (XD) to xanthine oxidase (XO) and the effect of trifluoperazine (TFP), a calmodulin inhibitor, on the conversion were examined during the normothermic ischemia of the rat small intestine. Rat jejunums were stored in lactated Ringer's solution (LR) at 37 degrees C for various hours after intravascular flushing with LR. The extents of the conversion from XD to XO (%XO) constituted 21.1% +/- 3.0%, 36.2% +/- 7.0%, 63.2% +/- 8.1%, and 88.2% +/- 8.6% after 0, 2, 4, and 6 hours of the preservation, respectively (control group). The preservation without the intravascular flushing showed significant increase in the %XO (99.5% +/- 6.0%) only after 6 hours compared with those in the control group (P < .05). When the intestines were stored in LR containing 50 mg/L of TFP at 37 degrees C, or stored in LR at 37 degrees C after the intraperitoneal pretreatment with 10 mg/kg of TFP 1 hour before laparotomy showed significant decrease in the extents of the conversion after 4 hours (P < .005) and 6 hours (P < .025) of the preservation, compared with those in the control group. When the dose of TFP for the pretreatment was increased to 50 mg/kg, the suppressive effect on the conversion was found even after 2 hours (P < .025) as well as after 4 hours (P < .005) and 6 hours (P < .025) of the preservation. These results suggest that TFP could be effective on reducing the XO-mediated postischemic reperfusion injury by means of inhibiting the conversion during ischemia of the rat small intestine.

Topics: Animals; In Vitro Techniques; Ischemia; Jejunum; Male; Rats; Reperfusion Injury; Trifluoperazine; Xanthine Dehydrogenase; Xanthine Oxidase

Application of the University of Wisconsin cold storage solution has rapidly expanded to include medium-term to long-term preservation of virtually all intraabdominal organs. Its use in intrathoracic organ transplantation has also been suggested. We therefore examined the efficacy of the University of Wisconsin solution in a primate allotransplantation model for preservation of hearts, and as a simple single-solution system for static preservation of heart-lung blocks, for periods of ischemia ranging from 6 to 24 hours. For comparison, we employed the histidine-tryptophane-ketoglutarate cardioplegic solution of Bretschneider. University of Wisconsin solution provided superior results with regard to clinical outcome and hemodynamic recovery of hearts after ischemic periods of up to 16 hours. This was in contrast to Bretschneider's solution, which allowed storage of hearts for periods of only up to 10 hours. Heart-lung blocks were equally well preserved with either University of Wisconsin or Bretschneider's solution after 6 to 12 hours, although the University of Wisconsin solution group exhibited a more notable increase in pulmonary water content. This was in accordance with histological data, which suggested that, although hemodynamic recovery of hearts stored for periods longer than 10 hours was poor, preservation of pulmonary ultrastructure was far superior using Bretschneider's solution as compared with University of Wisconsin solution after an ischemic period of up to 16 hours.

Topics: Adenosine; Allopurinol; Animals; Body Water; Cardiac Output; Cardioplegic Solutions; Cardiopulmonary Bypass; Catecholamines; Glucose; Glutathione; Heart Arrest, Induced; Heart Transplantation; Heart-Lung Transplantation; Hypertonic Solutions; Insulin; Ischemia; Lung; Mannitol; Monitoring, Physiologic; Myocardium; Organ Preservation Solutions; Papio; Positive-Pressure Respiration; Potassium Chloride; Procaine; Raffinose; Solutions; Stroke Volume; Survival Rate; Time Factors; Tissue Preservation; Ventricular Function, Left

Ischemia-reperfusion (I/R)-induced microvascular injury is characterized by capillary "no-reflow" and reflow-associated events, termed "reflow paradox," including leukocyte-endothelium interaction and increase in microvascular permeability. The major objectives of this study were 1) to elucidate the significance of reflow paradox after 4 h of tourniquet-induced ischemia in striated muscle and 2) to determine the role of reactive oxygen metabolites in the pathogenesis of reflow paradox-dependent microcirculatory alterations. By use of in vivo fluorescence microscopy in a striated muscle preparation of hamsters, leukocyte-endothelium interaction in postcapillary venules and macromolecular extravasation from capillaries and venules were quantified before ischemia and after 30 min, 2 h, and 24 h of reperfusion. I/R elicited marked enhancement (P < 0.01) of leukocyte rolling during initial reperfusion and a 20-fold increase of leukocyte adherence (P < 0.01) lasting for the entire postischemic reperfusion period (n = 7). These phenomena were accompanied by significant leakage (P < 0.01) of macromolecules from capillaries and in particular from postcapillary venules (n = 9). Both superoxide dismutase (SOD, 20 mg/kg body wt, n = 7) and allopurinol (50 mg/kg body wt, n = 7) were effective in attenuating I/R-induced leukocyte rolling and adherence. In addition, microvascular leakage was significantly reduced by allopurinol (n = 9) and completely abolished by SOD (n = 9) (P < 0.01). These results support the concept that reactive oxygen metabolites contribute to I/R-induced reflow paradox, resulting in leukocyte accumulation, adherence, and increase in microvascular permeability.

Topics: Allopurinol; Animals; Capillary Permeability; Cricetinae; Dextrans; Endothelium, Vascular; Fluorescein-5-isothiocyanate; Ischemia; Leukocytes; Mesocricetus; Microcirculation; Muscles; Regional Blood Flow; Reperfusion Injury; Superoxide Dismutase

Hind limb ischemia and reperfusion have been shown to result in high plasma levels of leukotriene B4 (LTB4) and polymorphonuclear neutrophil (PMN) sequestration in the pulmonary microvasculature. This study tests whether LTB4 is derived from PMNs and its role in mediating ischemic plasma-induced diapedesis. Plasma derived from rabbit hind limbs after 3 hours of tourniquet ischemia and 10 minutes of reperfusion (n = 6) showed an increased LTB4 level of 560 pg/ml, higher than sham plasma values of 106 pg/ml (p less than 0.05). Introduction of ischemic plasma in abraded skin chambers placed on the dorsum of normal rabbits (n = 6) led after 3 hours to PMN diapedesis of 1175 PMN/mm3, associated with a further increase in LTB4 levels to 820 pg/ml (both p less than 0.05). In contrast, ischemic plasma derived from neutropenic animals (n = 4; nitrogen mustard, 2 mg/kg; PMNs less than 30/mm3) contained lower levels of LTB4, 160 pg/ml (p less than 0.05). When introduced in skin chambers in normal rabbits (n = 4), this plasma induced accumulations of only 163 PMN/mm3, accompanied by a smaller increase in LTB4 levels in the blister fluid after 3 hours, 397 pg/ml (both p less than 0.05). A correlation was found between LTB4 levels in ischemic plasma and PMN accumulations in blister fluid (r = 0.92; p less than 0.05). Intravenous pretreatment of rabbits (n = 4) used in the blister chamber bioassay with the LT receptor antagonist FPL-55712, 40 micrograms/kg/hr, attenuated diapedesis induced by ischemic and ischemic-neutropenic plasma, 103 and 35 PMN/mm3, respectively (both p less than 0.05). Pretreatment with superoxide dismutase, 1500 units/kg, and catalase, 5000 units/kg, both conjugated to polyethylene glycol (n = 4), prevented ischemic plasma-induced LTB4 synthesis, as well as ischemic plasma-induced diapedesis, 12 PMN/mm3 (p less than 0.05). Finally, pretreatment with allopurinol, 25 mg/kg, was similarly effective in preventing LTB4 synthesis and PMN migration. These data suggest that oxygen free radicals are essential for ischemia-induced PMN synthesis of LTB4 that in turn mediates their diapedesis.

Topics: Allopurinol; Animals; Chemotaxis, Leukocyte; Chromones; Free Radicals; Hindlimb; Ischemia; Leukotriene B4; Male; Mechlorethamine; Neutrophils; Oxygen; Rabbits; Reperfusion; Skin; SRS-A

Injury to nonpulmonary organ systems often initiates systemic processes that cause recruitment of neutrophils to the lung. We found that rats subjected to intestinal ischemia-reperfusion (I/R) had increased transvascular leak of 125I-labeled albumin into lungs and decreased lung ATP levels (P less than 0.05). In addition, rats subjected to intestinal I/R had increased plasma xanthine oxidase (XO) activity, plasma leukotactic activity for neutrophils, and lung neutrophil retention (assessed by morphometry and myeloperoxidase activity) compared with sham-treated rats (P less than 0.05). By comparison, after intestinal I/R, rats fed an allopurinol- or tungsten-enriched diet had decreased plasma and intestinal XO activities, decreased plasma leukotacic and lung myeloperoxidase (MPO) activities, decreased lung leak, and increased lung ATP levels compared with rats fed control diets (P less than 0.05). Further studies suggested a more specific role for circulating rather than tissue XO in mediating lung neutrophil accumulation but not lung leak. Plasma XO, plasma leukotactic, and lung MPO activities, but not lung leak, increased in rats administered purified XO intravenously. In addition, plasma XO, plasma leukotactic, and lung MPO activities, but not lung leak, decreased in rats administered antisera against XO and then subjected to intestinal I/R. We conclude that circulating XO increases acutely and may contribute to pulmonary retention of neutrophils after an ischemic intestinal insult.

Topics: Allopurinol; Animals; Cell Movement; Endotoxins; Injections, Intravenous; Intestines; Ischemia; Lung; Male; Neutrophils; Peroxidase; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Tungsten; Xanthine Oxidase

The effects of ulinastatin (ULN), a human urinary protease inhibitor, on liver injury caused by ischemia-reperfusion were studied in rats. In the liver ischemia-reperfusion model, ULN suppressed the elevation of serum transaminase levels and tissue lipid peroxide levels in the liver. ULN did not exhibit a radical-trapping action on the superoxide and hydroxyl radicals as measured by electron spin resonance (ESR). ULN suppressed formylmethionyl-leucyl-phenylalanine (FMLP) and phorbol myristate acetate (PMA)-induced superoxide production from polymorphonuclear leukocytes (PMNs) as measured by the cytochrome c assay. ULN did not inhibit either xanthine oxidase (XO) activity or the conversion of xanthine dehydrogenase (XDH) to XO during the ischemic period. ULN also strongly protected against the hypotonic hemolysis of rat erythrocytes. These results suggest that ULN's membrane stabilizing action and suppressive effect against PMNs superoxide production might be attributed to its suppressive effect on the liver's lipid peroxidation caused by ischemia-reperfusion.

Topics: Animals; Enzymes; Erythrocyte Membrane; Free Radicals; Glycoproteins; Ischemia; Lipid Peroxides; Liver; Liver Circulation; Male; Neutrophils; Protease Inhibitors; Rats; Rats, Wistar; Reperfusion Injury; Superoxides; Trypsin Inhibitors; Xanthine Oxidase

Using luminol- and lucigenin-enhanced chemiluminescence (Lm-CL and Lg-CL), we monitored oxygen radical generation during ischemia-reperfusion in the isolated perfused rat liver. Both enhanced chemiluminescence levels decreased during 30 min of ischemia and increased markedly at the onset of reperfusion. When the liver was subjected to another 30 min of ischemia, reperfusion caused a progressive increase in both types of enhanced chemiluminescence. Administration of superoxide dismutase (SOD) into the perfusate strongly attenuated Lm-CL, but had a limited effect on Lg-CL. Catalase (CAT) and allupurionol (ALP) failed to attenuate both types of enhanced chemiluminescence. Thus the predominant oxygen radicals in the liver during reperfusion is superoxide and the lack of effect of ALP on oxygen radical generation indicates that hypoxanthine-xanthine oxidase reaction is unlikely to be a primary source of oxygen radicals. The different response to SOD in Lm-CL and Lg-CL is considered to be based on the diffusion space of luminol and lucigenin in the tissue. The relationship between oxygen radical levels and tissue damage, and the site of oxygen radical detection are discussed.

Topics: Acridines; Allopurinol; Animals; Catalase; Ischemia; Liver; Luminescent Measurements; Luminol; Male; Perfusion; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Reperfusion; Superoxide Dismutase; Superoxides

Studies in animals on the use of UW solution in liver transplantation have shown an inverse relation between cold ischaemia time (CIT) and graft function. There are few clinical data on this relation in human beings. We have investigated the effect of extended cold ischaemia in a prospective study. We assessed early graft function and subsequent outcome for 306 consecutive elective liver transplantations; for analyses, grafts were grouped according to CIT (< 12 h group A, > or = 12 h group B), since a preliminary study identified 12 h as a significant cut-off point. Initial graft function was better in group A than group B, as shown by maximum alanine aminotransferase activity (mean 623 [805] vs 946 [1148], p = 0.02), bile production on days 1-3 (p < 0.05), maximum serum bilirubin by day 10 (206 [166] vs 244 [163] mumol/l, p = 0.04), and frequencies of primary non-function (1 [0.4%] vs 4 [7%], p = 0.006) and hepatocyte necrosis on routine biopsy sample after reperfusion (18% vs 31%, p = 0.04). Long-term outcome was also better in group A than group B; graft and patient survival rates were higher and fewer retransplantations were needed. These findings suggest that cold ischaemia in UW solution for longer than 12 h is a risk factor for graft function and patient survival. We recommend that the limit of the safe CIT be reconsidered.

Topics: Adenosine; Adult; Alanine Transaminase; Allopurinol; Bile; Bilirubin; Cold Temperature; Female; Glutathione; Graft Survival; Humans; Insulin; Ischemia; Liver; Liver Transplantation; Male; Organ Preservation; Organ Preservation Solutions; Prospective Studies; Raffinose; Reoperation; Risk Factors; Solutions

Recent studies have demonstrated a connection between xanthine oxidase-generated reactive oxygen intermediates and histamine release during ischemia-reperfusion. In the present work, the effect of modulation of the endogenous histamine level on the xanthine oxidase activity was examined during the reperfusion of a canine ileal segment following a 2 hr of complete ischemia. The xanthine oxidase activity and the plasma histamine level peaked simultaneously at the beginning of reperfusion, reaching mean values of 14.9 nmol/ml/min and 12.1 nmol/l, respectively. Pretreatment with aminoguanidine, a blocker of diamine oxidase (histaminase), resulted in significantly higher levels of histamine during reperfusion, but this elevation was not accompanied by a further increase in xanthine oxidase activity. Pretreatment with the mast cell stabilizer cromolyn significantly diminished the rise in plasma histamine level, with an unchanging activity of xanthine oxidase. No significant alteration could be observed in the postocclusive activity of xanthine oxidase following the intra-arterial administration of 0.5, 1, or 5 nmol of histamine during the last 10 min of the ischemic period. These data suggest that the amount of histamine liberated during reperfusion does not result in a further increase in the xanthine oxidase activity. The release of histamine is not a cause, but rather an effect of the elevated activity of intestinal xanthine oxidase.

Topics: Animals; Cromolyn Sodium; Disease Models, Animal; Dogs; Female; Guanidines; Histamine; Histamine Release; Intestines; Ischemia; Male; Mast Cells; Reperfusion Injury; Xanthine Oxidase

Under normal conditions the intestinal mucosa is impermeable to potentially harmful materials from the intestinal lumen. Mucosal disruption promotes bacterial translocation, which is postulated to be a fuel source for sepsis and multiorgan failure. We have previously demonstrated that mesenteric ischemia-reperfusion (I/R) injury increases intestinal permeability (IP); however, the mechanism remains unclear. This study was designed to examine the hypothesis that changes in IP, after I/R injury, are mediated by xanthine oxidase-generated, oxygen-derived free radicals. Thirty-three Sprague-Dawley rats (weighing 300 to 400 g) were included in this study. Group 1 (n = 10) received enteral allopurinol, a xanthine oxidase inhibitor, 10 mg/kg daily for 1 week prior to mesenteric ischemia. Group 2 consisted of 11 untreated, ischemic animals. Groups 1 and 2 were subjected to superior mesenteric artery occlusion with interruption of collateral flow for 20 minutes to produce ischemic injury to the intestine. An additional 12 rats (group 3), served as nonischemic controls (sham). A loop of distal ileum was isolated and cannulated proximally and distally to allow luminal perfusion with warmed Ringer's lactate at 1 mL/min. IP was determined in all groups by quantitatively measuring the plasma-to-luminal clearance of chromium (51Cr)-labeled ethylenediaminetetraacetate (EDTA) at baseline, during ischemia and 20, 40, and 60 minutes after reperfusion. Complete ischemia produced significant increases in IP over baseline values in the untreated rats (group 2, baseline: 0.49 +/- 0.006, ischemia: 0.149 +/- 0.039) compared with sham rats (baseline: 0.41 +/- 0.006; ischemia: 0.047 +/- 0.009) or allopurinol-treated rats (baseline: 0.098 +/- 0.020, ischemia: 0.073 +/- 0.012, P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Allopurinol; Animals; Hemodynamics; Intestinal Mucosa; Ischemia; Male; Permeability; Rats; Rats, Wistar; Reperfusion Injury

Ischemia and reperfusion of the small intestine and colon in rats were produced by reversible occlusion (for 30 min and 1 or 3 h) of the superior mesenteric artery and the aorta above the inferior mesenteric artery. Despite a greater reduction of mucosal perfusion in the colon than in the small intestine with 30 min of ischemia, the depth of mucosal damage was significantly smaller in the former than in the latter. Thirty minutes of ischemia followed by 1 h of reperfusion induced an increase in polymorphonuclear leukocyte infiltration in both locations. Exacerbation of mucosal injury occurred only in the small intestine, suggesting that reperfusion injury is independent of polymorphonuclear leukocyte infiltration. Reperfusion after 1 or 3 h of ischemia did not exacerbate mucosal damage in either location. Allopurinol significantly diminished the exacerbation of injury after reperfusion in the small intestine. The protective effect of allopurinol, however, was neither associated with an improvement in perfusion nor a reduction in polymorphonuclear leukocyte infiltration. These data indicate that there is a window (30 min) of reperfusion injury in the small intestine, but there is no evidence of reperfusion injury in the colon.

Topics: Allopurinol; Animals; Intestinal Mucosa; Intestines; Ischemia; Male; Rats; Rats, Sprague-Dawley; Regional Blood Flow; Reperfusion; Reperfusion Injury

A rat liver normothermic ischemia-reperfusion model was used to investigate whether hypoxanthine (HXA) that accumulated during ischemia was washed out in hepatic veins during reperfusion. Ischemia was induced in median and left lobes by clamping of the proper hepatic artery and portal branches. The effect of allopurinol (ALL) on metabolism of ATP and HXA was studied before, during and after a 60-min normothermic ischemic insult. Liver cell concentration of HXA in the group treated with ALL increased during ischemia and decreased rapidly during the first 10-min reperfusion. Recovery of ATP increased gradually during the 10-min reperfusion period and was significantly higher in the group treated by ALL compared to that of controls. Liver venous blood concentration of HXA in the ALL-treated group was 10-to 40-fold lower than that in liver tissue. The rapidly decreasing concentration of HXA in liver tissue during reperfusion and a minimal washout may indicate that HXA was used for resynthesis of ATP during reperfusion.

Topics: Adenosine Triphosphate; Allopurinol; Animals; Hypoxanthine; Hypoxanthines; In Vitro Techniques; Ischemia; Liver; Liver Circulation; Nucleotides; Osmolar Concentration; Rats; Rats, Wistar; Reperfusion

The role of platelet-activating factor as a potential mediator of hepatic inflammatory injury associated with liver ischemia/reperfusion was investigated using a partial no-flow model in rats in vivo. Platelet-activating factor levels of livers from sham-operated rats and from animals experiencing hepatic reperfusion for less than 6 hr were very low. They were observed to increase significantly after 12 hr of reperfusion and reached peak levels after a 24-hr reperfusion period, a time when maximal hepatic injury and inflammation occurred. Treatment of experimental rats with WEB2170, a platelet-activating factor receptor antagonist, attenuated the hepatic injury and inflammation, as evidenced by decreases in plasma ALT and in hepatocyte necrosis and neutrophil infiltration. Both inactivation of Kupffer cells with gadolinium chloride and inhibition of the formation of reactive oxygen species with allopurinol reduced platelet-activating factor production in the liver, whereas induction of neutropenia had no effect, suggesting that interaction of Kupffer cells with oxygen-derived free radicals may be a plausible mechanism for hepatic platelet-activating factor accumulation. It is concluded that platelet-activating factor contributes to the inflammatory consequences of ischemia/reperfusion underlying late-phase hepatic injury.

Topics: Alanine Transaminase; Allopurinol; Animals; Azepines; Gadolinium; Hepatitis; Ischemia; Leukocytes; Liver; Male; Necrosis; Platelet Activating Factor; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Triazoles

Lazaroids are a class of novel 21 aminosteroids. They have been reported to be potent inhibitors of lipid peroxidation, which is a major contributing factor to ischemia-reperfusion injury in the lung. A Lewis rat orthotopic left lung isotransplant model was used to investigate the effects of the lazaroid U74500A on pulmonary preservation. The heart-lung blocks of donor rats were flushed with and then stored in either standard University of Wisconsin solution or University of Wisconsin solution with 30 mumol/L of U74500A substituted for the dexamethasone. After 6 or 12 hours of cold storage at 0 degrees C, the left lungs were transplanted into recipient rats and reperfused for 1 hour. Pulmonary function was assessed by measuring oxygen and carbon dioxide tensions in arterial blood after removal of the right lung. Lipid peroxide concentrations were measured as a thiobarbituric acid-reactive substance. Although arterial oxygen and carbon dioxide pressures and water content after 6 hours of preservation followed by reperfusion were similar in both the lazaroid and dexamethasone groups, lipid peroxide concentration was significantly higher in the dexamethasone group (0.88 +/- 0.07 mumol/gm) than in the lazaroid group (0.54 +/- 0.07 mumol/gm) (p < 0.01). After 12 hours of preservation, there were significant differences between the lazaroid and dexamethasone groups in arterial oxygen pressure (339 +/- 70 vs 27 +/- 3 mm Hg, p < 0.01), arterial carbon dioxide pressure (24.3 +/- 2.7 vs 47.7 +/- 7.0 mm Hg, p < 0.001), and lipid peroxide concentrations (0.69 +/- 0.07 vs 1.30 +/- 0.09 mumol/gm, p < 0.001). We conclude that addition of U74500A to the flush and storage solution enhances the preservation of the pulmonary graft in this transplant model.

Topics: Adenosine; Allopurinol; Animals; Body Water; Carbon Dioxide; Cardioplegic Solutions; Cold Temperature; Dexamethasone; Glutathione; Insulin; Ischemia; Lipid Peroxides; Lung; Male; Organ Preservation; Organ Preservation Solutions; Oxygen; Pregnatrienes; Raffinose; Rats; Rats, Inbred Lew; Reperfusion Injury; Solutions

The protective effect of a new potent protease inhibitor, ONO 3307, in combination with a xanthine oxidase inhibitor, allopurinol, was tested in pancreatico-biliary duct obstruction (PBDO) with temporary pancreatic ischemia in rats. After PBDO with ischemia, we observed hyperamylasemia, pancreatic edema, congestion of amylase and lysosomal enzyme cathepsin B as well as impaired output of amylase and cathepsin B into the pancreatic juice and a redistribution of lysosomal enzyme from the lysosomal fraction to the zymogen fraction. The administration of ONO 3307 plus allopurinol almost completely prevented the pancreatic injuries induced by PBDO with ischemia. These results indicate the important roles of temporary pancreatic ischemia in the pathogenesis of pancreatic damage and the usefulness of combination therapy with a new potent protease inhibitor and xanthine oxidase inhibitor in the protection against clinical acute pancreatitis.

Topics: Acute Disease; Allopurinol; Animals; Bile Ducts; Constriction; Drug Therapy, Combination; Guanidines; Ischemia; Male; Pancreas; Pancreatic Ducts; Pancreatitis; Rats; Rats, Wistar; Reperfusion; Serine Proteinase Inhibitors; Xanthine Oxidase

Allopurinol and dimethyl sulfoxide (DMSO; 1 mL of 1, 2, or 5% by gavage daily) were used to examine the influence of scavenging oxygen-derived free radicals on the healing of reserpine- (5 mg/kg, intraperitoneal) and 5-hydroxytryptamine- (50 mg/kg, intraperitoneal) induced acute ischemic injury of the rat gastric mucosa. Allopurinol and DMSO demonstrated a time- but not dose-dependent power to stimulate healing of this injury. The magnitude of injury produced by reserpine or 5-hydroxytryptamine (serotonin) followed by gavage with allopurinol or DMSO was significantly (p < 0.01) less after day 4 than that after day 3 of this gavage, and the magnitude after day 3 was itself significantly (reserpine, p < 0.001; 5-hydroxytryptamine, p < 0.01) less than that after day 2 of the same gavage. The actions of allopurinol and DMSO were not associated with any significant influence on H+ output. These results suggest that oxygen-derived free radicals are detrimental to the integrity of the rat gastric mucosa and that scavenging them stimulates healing of the ischemia-induced injury of the mentioned mucosa.

Topics: Allopurinol; Animals; Dimethyl Sulfoxide; Female; Free Radical Scavengers; Intestinal Mucosa; Ischemia; Male; Rats; Rats, Sprague-Dawley; Reserpine; Serotonin

Oxygen-derived free radicals produced during reperfusion may be responsible for the disturbed pathology which follows prolonged ischaemia. Measurement of hepatic chemiluminescence (low level light emission resulting from the energy released during chemical reactions of free radicals) allowed determination of whether allopurinol could prevent formation of oxygen-derived free radicals during reperfusion of the ischaemic liver. While control animals demonstrated a burst of light emission shortly after reperfusion, the rats pretreated with allupurinol showed no evidence of chemiluminescence during either ischaemia or reperfusion. It is concluded that allopurinol may modify reperfusion-induced free radical formation and possibly ameliorate the organ damage which can follow ischaemia.

Topics: Administration, Oral; Allopurinol; Animals; Free Radicals; Ischemia; Lipid Peroxidation; Liver; Liver Circulation; Luminescent Measurements; Oxygen; Rats; Rats, Wistar; Reperfusion Injury

The enzyme xanthine oxidase has been implicated in the tissue oxidative injury after ischemia-reperfusion. This enzyme, which is a source of oxygen free radicals, is formed from a dehydrogenase form during ischemia. The ratio dehydrogenase/oxidase of rat kidney homogenates decreases during the ischemia and the reperfusion. Two flavonoids, quercetin and silybin, characterized as free radical scavengers, exert a protective effect preventing the decrease in the dehydrogenase/oxidase ratio observed during ischemia-reperfusion. The mechanism of this effect and the role of flavonoids in the ischemia-reperfusion tissue damage is discussed.

Topics: Animals; Free Radical Scavengers; Ischemia; Kidney; Male; Quercetin; Rats; Rats, Wistar; Reperfusion Injury; Silymarin; Uric Acid; Xanthine Dehydrogenase; Xanthine Oxidase

To investigate the pathophysiology of warm ischemia (WI) of the liver, the changes in hemodynamics and energy metabolism were studied during and after 60-min complete WI induced by total hepatic vascular exclusion (HVE) in the canine model. Hepatic arterial blood flow after WI was maintained at 76% of the pre-ischemic level, while portal blood flow was only 27% of the pre-ischemic level associated with increased portal vein pressure, which was twice the pre-ischemic level, resulting in a decrease of total hepatic blood flow to 46% of the pre-ischemic level. Concentration of tissue lipid peroxide increased after WI. Arterial blood ketone body ratio (AKBR), which reflects the hepatic mitochondrial redox state, could not recover to the pre-ischemic level after termination of WI. However, when 100 mg/kg of allopurinol (xanthine oxidase inhibitor) was administered intravenously 10 min prior to initiating WI, AKBR was restored to the pre-ischemic level at 30 min after WI in spite of the fact that allopurinol administration to one group produced no remarkable changes in the hepatic hemodynamics compared with the group without allopurinol treatment. Concentration of adenine nucleotides was significantly higher for the treated group at the end of and after WI than for the group without allopurinol treatment and was maintained at a higher level even after WI. Lipid peroxide production was suppressed. Electron microscopic examination revealed that allopurinol treatment could not prevent mitochondrial swelling. It is suggested that WI causes injury primarily to the portal sinusoidal circulation, resulting in portal congestion concomitant with high portal pressure after the release of WI. Allopurinol could prevent the deterioration of mitochondrial ATP metabolism, and was able to inhibit lipid peroxide production, resulting in the rapid recovery of mitochondrial redox state in spite of the fact that it produced no amelioration of hepatic hemodynamics and morphological alterations.

Topics: Adenosine Triphosphate; Allopurinol; Animals; Blood Pressure; Disease Models, Animal; Dogs; Female; Hemodynamics; Injections, Intravenous; Ischemia; Ketone Bodies; Lipid Peroxides; Liver; Male; Mitochondria, Liver

"No reflow" has been implicated as prominent phenomenon in microvascular injury associated with ischemia-reperfusion (I/R). The objectives of this study were 1) to elucidate the significance of no reflow in microvascular I/R injury of striated muscle and 2) to determine whether reactive oxygen metabolites play a role in the development of postischemic no reflow. By use of the hamster dorsal skinfold preparation and intravital microscopy, microvascular perfusion of capillaries and postcapillary venules of striated muscle was quantitatively assessed before and 30 min, 2 h, and 24 h after 4 h of tourniquet-induced ischemia. I/R was characterized by a significant reduction (P < 0.01) in functional capillary density to 35% of baseline values during initial reperfusion, with incomplete recovery after 24 h (n = 9). In addition, capillary perfusion was found to be extremely heterogeneous, and wall shear rate in postcapillary venules was significantly decreased (P < 0.01). Treatment with either superoxide dismutase (SOD; n = 9) or allopurinol (n = 9) resulted in maintenance of capillary density of 60% of baseline (P < 0.05). Furthermore, I/R-induced capillary perfusion inhomogeneities and decrease of wall shear rate in venules were attenuated significantly (P < 0.01) by SOD and allopurinol. Thus part of capillary perfusion disturbances during I/R in striated muscle may be caused by increased postcapillary vascular resistance, probably mediated by reactive oxygen metabolites. However, the fact that in SOD- and allopurinol-treated animals 40% of the capillaries were still found to be nonperfused indicates that mechanisms other than oxygen radicals play an important role in the development of postischemic no reflow.

Topics: Allopurinol; Animals; Capillaries; Cricetinae; Guinea Pigs; Ischemia; Mesocricetus; Microcirculation; Muscles; Regional Blood Flow; Reperfusion Injury; Skin; Superoxide Dismutase; Venules

The mechanisms of gastric mucosal injury following a period of ischemia remain unclear. The aim of this study was to determine the relative contributions of ischemia, reperfusion, and reactive oxygen metabolites to mucosal injury induced by temporary occlusion of the celiac artery. Rats were subjected to 30 min of gastric ischemia in the presence of 100 mM HCl. Reperfusion periods ranged from 1 min to 24 hr. Drug treatments included allopurinol (100 mg/kg) or a combination of superoxide dismutase (15,000 units/kg), catalase (90,000 units/kg), and desferrioxamine (50 mg/kg). Mucosal injury was assessed by quantitative histology and the extent of macroscopic hemorrhage. Approximately one third of the total injury to the volume of the mucosa (11.8 +/- 9.1%) was due to ischemia alone. Another third was blocked by allopurinol or superoxide dismutase, catalase, and desferrioxamine (22.1 +/- 6.9%, P less than 0.001; and 25.9 +/- 4.6%, P less than 0.01), respectively, compared with control (32.5 +/- 5.1%). In contrast, extensive surface mucosal injury (62.2 +/- 27.6%) occurred primarily during ischemia and was not affected by antioxidants. Macroscopic hemorrhage was halved by treatment with allopurinol (17.5 +/- 12.6%, P less than 0.01) or superoxide dismutase, catalase, and desferrioxamine (15.9 +/- 14.5%, P less than 0.01). We conclude that temporary celiac occlusion results in gastric mucosal damage that consists of both ischemic and reperfusion components. The majority of surface mucosal injury occurred during ischemia, whereas injury to the volume of the mucosa and the vasculature occurred equally during reperfusion and was associated with reactive oxygen metabolites.

Topics: Allopurinol; Animals; Catalase; Deferoxamine; Free Radicals; Gastric Mucosa; Ischemia; Male; Oxygen; Rats; Rats, Inbred Strains; Reperfusion Injury; Superoxide Dismutase

In this study rat epigastric island flaps were used as a model to investigate selected tissue biochemical changes occurring during secondary ischemia. It was hypothesized that free radical damage, depletion of free radical scavengers, depletion of ATP, and increased edema might explain differences in flap survival between partial (venous obstruction) and total (arteriovenous obstruction) ischemia and decreased flap survival with increasing ischemia time. Flaps were given 2 hr or primary ischemia, 8 hr of normal perfusion, then secondary ischemia of 0, 2, 4, 8, or 12 hr with either arteriovenous obstruction or venous obstruction. Biochemical analysis of the skin was performed after 0, 24, or 96 hr reperfusion. Only minor differences were found between arteriovenous and venous ischemia for any of five biochemical parameters, despite a previous finding that venous ischemic flaps are more susceptible to necrosis. Levels of xanthine oxidase and malonyldialdehyde (both indices of free radical generation) increased with ischemia time. Levels of superoxide dismutase (a free radical scavenger) correspondingly decreased. Tissue levels of ATP decreased after ischemia and recovered to normal for shorter but not for longer ischemia times after 96 hr of reperfusion in parallel with flap survival. Edema increased immediately after the ischemic insult but decreased once the tissue became necrotic. These results imply roles for free radicals, ATP, and edema in secondary ischemia, but do not distinguish between arteriovenous and venous secondary ischemia.

Topics: Adenosine Triphosphate; Animals; Constriction; Edema; Ischemia; Male; Malondialdehyde; Rats; Rats, Inbred Strains; Reperfusion Injury; Superoxide Dismutase; Surgical Flaps; Xanthine Oxidase

This study compared the function of reduced grafts prepared in situ or ex vivo and transplanted immediately or after 4 hr of cold storage. Measurements of acid/base balance, plasma electrolytes, albumin, and urea showed no differences between groups. There was no difference between the increase and decline of plasma AST in recipients of grafts transplanted immediately after either ex vivo or in situ reduction; the increase in plasma AST of recipients of stored grafts was up to 10-fold and persisted until the end of the study at 7 days, with some decline. Plasma fibrinogen decreased intraoperatively but levels were restored within 24 hr in all groups; plasma prothrombin and partial thromboplastin times were not significantly disturbed. The patterns of decline and return of tissue adenine nucleotides were similar in all groups. While the regenerative response measured by tissue thymidine kinase and mitotic figures was not different between the groups, comparison with results from a group of partially hepatectomized animals showed a 3-4-fold depression in response in reduced liver grafts. The contributions of the effects of ischemia, flushing, and preservation to the depressed regenerative response of reduced liver grafts need to be determined. The present studies suggest however, that with regard to functional assessment, results are not affected either by ex vivo or in situ reduction of the graft, or by cold storage for 4 hr.

Topics: Adenine Nucleotides; Adenosine; Allopurinol; Animals; Blood Coagulation; Cryopreservation; Glutathione; Graft Survival; Insulin; Ischemia; Liver; Liver Regeneration; Liver Transplantation; Organ Preservation Solutions; Raffinose; Solutions; Swine; Time Factors

We have previously shown that gut ischemia/reperfusion (I/R) causes simultaneous liver and lung dysfunction and that neutrophils play a critical role in this process. The purpose of this study was to ascertain whether xanthine oxidase (XO) was likewise operational. Normal and XO-inactivated rats (given a tungsten-enriched, molybdenum-depleted diet for 3 weeks) underwent 45 minutes of occlusion of the superior mesenteric artery, and control rats were subjected to a sham laparotomy. After zero and six hours of reperfusion, blood was sampled and livers and lungs harvested. Iodine-125-labeled albumin leak was used as a marker for pulmonary and liver capillary permeability barrier function, and serum acetoacetate/3-hydroxybutyrate (AcAc/3-OHB) levels as an index of hepatic mitochondrial redox state. Gut ischemia/six hours of reperfusion (I/R) increased the 125I albumin lung/blood ratio and the 125I albumin liver/blood ratio; AcAc/3-OHB levels decreased significantly. Xanthine oxidase activation eliminated the observed lung and liver capillary leak as well as the hepatic metabolic derangement induced by gut I/R. In conclusion, the simultaneous lung and liver dysfunction produced by gut I/R is mediated by XO.

Topics: Animals; Disease Models, Animal; Evaluation Studies as Topic; Ischemia; Liver; Lung; Male; Mesentery; Multiple Organ Failure; Neutrophils; Rats; Rats, Inbred Strains; Reperfusion Injury; Respiratory Distress Syndrome; Serum Albumin, Radio-Iodinated; Xanthine Oxidase

Nonanastomotic biliary strictures that involve only the biliary tree of the graft occur after orthotopic liver transplantation in patients with hepatic artery thrombosis, chronic ductopenic rejection and ABO blood group incompatibility. This complication may also occur in the absence of these known risk factors. The major focus of our study was to evaluate the risk factors for nonanastomotic biliary stricturing of unknown cause after orthotopic liver transplantation. Results demonstrate that the development of biliary strictures is strongly associated with the duration of cold ischemic storage of allografts in both Euro-Collins solution and University of Wisconsin solution. Results also demonstrate that strictures are not associated with the type of biliary reconstruction, the primary liver disease, cytomegalovirus infection, allograft rejection or the presence of a positive lymphocytotoxic crossmatch. More recently, we have markedly reduced the occurrence of nonanastomotic biliary stricturing by decreasing the ischemia time of our allografts. Thus nonanastomotic biliary strictures appear to be the result of the ischemia/reperfusion-induced tissue injury associated with the harvest and implantation of allografts.

Topics: Adenosine; Adult; Allopurinol; Child; Cholangiography; Gallbladder; Glutathione; Humans; Hypertonic Solutions; Insulin; Ischemia; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Postoperative Complications; Raffinose; Retrospective Studies; Risk Factors; Solutions

This study was designed to probe the hypothesis that oxygen-derived free radicals are involved in initiation of the no-reflow phenomenon. We developed a reproducible model of no reflow in the rat hind limb. Laser Doppler studies confirmed that the hind limbs perfused well after 2 or 4 hours of ischemia, but perfusion ceased in the first 10 minutes after 6 hours of ischemia. Venous blood samples and biopsy specimens of skin and muscle were taken after 2 and 4 hours of ischemia to study tissue injury. Blood samples were evaluated for xanthine oxidase (XO), xanthine dehydrogenase, and creatine phosphokinase (CPK) activities. Conjugated dienes and iodine 125-labeled albumin extravasation were quantified in tissue samples. Groups of animals were treated with inhibitors of XO (allopurinol), antioxidant enzymes (superoxide dismutase plus catalase), and free radical scavengers (dimethyl sulfoxide and dimethyl thiourea) to assess the roles of free radicals in ischemia-reperfusion injury in the hind limbs. After 4 hours of ischemia followed by reperfusion, plasma XO activity rose threefold over preischemia levels (p less than 0.05). Xanthine dehydrogenase activity did not change; conjugated diene levels in muscle rose twofold; CPK levels rose sixfold, and 125I albumin extravasation rose twofold (p less than 0.05). Pretreatment with the XO inhibitor allopurinol reduced XO activity to negligible levels and significantly attenuated conjugated diene levels, CPK levels, and albumin extravasation. Albumin extravasation was also significantly attenuated by pretreating animals with superoxide dismutase together with catalase, dimethyl thiourea, and dimethyl sulfoxide. In all animals pretreated with allopurinol or superoxide dismutase and catalase, reperfusion persisted after 6 hours of ischemia. These data suggest that, in ischemia followed by reperfusion, tissue injury is related to oxygen products derived from XO activity.

Topics: Allopurinol; Animals; Antioxidants; Capillary Permeability; Creatine Kinase; Free Radical Scavengers; Free Radicals; Hindlimb; Histamine; Ischemia; Rats; Rats, Inbred Strains; Regional Blood Flow; Reperfusion; Serum Albumin, Bovine; Xanthine Dehydrogenase; Xanthine Oxidase

1. Nilvadipine (FK 235, FR 34235) suppressed ischemia (20 min)-reflow (20 min)-induced paw edema of mice (ED30:0.4 mg/kg i.v. and 2 mg/kg p.o.). Other calcium entry blockers of dihydropyridine-type also suppressed the edema, but 30-fold higher doses were required. 2. Oral dosing of nilvadipine suppressed carrageenan-induced paw edema (ED30:15 mg/kg in rats and 20 mg/kg in mice) at a potency corresponding to that of an anti-inflammatory drug, ibuprofen. Nifedipine, nicardipine and nimodipine resulted in a suppression of 30% only with 100 mg/kg oral dosing in rats. Nitrendipine, diltiazem and verapamil were without effect. 3. Nilvadipine inhibited superoxide radical (O-2production from xanthine oxidase (XOD) both with lactate dehydrogenase + NADH method and cytochrome c method (IC50:90 and 100 micrograms/ml, respectively). Nifedipine and nicardipine showed some inhibition, but the other calcium entry blockers failed to inhibit significantly even at 320 micrograms/ml. As uric acid formation was not reduced by the tested drugs, the inhibitory action might be due to their O-2scavenging effects. 4. Superoxide production of neutrophils from casein-induced peritoneal fluid in rats was most strongly inhibited by nilvadipine when the cells were stimulated by a calcium ionophore, A23187 (IC50:4 micrograms/ml). Inhibition by this drug when stimulated by f-methonyl-leucyl-phenylalanine and phorbol myristate acetate was less effective (IC50:20 and 30 micrograms/ml, respectively). Nifedipine and nicardipine inhibited neutrophil O-2production at higher concentrations (30-200 micrograms/ml) with all stimulants. Inhibitory actions by other drugs were weak. 5. Triggering of atherosclerosis depends largely on the oxidative stress on blood vessels after recently established concept.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Calcimycin; Carrageenan; Edema; Free Radicals; Ischemia; L-Lactate Dehydrogenase; Male; Mice; Mice, Inbred Strains; N-Formylmethionine Leucyl-Phenylalanine; Neutrophils; Nifedipine; Rats; Rats, Inbred Strains; Superoxides; Tetradecanoylphorbol Acetate; Xanthine Oxidase

The generation of free oxygen radicals is presumed as a substantial pathogenetic principle in reperfusion injury. Although demonstrated in gut, muscle and kidneys its role in liver reperfusion injury is still under investigation. In an experimental rat model of warm liver ischemia of 60 min and 8 h reperfusion electron resonance spectroscopy assessed the increased generation of free radicals in early reperfusion period, leading to a decrease of polyunsaturated free fatty acids in liver tissue within 15 min of reperfusion. Histologically, single cell death, local and patchy necrosis of hepatic lobuli could be observed after 8 h reperfusion (n = 6). These histologic signs of liver injury could be attenuated by administration of superoxide-dismutase in combination with catalase but not by allopurinol. Best results could be obtained by deferoxamine. This indicates that increased generation of free oxygen radicals in reperfusion is not caused by the known conversion of xanthine-dehydrogenase to -oxidase but is mediated by an increased generation of hydroxyl-radicals, which can be scavenged by deferoxamine.

Topics: Allopurinol; Animals; Deferoxamine; Electron Spin Resonance Spectroscopy; Fatty Acids, Nonesterified; Free Radicals; Ischemia; Liver; Male; Oxygen; Rats; Rats, Inbred Strains; Reperfusion Injury

The effect of allopurinol, a xanthine oxidase inhibitor, on canine experimental ischemic pancreatitis was studied. The animals were divided into nine groups: 1. Group 1. Control with pancreatic ischemia; 2. Group 2. Received allopurinol once, previous to ischemia; 3. Group 3. Received allopurinol once, immediately after ischemia; 4. Group 4. Received allopurinol immediately after ischemia and then daily; and 5. Groups 5, 6, and 7 were controls for the operation, allopurinol, and its vehicle, respectively; 6. Group 8 (pancreatic ischemia) and Group 9 (that received allopurinol after ischemia and daily) were also studied histologically. Serum amylase was determined in all animals. In Groups 1 and 5, following the ischemic period, hyperamylasemia developed and a peak was reached 24 h after ischemia. In Group 2, a significant decrease of amylase levels was found, compared to matched controls immediately after ischemia and then rose, reaching on the fifth day a peak that was less than the controls at 24 h. In Group 3, the serum amylase level increased immediately to values similar to controls; later, there was a drop to levels lower than those found in controls, followed by a peak on the fifth day. In Group 4, there was no significant elevation in the amylase values. Groups 6 and 7 showed no changes of amylasemia. In this experimental model, allopurinol blocked or ameliorated significantly cellular injury, as shown by a decrease of amylase levels in blood, and of histopathological changes, depending on dose and time of administration. These results offer the possibility of a prophylactic therapy for chronic relapsing and idiopathic pancreatitis.

Topics: Allopurinol; Amylases; Animals; Dogs; Female; Free Radicals; Ischemia; Male; Pancreas; Pancreatitis

Oxygen-derived free radicals are cytotoxic and promote tissue damage. Dimethyl sulfoxide (DMSO) and allopurinol scavenge hydroxyl radicals, and the latter agent also inhibits the enzyme xanthine oxidase, which is responsible for the formation of superoxide anions. These agents were given daily by gavage (1 ml/d). After 2 days of administration as 1, 2, or 5% solutions, the H+ output of the rat with or without pyloric ligation was not significantly affected. After six hours reserpine (5 mg/kg i.p.) or serotonin (50 mg/kg i.p.) produced ischemic mucosal injury in all stomachs (39 +/- 5.2 mm2 and 25.9 +/- 2.8 mm2, mean +/- standard error of the mean [SEM], n = 10). Pretreatment for 2 days with 1 ml/d of 1% allopurinol or DMSO significantly (p less than 0.001) protected the rat against the reserpine (23 +/- 2.1 mm2 and 24 +/- 1.9 mm2, respectively, vs 39 +/- 5.2 mm2, n = 10) and serotonin injury (10 +/- 1.5 mm2 and 11 +/- 1.8 mm2, respectively, vs 25.9 +/- 2.8 mm2, n = 10). However, 2 days pretreatment with 1 ml/d of 2% allopurinol or DMSO was more effective (p less than 0.001) in this respect, and injury only developed in 40% of the rats given reserpine (8 +/- 1.2 mm2 and 9 +/- 1.6 mm2) and in 20% of those given serotonin (2.4 +/- 0.4 mm2 and 1.9 +/- 0.5 mm2). Similar pretreatment with 5% solutions completely protected the rat stomach against the reserpine and serotonin injuries without significantly influencing the H+ output.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Allopurinol; Animals; Dimethyl Sulfoxide; Free Radicals; Gastric Juice; Gastric Mucosa; Ischemia; Male; Oxygen; Rats; Rats, Inbred Strains; Reserpine; Secretory Rate; Serotonin

The benefit of perfusion washout in both experimental and clinical skin flaps has long been debated. By perfusing ischemic rat pedicled flaps with UW solution, a recently developed, high-molecular-weight, organ-preservation medium, a 170 percent increase in the critical ischemia time of treated versus untreated control flaps was demonstrated. Sixty rats were used in this study. A 3- x 6-cm unilateral abdominal skin flap based on the superficial inferior epigastric artery and vein was raised. The flaps were divided into three groups: Group 1 (control--no perfusion washout (n = 15); Group 2 (LR)--perfusion washout with lactated Ringer's solution (n = 15); Group 3 (UW)--perfusion washout with UW solution (n = 30). Flaps were subjected to varying periods of ischemia, ranging between 8 and 30 hr. The primary ischemia time at which 50 percent of the flaps survived clinically was 10 hr for Group 1, 15 hr for Group 2, and 27 hr for Group 3. The differences between the survival rates for flaps in Groups 1, 2, and 3 were statistically significant (p less than .0005). By bathing the vascular and parenchymal cells in an impermeant preservation solution, it was hypothesized that cellular swelling would be inhibited, thereby significantly improving a skin flap's tolerance to warm ischemia. Furthermore, after reviewing the pertinent literature, it is evident that the primary critical ischemia time of 27 hr is the highest reported to date for the normothermic experimental rat pedicled flap. Clinical application of these findings, as well as the need for further studies, are discussed.

Topics: Abdomen; Adenosine; Allopurinol; Animals; Female; Glutathione; Graft Survival; Insulin; Ischemia; Organ Preservation Solutions; Perfusion; Raffinose; Rats; Rats, Inbred Strains; Skin; Solutions; Surgical Flaps; Tissue Preservation

Conflicting data have been reported on the relationship between reactive oxygen intermediates and the formation of oxygenase-derived eicosanoids. Plasma levels of prostacyclin (PGI2, measured as the stable metabolite 6-keto-PGF1 alpha) and thromboxane A2 (TxA2, measured as TxB2) in the effluent blood of a canine ileal segment were determined following 1 or 2 h of ischemia. The synthesis of both eicosanoids was significantly stimulated during reperfusion, but extension of the ischemic interval from 60 to 120 min was not followed by a further increase. The role of oxidants potentially involved in the process was investigated by using materials that inactivate the xanthine-oxidase-generated intermediates. Previous studies on the same in vivo animal model had demonstrated the effectiveness of antioxidant therapy in reducing the postischemic histamine release. There was no significant alteration in the amount of eicosanoids synthesized following oral allopurinol, catalase, dimethylsulfoxide, mannitol or desferrioxamine treatment. Intravenously administered allopurinol, however, significantly elevated the postischemic 6-keto-PGF1 alpha/TxB2 ratio. The results suggest that these antioxidants at doses inhibitory to histamine liberation are not effective in influencing the postischemic eicosanoid release. Intravenously administered allopurinol could exert a potentially beneficial effect through a mechanism other than the blockade of xanthine oxidase.

Topics: Allopurinol; Animals; Antioxidants; Dogs; Epoprostenol; Female; Intestines; Ischemia; Male; Prostaglandin-Endoperoxide Synthases; Reperfusion Injury; Thromboxane A2

Topics: Adenine Nucleotides; Adenosine Triphosphate; Allopurinol; Animals; Dogs; Ischemia; Kinetics; Liver; Reperfusion

We hypothesized that xanthine oxidase plays a role in the postischemic reperfusion injury in the equine small intestine. Under anesthesia, four horses and two ponies underwent ischemic strangulating obstructions of segments of the proximal jejunum, mid-jejunum and ileum. Prior to vascular occlusion, and at 1 h and 2 h of ischemia, full-thickness intestinal biopsies were collected for histopathological evaluation and for determination of combined xanthine dehydrogenase (XDH) plus xanthine oxidase (XO) activity, and XO activity alone. The level of XO activity was expressed in percentage according to the ratio of XO/(XDH + XO). We found a nearly threefold increase in the combined level of XDH plus XO activity from ileum to duodenum (p less than 0.04). However, the preischemic level of % XO activity did not vary significantly (p = 0.61) between segments of jejuno-ileum. Likewise, no significant difference was noted between intestinal segments after ischemia. Therefore, the data from all intestinal segments were pooled for each time and analyzed using Wilcoxon's signed rank test (one-tailed). Compared to the pre-ischemic level of % XO activity (median 27%), the % XO activity increased after 1 h of ischemia (median 37.0%), reaching statistical significance (p = 0.016). There were no statistical differences between the preischemic % XO activity and the % XO activity in non-ischemic bowel at the end of the anesthetic period. During ischemia, % XO activity increased, which lends credence to the importance of xanthine oxidase in previously-documented reperfusion injury in the equine small intestine.

Topics: Animals; Biopsy; Horse Diseases; Horses; Intestine, Small; Ischemia; Reperfusion Injury; Xanthine Dehydrogenase; Xanthine Oxidase

This study was undertaken to determine whether hepatic ischemia and the subsequent reflow of blood have any effect on the conversion of xanthine dehydrogenase to xanthine oxidase (XO). Ischemia of the liver for 90 or 120 minutes did not permit survival of the animals. XO represented 15% of the total xanthine dehydrogenase plus XO activity in the control liver. XO activity remained unchanged even after 90 minutes of hepatic ischemia, although a marked increase in lipid peroxide in the liver tissue was observed during the reperfusion. When hepatic ischemia was prolonged for 6 hours (animals were dead), XO activity rose to 35% of the total activity. Incubation of the liver at 37 degrees C resulted in a definite change in XO activity dependent on the length of incubation period. Although no significant changes occurred in XO activity during the first 2 hours of incubation, a marked XO conversion was observed between 2 and 4 hours, and a maximal conversion was achieved after 6 hours of incubation. These results suggest that XO newly generated during ischemia has a very limited role in oxygen free radical production after resuming perfusion.

Topics: Animals; Hypoxanthine; Hypoxanthines; In Vitro Techniques; Ischemia; Lipid Peroxides; Liver; Male; Rats; Rats, Inbred Strains; Xanthine; Xanthine Dehydrogenase; Xanthine Oxidase; Xanthines

The mechanism of warm ischemic damage was investigated by assessing hepatic energy metabolism, mitochondrial functions, and lipid peroxidation (LP) of transplanted liver grafts in rats. Donor livers were stored ischemically either for 90 min at 4 degrees C (control) or for 20 min at 37 degrees C and 70 min at 4 degrees C (warm ischemia). In the control group, adenosine 5'-triphosphate (ATP) recovered within 8 min to 86% of the normal preischemic value (10.30, SEM 0.26 mumol/g dw). Total adenine nucleotides (TAN) recovered to 14.83 (SEM 0.22) mumol/g dw within 30 min, as compared with a normal level of 15.44 (SEM 0.36) mumol/g dw. The energy charge potential (ECP) immediately recovered to 0.79 (SEM 0.01) within 8 min (normal, 0.81, SEM 0.01). Mitochondrial phosphorylation rate (PR) was not significantly altered. LP averaged 451 (SEM 10) nmol/g dw in normal livers and did not change even during reperfusion (504, SEM 79, nmol/g dw, at 15 min). In contrast, in the warm ischemic group, ATP recovered only to 65% of the normal value even at 30 min (P less than 0.01), and TAN remained significantly lower than the control value (12.39, SEM 0.47, mumol/g dw, P less than 0.001). PR was normal at the end of warm ischemia, was significantly reduced at the end of the total ischemic period (P less than 0.001 and P less than 0.01, as compared with control and normal values, respectively), and gradually recovered over 30 min. LP increased and reached the maximum of 795 (SEM 84) nmol/g dw at 15-min reperfusion (P less than 0.05). In grafts treated with 50 mg/kg bw allopurinol (i.v.) 10 min prior to the onset of warm ischemia, ATP and ECP recovered to normal values at 30 min, and TAN was significantly higher than in the warm ischemic group (13.28, SEM 0.28, mumol/g dw, P less than 0.05). PR was maintained at normal values, and LP was increased but to a lesser degree than in the ischemic group. It is concluded that the delayed recovery of ATP metabolism in the warm ischemic group might be due to the loss of adenine nucleotides and the decreased PR, and that allopurinol has a protective effect against warm ischemic damage.

Topics: Allopurinol; Animals; Energy Metabolism; Glucose; Ischemia; Ketone Bodies; Lipid Peroxides; Liver; Liver Transplantation; Male; Mitochondria; Rats; Rats, Inbred Strains; Tissue Preservation; Tissue Survival

An in vitro canine tibia model was used to assess the effects of 48 h of hypothermic (4 degrees C) ischemia on bone vascular resistance and on responsiveness of intraosseous blood vessels to circulating norepinephrine. Three groups of bones were studied: Group I (n = 11), 48 h hypothermic ischemia; Group II (n = 11), 48 h hypothermic ischemia with pretreatment with allopurinol and oxypurinol; and Group III (n = 10), no ischemia. Resting vascular resistance in both ischemic groups (79 and 74 mmHg/ml/min) was significantly higher (p less than 0.0001) than in the nonischemic group (22 mmHg/ml/min). Effects of norepinephrine on vascular resistance were significantly greater in both ischemic groups (p less than 0.004). In all three groups, acetylcholine infusion attenuated the increases in perfusion pressure caused by norepinephrine. This demonstrates secretion of endothelial-mediated relaxing factors (EDRF) and prostaglandin for up to 48 h of hypothermic ischemia. As no significant differences were detected between the two ischemic groups, this study failed to demonstrate any protective effect of xanthine oxidase inhibitors.

Topics: Acetylcholine; Allopurinol; Animals; Cold Temperature; Disease Models, Animal; Dogs; Drug Hypersensitivity; Ischemia; Nitric Oxide; Norepinephrine; Oxypurinol; Regional Blood Flow; Reperfusion Injury; Tibia; Vascular Resistance; Xanthine Oxidase

Experimental and clinical data suggest that even a brief period of intestinal ischemia followed by reperfusion initiates a sequence of events that include release of inflammatory mediators and multiorgan failure. In this study, 41 rats were subjected to occlusion of the superior mesenteric artery (SMA) for 20 min and collateral arcade ligation. Twelve rats were sham operated and served as controls (group 1). Groups of rats with SMA occlusion were killed at several time intervals after reperfusion (group 2, 2-3 h; group 3, 4-5 h; group 4, 12-16 h). In group 5, rats were pretreated with enterally administered allopurinol (10 mg.kg-1.day-1) for 4 days before the intestinal ischemia episode and were studied 2-3 h after reperfusion. In vivo studies confirmed that 20 min of intestinal ischemia produced a transient bradycardia (P less than 0.05) and no change in systemic blood pressure, acid-base balance, or hematocrit. In vitro studies showed marked cardiac contractile depression as early as 2 h after ischemia-reperfusion as indicated by a fall in left ventricular pressure (LVP; from 77 +/- 3 to 63 +/- 4 mmHg, P = 0.01) and +dP/dtmax (from 1,827 +/- 59 to 1,557 +/- 99 mmHg/s, P less than 0.02) and -dP/dtmax (from 1,267 +/- 57 to 953 +/- 67 mmHg/s, P = 0.02), a rightward shift in LV function curves, and a decreased responsiveness to perfusate Ca2+. Allopurinol pretreatment prevented ischemia-reperfusion-mediated deficits in cardiac contraction and relaxation.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Allopurinol; Animals; Blood Circulation; Calcium; Dose-Response Relationship, Drug; Heart; Hemodynamics; Intestines; Ischemia; Male; Myocardial Contraction; Rats; Rats, Inbred Strains

The purpose of this study was to assess the protective effects of allopurinol, a blocker of free oxygen radical (FOR) formation, and superoxide dismutase-polyethylene glycol (SOD-PEG), a scavenger of FORs, on ischemic and reperfusion-induced cochlear damage. Fifteen Wistar Kyoto rats (WKY) were randomly assigned to three groups: (1) a control group (5 animals) that was exposed to 15 minutes of cochlear ischemia by clamping the anterior inferior cerebellar artery (AICA), followed by 15 minutes of reperfusion as documented by laser Doppler flowmetry; (2) a drug-treated group (5 animals) that received allopurinol before ischemia/reperfusion; and (3) a drug-treated group (5 animals) that received SOD-PEG before ischemia/reperfusion. In the control group, the tone burst-evoked compound action potential (CAP) recorded from the round window (RW) of the cochlea was abolished, and the cochlear microphonic (CM) was reduced after ischemia. In contrast, both allopurinol and SOD-PEG-treated animals showed post-reperfusion sensitivity in CAP and CM measures. We interpret these results to indicate that damage to the cochlear from ischemia and subsequent reperfusion can be attenuated by pretreatment with allopurinol or SOD-PEG. This provides indirect evidence that FORs may be partially responsible for cochlear damage resulting from ischemic conditions.

Topics: Action Potentials; Allopurinol; Animals; Auditory Threshold; Cochlea; Ischemia; Polyethylene Glycols; Rats; Rats, Inbred Strains; Reperfusion Injury; Superoxide Dismutase

Elevation of a vascular island flap 24 hours before an ischemic insult (prior elevation) has been shown to significantly increase flap survival, and to decrease blood thromboxane levels, compared with acutely ischemic flaps. The current study considered whether prior elevation causes other biochemical alterations that could be beneficial for flap survival. Tissue levels of adenosine triphosphate (a major tissue energy store), superoxide dismutase (a major defense against free radicals), xanthine oxidase (an enzymatic source of free radicals), and edema were measured. Rat epigastric flaps, with or without prior elevation, had 10 or 12 hours of acute ischemia. Biopsies were taken at 0, 12, or 24 hours after reperfusion. Skin from flaps with no ischemia (control flaps) or control skin was harvested at the same times. Acutely ischemic flaps had significantly lower levels of adenosine triphosphate and less edema than those in prior elevated ischemic flaps after 12 hours of ischemia (both, p less than 0.05). Superoxide dismutase and xanthine oxidase did not vary significantly. It is not clear whether the increased adenosine triphosphate level in prior elevated flaps is the cause or the result of increased tissue viability. Prior elevation did not alter free radical mechanisms. Furthermore, prior elevation was beneficial for flap survival despite increased edema.

Topics: Adenosine Triphosphate; Analysis of Variance; Animals; Dermatologic Surgical Procedures; Graft Survival; Ischemia; Rats; Rats, Inbred Strains; Skin; Superoxide Dismutase; Surgical Flaps; Xanthine Oxidase

Topics: Adenosine; Alanine Transaminase; Allopurinol; Aspartate Aminotransferases; Cold Temperature; Glutathione; Graft Survival; Humans; Insulin; Ischemia; Liver Transplantation; Organ Preservation; Organ Preservation Solutions; Prothrombin Time; Raffinose; Retrospective Studies; Solutions; Survival Analysis; Time Factors

The effectiveness of superoxide dismutase and allopurinol was evaluated in preventing reperfusion injury in Sprague-Dawley rats utilizing a limb replantation model after 6 hours of warm ischemia. Immediately prior to reperfusion of the replanted limb the animals received (intravenously) either a single bolus of superoxide dismutase (16,000 units/kg), a single bolus of allopurinol (45 mg/kg), both agents, or only control solutions. In the rats that received only control solutions, 30% of the limbs survived the ischemic insult. The group that received both superoxide dismutase and allopurinol had a 75% limb survival (P = 0.005). The animals that had only superoxide dismutase or allopurinol had 58% and 60% of the replanted limbs survive, respectively. This study suggests that the administration of superoxide dismutase and allopurinol may be helpful in the prevention of reperfusion injury in skeletal muscle in an acute injury setting (without pretreatment) and may thereby improve limb salvage after a significant ischemic period.

Topics: Allopurinol; Animals; Hindlimb; Injections, Intravenous; Ischemia; Male; Muscles; Rats; Rats, Inbred Strains; Reperfusion Injury; Replantation; Superoxide Dismutase; Tissue Survival

Trolox, a hydrophilic analog of vitamin E, was reported to scavenge peroxyl radicals from artificial systems better than its parent compound. Here we examined the possible cytoprotective effect of Trolox in cultured hepatocytes and in the rat liver. In cultured rat hepatocytes, 0.5 to 16 mmol/L Trolox (with optimum between 1 to 2 mmol/L) was observed to prolong the survival of cells exposed to oxyradicals generated with xanthine oxidase-hypoxanthine. The protection by 1 mmol/L Trolox surpassed that provided by either ascorbate, mannitol, superoxide dismutase and/or catalase--each at a level giving its maximal protection in the same system. In both a global and partial model of hepatic ischemia-reperfusion in rats, infusion of Trolox (7.5 to 10 mumol/kg body weight) just before reflow reduced by greater than 80% the liver necrosis sustained in untreated (no Trolox) control rats. Such organ salvage was apparently accompanied by approximately 50% reduction in the amount of hepatic conjugated dienes, which were quantified by a highly specific radiochemical assay. Since conjugated dienes are presumed to be good "markers" of oxyradical damage, our data may have provided a semiquantitative link between free radical-induced necrosis and its chemical imprint in vivo. The data also indicated a relatively rapid and potent antioxidant-like action by Trolox on rat hepatocytes and on the postischemic reperfused rat liver.

Topics: Animals; Cells, Cultured; Chromans; Free Radicals; Hypoxanthine; Hypoxanthines; Ischemia; Liver; Liver Diseases; Male; Rats; Rats, Inbred Strains; Reperfusion Injury; Xanthine Oxidase

Oxygen-derived free radicals have been implicated in a variety of diseases and pathologic processes, including ischemia reperfusion injury (IRI). Based on experimental work with rat skin-flap models, the enzyme xanthine oxidase (XO) has been proposed as a major source of free radicals responsible for tissue injury and flap necrosis. The presence of this enzyme is variable within different tissues of a specific species and between species. Xanthine oxidase levels in pig and human skin have not previously been reported. The activity of xanthine oxidase in the skin of rats (N = 16), pigs (N = 7), and humans (N = 8) was measured after varying intervals of ischemia and in the rat also following reperfusion. Control pig and human skin were found to contain minimal enzyme activity, almost 40 times less than that of the rat. In the rat, xanthine oxidase activity was stable throughout a prolonged period of ischemia, and a significant decrease in activity was found after 12 hours of reperfusion (p less than 0.05). In humans, xanthine oxidase activity was unaffected by ischemia time, and in the pig, it did not increase until 24 hours of ischemia (p less than 0.05). The potential sources of free radicals and the mechanism of action of xanthine oxidase and its inhibitor allopurinol in improving flap survival in different species are reviewed.

Topics: Analysis of Variance; Animals; Female; Free Radicals; Humans; Ischemia; Male; Rats; Rats, Inbred Strains; Reperfusion Injury; Skin; Surgical Flaps; Swine; Time Factors; Xanthine Oxidase

Five hundred ninety-three cadaveric livers were used for primary liver transplantation between October 24, 1987, and May 19, 1989. The grafts were procured with a combined method, using in situ cooling with cold electrolyte solution and backtable flushing with UW solution. The mean cold-ischemia time was 12.8 (range 2.4-34.7) hr. The cases were divided into 5 groups according to the cold-ischemia time: group 1: less than 10 hr (n = 223); group 2: 10-14 hr (n = 188); group 3: 15-19 hr (n = 101); group 4: 20-24 hr (n = 52); and group 5: greater than or equal to 25 hr (n = 29). There was no difference between the 5 groups in 1-year patient survival, highest SGOT in first week after operation, and SGOT and total bilirubin during the first month after operation. However, with a logistic regression model, the retransplantation rate (P = 0.001) and primary nonfunction rate (P = 0.006) significantly rose as cold-ischemia time increased, meaning that the equivalency of patient survival was increasingly dependent on aggressive retransplantation.

Topics: Adenosine; Adolescent; Adult; Aged; Allopurinol; Child; Child, Preschool; Cold Temperature; Glutathione; Graft Survival; Humans; Infant; Infant, Newborn; Insulin; Ischemia; Liver; Liver Transplantation; Middle Aged; Organ Preservation; Organ Preservation Solutions; Raffinose; Reoperation; Solutions; Time Factors; Transplantation, Homologous

The effect of allopurinol at doses of 25, 50 and 100 mu p/Kg on the release of free toxic radicals in acute mesenteric ischemia (AMI) produced experimentally has been studied in rats after clamping the superior mesenteric artery. Mortality and variations in haematological, biochemical and morphological parameters (both microscopic and ultrastructural) were recorded. A dose-dependent effect of a bolus of intraperitoneal alopurinol on the severity of mucosal lesions has been noted. A protection against mucosal damage was observed which may be due to the block by alopurinol of the xantine-oxidase system in the ischaemic reperfused intestine. This should be confirmed by larger studies. Alopurinol might be useful prophylactically to prevent damage of the intestine after ischaemia-revascularization events.

Topics: Allopurinol; Animals; Dose-Response Relationship, Drug; Drug Evaluation, Preclinical; Injections, Intraperitoneal; Ischemia; Male; Mesentery; Rats; Rats, Inbred Strains

Topics: Allopurinol; Animals; Ischemia; Lipid Peroxidation; Liver; Liver Circulation; Luminescent Measurements; Rats; Rats, Inbred Strains; Reperfusion

Xanthine oxidase (XO)-derived oxygen radicals are thought to play an important role in the intestinal injury resulting from ischemia and reperfusion. In vitro data shows enhanced XO activity in the presence of histamine. Histamine is known to be released during intestinal ischemia and reperfusion. The purpose of this study was to evaluate the relationship between histamine and XO in vivo in intestinal ischemia/reperfusion injury. Using an established model of gut ischemia and reperfusion, portal venous plasma was obtained and assayed for histamine levels, XO activity, and xanthine dehydrogenase (XD) activity following injury. Intestinal ischemia for 120 minutes resulted in a 200% increase in plasma histamine levels (263.4 +/- 36.9 nmol/mL control, v 548.7 +/- 35.1 nmol/mL experimental, P less than .05). Reperfusion for 15 minutes resulted in a further increase in plasma histamine (to 658.3 +/- 33.9 nmol/mL), compared with 120 minutes of ischemia alone. No significant change in plasma XO activity resulted after simple ischemia for 120 minutes. However, XO activity doubled within 15 minutes of reperfusion of the ischemic intestine (6.37 +/- 0.53 nmol O2- per milliliter per minute v 3.12 +/- 0.25 nmol O2- per milliliter per minute, P less than .05). Reperfusion for 60 minutes resulted in the maximal observed increase in plasma XO activity (9.49 +/- 0.67 nmol O2- per milliliter per minute). Analysis of XD activity demonstrated no significant decrease compared with controls until 120 minutes of ischemia and 60 minutes of reperfusion (1.62 +/- 0.49 nmol uric acid per milliliter per minute at 60 minutes of reperfusion, versus 5.02 +/- 0.52 nmol uric acid per milliliter per minute control, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Germ-Free Life; Histamine; Histamine Release; Intestines; Ischemia; Male; Rats; Rats, Inbred Strains; Reperfusion Injury; Time Factors; Xanthine Dehydrogenase; Xanthine Oxidase

The effect of organ flushing with the calcium entry blocker verapamil on the conversion of innocent enzyme xanthine dehydrogenase (XDH) to superoxide generating enzyme xanthine oxidase (XOD) in ischemic rat livers was studied. This enzyme conversion progressed over time in warm or cold ischemia. In non-flushed livers, the activities of XOD as percentages of XDH plus XOD after 6 h at 37 degrees C and 6 days at 4 degrees C were 80.3 +/- 5.2 and 31.6 +/- 2.1, respectively. In the livers flushed with Euro-Collins solution, the conversion was inhibited to 37.0 +/- 3.9% (P less than 0.001) after 6 h of warm ischemia, while this inhibitory effect was not found in cold ischemia. Verapamil given through the portal vein on flushing further suppressed the conversion in both warm and cold ischemia (with 5.0 microM of verapamil, 21.2 +/- 5.8% (P less than 0.001) after 6 h of warm ischemia and 25.2 +/- 3.3% (P less than 0.01) after 6 days of cold ischemia). A similar effect was also obtained with the addition of 10 or 30 mM of EGTA instead of verapamil. In contrast, no inhibitory effect on conversion was obtained in livers flushed and homogenized with 10.0 microM of verapamil followed by incubation for 6 h at 37 degrees C. In the livers that were flushed and stored at a warm temperature for 6 h, verapamil reduced the increase of tissue lipid peroxidation product (P less than 0.02) after 15 min of reperfusion. Although the precise mechanisms of these inhibitory effects of verapamil on the enzyme conversion are still uncertain, it is thought that organ flushing with verapamil might reduce the XOD-mediated postischemic reperfusion injury in livers subjected to prolonged ischemia.

Topics: Animals; Calcium; Free Radicals; In Vitro Techniques; Ischemia; Liver; Male; Oxygen; Rats; Rats, Inbred Strains; Reperfusion Injury; Verapamil; Xanthine Dehydrogenase; Xanthine Oxidase

The possible relationship between increased blood levels of thromboxane (TXA2) and tissue levels of free radicals during ischaemia was investigated. Rabbit epigastric skin flaps were subjected to 4 h of body temperature ischaemia, then infused with either the TXA2 synthetase inhibitor UK-38,485, the free radical scavenger superoxide dismutase (SOD), or both immediately prior to reperfusion. After 30 min of reperfusion, increases in the tissue levels of xanthine oxidase (XO) and malonyldialdehyde (MDA), both of which are indices of free radical generation and decreases in the tissue levels of SOD were found. SOD treatment completely restored XO, MDA and SOD levels to normal, whereas UK-38,485 only partially improved all three parameters. None of these changes was statistically significant. Effluent blood thromboxane B2 (TXB2) levels from the flap increased significantly (P less than 0.01) after ischaemia and were reduced significantly by both UK-38,485 and SOD (P less than 0.05). Combined UK-38,485 and SOD treatment was no better than treatment with either agent alone. ATP levels and oedema, which decreased and increased respectively due to ischaemia, were not significantly altered by drug infusion. These results suggest that free radical damage may be related to TXA2-generated thrombosis in ischaemia/reperfusion injury.

Topics: Adenosine Triphosphate; Animals; Body Water; Free Radicals; Imidazoles; Ischemia; Malondialdehyde; Rabbits; Reperfusion Injury; Skin; Superoxide Dismutase; Surgical Flaps; Thromboxane-A Synthase; Thromboxanes; Xanthine Oxidase

The influence of different drugs on ischemia induced oxygen free radical damage was examined in intestinal tissue of rats by determination of thiobarbituric acid reactive substances (TBARS). Some methodical aspects of this method were considered. Experiments were done with and without the use of polymerized stromafree hemoglobin (PHb) as an additional oxygen carrier. Reversible total occlusion of the superior mesenteric artery was performed for 90 min, reperfusion time was 2.5 hours. Despite higher O2 availability PHb did not increase the TBARS level any further. Superoxide dismutase with catalase; allopurinol; ciprofloxacin; and deferoxamine produced a highly significant reduction of TBARS, even if used together with PHb.

Topics: Allopurinol; Animals; Catalase; Deferoxamine; Free Radicals; Hemoglobins; Intestinal Mucosa; Intestines; Ischemia; Lipid Peroxides; Male; Oxygen; Prohibitins; Rats; Rats, Inbred Strains; Reperfusion Injury; Superoxide Dismutase

Our previous studies demonstrated that the bilateral hindlimb ischemia/reperfusion stimulates thromboxane A2 (TXA2) production. The present study tests the role of xanthine oxidase-derived oxygen free radicals in mediating this event. In twelve anesthetized dogs, the abdominal aorta and the inferior vena cava were clamped for 150 min, declamped and reperfused for 30 min. Two groups were studied: untreated control group and pretreated group with xanthine oxidase inhibitor, allopurinol 100 mg.kg-1 orally 24 hr before clamping plus 25 mg.kg-1 intravenously 15 min before clamping. In the control group, plasma TXB2 levels increased markedly after reperfusion. On the other hand, prior treatment with allopurinol attenuated the increase in plasma TXB2 levels at 30 min after reperfusion. This model revealed partial ischemia, because the femoral arterial blood flow was approximately 15% of baseline during clamping. However, the present study suggests that ischemia/reperfusion stimulates TXA2 production, which may be partly affected by hypoxanthine-xanthine oxidase-derived oxygen free radicals and may be an important mechanism responsible for reperfusion injury.

Topics: Allopurinol; Animals; Dogs; Hindlimb; Ischemia; Reperfusion; Thromboxane A2; Xanthine Oxidase

After a 30-minute control period ischaemia was evoked in dogs under Nembutal (30 mg/kg, i.v.) anesthesia, by clamping the left renal artery for 45 minutes. This was followed by a 90-minute reperfusion period when diuresis, GFR, PAH clearance, sodium and potassium excretion, malondialdehyde level in the plasma of the renal vein and SOD enzyme activity of the erythrocytes in renal venous blood were determined. Besides the control group (n = 6), the following treated groups were investigated: 1. Allopurinol (n = 7) in a dose of 100 mg/kg, given orally for two days, 2. Silibinin (n = 6) in a dose of 4 mg/kg/hour, given into the renal artery, 3. MTDQ-DS (n = 6) in a dose of 150 mg/kg/hour, given intravenously. 4. SOD (n = 4) 4 mg infusion (initiated 1 minute prior reperfusion). In the first 15-minute period following reperfusion GFR was 21%, cPAH 29% and sodium and potassium excretion 67 and 42% of the values of the contralateral kidney, respectively. Renal function improved gradually during the 90 minutes of reperfusion, and the above-mentioned parameters reached 59, 57, 65 and 76% of the corresponding control data. Increase of malondialdehyde level in the venous blood of the kidney during reperfusion might have been indicative of the production of free radicals; the difference, however, was not significant statistically. The administrations did not lead to considerable change in any of the parameters investigated. No difference could be demonstrated by histological methods between the kidneys of the treated and untreated animals. The compounds studied are thought to be free radical scavengers; in the present work, however, no protective effect could be demonstrated.

Topics: Acute Kidney Injury; Allopurinol; Animals; Antioxidants; Dogs; Free Radicals; Ischemia; Kidney; Quinolines; Reperfusion; Silymarin

We hypothesized that xanthine oxidase (XO)-derived hydrogen peroxide (H2O2) contributes to ischemic skeletal muscle injury during reperfusion. We found that after ischemia (3 h) and then reperfusion (4 h) rat gastrocnemius muscles had decreased contractile function following direct stimulation. Three lines of investigation suggested that XO-derived H2O2 contributes to reperfusion injury of ischemic skeletal muscle. First, treatment with dimethylthiurea (DMTU), a highly permeant O2 metabolite scavenger, but not urea, just before reperfusion improved muscle function in legs subjected to ischemia and then reperfusion. Second, gastrocnemius muscles from rats fed tungsten or allopurinol had negligible XO activities and increased muscle function after ischemia and reperfusion. Third, as assessed by measurement of skeletal muscle catalase activity in the presence of aminotriazole, H2O2 was measured during reperfusion of ischemic muscles from untreated or urea-treated rats but not during reperfusion of muscles from rats treated with DMTU, tungsten, or allopurinol.

Topics: Allopurinol; Amitrole; Animals; Catalase; Hydrogen Peroxide; Ischemia; Male; Muscle Contraction; Muscles; Rats; Rats, Inbred Strains; Reperfusion Injury; Thiourea; Tungsten; Urea; Xanthine Oxidase

While studying xanthine-xanthine oxidase system it was found, that a considerable accumulation of xanthine and uric acid occurred whereas xanthine dehydrogenase did not transfer in xanthine oxidase during 2 hours of total rat liver ischemia. These data make it possible to reject the generally accepted hypothesis of xanthine oxidase key role in free radical mechanism of ischemia damage.

Topics: Animals; Chromatography; Free Radicals; Hypoxanthine; Hypoxanthines; Ischemia; Liver; Rats; Reperfusion; Superoxides; Uric Acid; Xanthine; Xanthine Dehydrogenase; Xanthine Oxidase; Xanthines

Topics: Animals; Antioxidants; Capillary Permeability; Cats; Cell Adhesion; Intestinal Mucosa; Intestine, Small; Ischemia; Kinetics; Leukocytes; Muscle, Smooth; Peroxidase; Reperfusion; Xanthine Oxidase

Topics: Allopurinol; Animals; Clinical Trials as Topic; Double-Blind Method; Free Radicals; Humans; Ischemia; Kidney Transplantation; Random Allocation; Renal Circulation; Reperfusion Injury; Superoxide Dismutase; Swine

Topics: Allopurinol; Animals; Dimethyl Sulfoxide; Diterpenes; Female; Free Radicals; Ginkgolides; Intestinal Diseases; Intestinal Mucosa; Ischemia; Lactones; Platelet Activating Factor; Rats; Rats, Inbred Strains; Reperfusion Injury; Superoxide Dismutase

Irreversible transformation of xanthine dehydrogenase (XDH) to xanthine oxidase (XO) during ischemia was determined measuring XDH and total enzyme activity in kidneys before and after 60 min of clamp of the renal pedicle. Tissue levels of adenine nucleotides, xanthine and hypoxanthine were used as indicators of ischemia. After 60 min of clamping, ATP levels decreased by 72% with respect to controls whereas xanthine and hypoxanthine progressively reached tissue concentrations of 732 +/- 49 and 979 +/- 15 nmol.g tissue-1, respectively. Both total and XDH activities in ischemic kidneys (30 +/- 15 and 19 +/- 1 nmol.min-1.g tissue-1) were significantly lower than in controls when expressed on a tissue weight basis. The fraction of enzyme in the XDH form was however unchanged indicating that the reduction of the nucleotide pool is not accompanied by induction of the type-O activity of xanthine oxidase.

Topics: Adenosine Diphosphate; Adenosine Monophosphate; Adenosine Triphosphate; Animals; Ischemia; Kidney; Kinetics; Male; Rats; Rats, Inbred Strains; Xanthine Dehydrogenase; Xanthine Oxidase

Oxygen free radicals (OFRs) generated during reperfusion are putative mediators of postischemic renal dysfunction. To address this issue, the renal response to ischemia and reperfusion was compared to the response to OFR generation without ischemia. Isolated rat kidneys were perfused at 37 degrees C and 90-100 mm Hg with an asanguinous modified Krebs' buffer. Kidneys were subjected to 30 min of ischemia followed by reperfusion or to OFRs generated by combining 25 mumole hypoxanthine with 1 unit xanthine oxidase. Both insults caused a 50% increase in vascular resistance. This was accompanied by a 30% reduction in perfusate flow rate and an 80% reduction in glomerular filtration and urine flow rates. The OFR scavengers, superoxide dismutase (SOD, 250 units/ml) and catalase (CAT, 500 units/ml), prevented these alterations after OFR generation but not after 30 min of ischemia and reperfusion. SOD and CAT also afforded no protection against the less severe dysfunction observed after 10 or 20 min of ischemia and reperfusion. OFRs do not appear to be prominent mediators of postischemic renal dysfunction; other factors, probably associated with ischemia must be primarily responsible.

Topics: Animals; Diuresis; Free Radicals; Glomerular Filtration Rate; Ischemia; Kidney; Male; Oxygen; Rats; Rats, Inbred Strains; Renal Circulation; Reperfusion; Vascular Resistance; Xanthine Oxidase

Allopurinol, a xanthine-oxidase (XO) inhibitor, has been used to improve the resistance to ischemia with disappointing results that have been attributed to administration regimen of the drug. Our aim was to investigate the effect of different administration schedules of allopurinol on the survival in rats undergoing intestinal ischemia testing the blockade of XO. Intestinal ischemia was achieved by 90 min of clamping the superior mesenteric artery (SMA) close to its origin from the aorta. Three groups of animals were evaluated: A-group: only the allopurinol solvent was given; B-group: the full dose of allopurinol (100 mg/k b.w.) was given iv and C-group: the 75% dose was administered orally 24 hr before and the remaining 25% was administered 30 min before. Survival was evaluated at 48 hr and the blockade of XO was assayed by High Efficacy Liquid Chromatography (HELC) in homogenate of intestinal wall. Survival was only improved in the C-group (P = 0.02). Levels of hypoxanthine were significantly increased both in B-group and C-group (P = 0.003) when compared with the A-group. Levels of uric acid in B-group (P = 0.0003) and C-group (P = 0.0009) were significantly decreased with respect to A-group. That means that an effective blockade of XO is achieved whichever the regimen of administration. Allopurinol and oxypurinol levels were significantly increased (P = 0.05 and P = 0.008) in C-group when compared with B-group. We conclude that the protective effect of allopurinol on survival in intestinal ischemia in rats is not related to the blockade of XO but rather to the allopurinol and oxypurinol levels in intestinal wall.

Topics: Allopurinol; Animals; Chromatography, Liquid; Hypoxanthine; Hypoxanthines; Intestines; Ischemia; Oxypurinol; Rats; Rats, Inbred Strains; Uric Acid; Xanthine Oxidase

Ischemia followed by reflow often results in tissue injury. Although reactive oxygens seem to play an important role in the pathogenesis of postischemic reflow-induced tissue injury, the mechanism and an efficient way to inhibit oxidative injury are not known. We studied the mechanism by which hepatic transport function was inhibited by a transient occlusion followed by reflow of the portal vein and hepatic artery by using a superoxide dismutase (SOD) derivative (SM-SOD) which circulates bound to albumin with a half-life of 6 h. Occlusion of the hepatic vessels for 20 min followed by reflow for 60 min significantly inhibited transhepatic transport of cholephilic ligands, such as bromosulfophthalein (BSP) and taurocholic acid. Intravenous administration of SM-SOD markedly inhibited the reflow-induced decrease in transhepatic transport of these ligands. Thiobarbituric acid - reactive metabolites (TBAR) in the liver and plasma remained unchanged during occlusion and reflow, while TBAR in the bile increased significantly. Intravenous injection of SM-SOD inhibited the reflow-induced increase in biliary TBAR. Xanthine oxidase activity in plasma also increased during occlusion and reflow by an SM-SOD-inhibitable mechanism. Polymorphonuclear leukocyte-dependent chemiluminescence of the peripheral blood remained unchanged during occlusion, but increased markedly with time after reflow. SM-SOD also inhibited the increase in chemiluminescence almost completely. These and other results suggested that the superoxide radical and/or its metabolite(s) might play an important role in the pathogenesis of the reflow-induced liver injury and that SM-SOD might be useful for studying the mechanism for tissue injury caused by oxygen toxicity.

Topics: Animals; Bile; Blood Pressure; Half-Life; Ischemia; Kinetics; Liver; Liver Circulation; Male; Maleates; Polymers; Polystyrenes; Rats; Rats, Inbred Strains; Reperfusion; Sulfhydryl Compounds; Superoxide Dismutase; Time Factors; Xanthine Oxidase

The conversion rates of xanthine dehydrogenase (XDH) to xanthine oxidase (XO) were compared with the time course of in vivo lipid peroxidation (LPO) in an ischemia-reperfusion model of acute renal failure in the rat. LPO, measured as the renal release of malondialdehyde (MDA), was found to be markedly elevated only during the first 5 min of blood reflow following a 45-min interval of ischemia (arteriovenous MDA difference -277.3 +/- 53.5 vs. 3.7 +/- 5.7 nmol/l in controls, n = 14). After 30 min of reperfusion, arteriovenous MDA differences nearly reached control values (9.7 +/- 31.8 nmol/l, n = 7). In contrast to enhanced LPO, no significant conversion of XDH to XO was found (XO activity in controls: 23 +/- 1% of XO plus XDH activity vs. 26 +/- 3% after 45 min of ischemia, n = 7). Therefore XO-derived superoxide anion radicals cannot be considered causative for LPO in the reperfusion interval of experimental ischemic acute renal failure.

Topics: Animals; Ischemia; Kidney; Lipid Peroxides; Male; Rats; Rats, Inbred Strains; Reperfusion Injury; Xanthine Dehydrogenase; Xanthine Oxidase

In the present study, the effects of alpha-tocopherol and allopurinol in liver ischemia and reperfusion injury on lipid peroxidation and mitochondrial respiratory function were investigated in rats. Ischemia was induced in the left and median liver lobes clamping the vessels for 90 minutes. After declamping reperfusion was continued for 60 minutes. Liver tissue was taken before and 90 minutes after ischemia and 60 minutes after reperfusion to measure lipid peroxides and mitochondrial respiratory function. In one group of rats alpha-tocopherol (10mg/kg) was given intraperitoneally for three consecutive days preoperatively and in the other group allopurinol (50mg/kg) was given intravenously 10 minutes before ischemia. alpha-Tocopherol caused inhibition of increase in lipid peroxides at reperfusion and improvement in lowering of mitochondrial respiratory function. This improvement was less than previously reported, probably due to not only reperfusion injury but also ischemic injury. Allopurinol, on the other hand, caused neither such inhibition nor such improvement, suggesting the other source of oxygen-derived free radicals than xanthine oxidase system.

Topics: Allopurinol; Animals; Ischemia; Lipid Peroxidation; Lipid Peroxides; Liver; Mitochondria, Liver; Rats; Rats, Inbred Strains; Vitamin E; Xanthine Oxidase

We evaluated effluent blood from extremities of human patients undergoing reconstructive surgical treatment, which is routinely accompanied by upper-extremity exsanguination and application of a tourniquet, resulting in total interruption of arterial blood flow to one upper extremity. After tourniquet release (reperfusion), there were immediate increases in the plasma levels of xanthine oxidase activity, uric acid, and histamine in the ipsilateral limb and much smaller increases, if any, in levels of the same materials in plasma obtained from the contralateral extremity. There was no detectable xanthine dehydrogenase activity in plasma from either limb. Plasma also contained evidence of products consistent with the formation of oxygen-derived free radicals, namely, the appearance predominantly in the reperfused limb of hemoglobin and fluorescent compounds. These data indicate for the first time in humans that ischemia-reperfusion events are associated with the appearance of xanthine oxidase activity and its products in the plasma effluent.

Topics: Adult; Arm; Fluorescence; Free Radicals; Hemoglobins; Humans; Ischemia; Middle Aged; Reperfusion; Reperfusion Injury; Xanthine Oxidase

Topics: Alanine Transaminase; Allopurinol; Animals; Aspartate Aminotransferases; Catalase; Female; Graft Survival; Ischemia; L-Lactate Dehydrogenase; Liver; Liver Circulation; Liver Transplantation; Organ Preservation; Rats; Rats, Inbred Strains; Superoxide Dismutase

Topics: Alanine Transaminase; Animals; Aspartate Aminotransferases; Disease Models, Animal; Histamine; Ischemia; L-Lactate Dehydrogenase; Liver Circulation; Male; Radioimmunoassay; Rats; Reperfusion Injury; Time Factors; Xanthine Oxidase

Reactive oxygen metabolites generated from the enzyme xanthine oxidase (XO) play an important role in the pathogenesis of ischemia-induced tissue injury. The observation that intracellular proteins such as aspartate transaminase (AST) and alcohol dehydrogenase (ADH) are released from the ischemic liver during reperfusion led us to postulate that XO could be released into the systemic circulation. Livers from fasted rats were extirpated, perfused with oxygenated Krebs-Henseleit buffer, and subjected to 2 h ischemia followed by 2 h reperfusion. Reperfusion increased AST in the perfusate from 1 +/- 1 to 830 +/- 280 U/l, whereas ADH increased from 0.3 +/- 0.1 to 95 +/- 26 U/l. Concomitantly, xanthine dehydrogenase (XDH) + XO activity in the perfusate increased from 0 to 4.1 +/- 1.0 mU/ml. A 64% decrease in endogenous tissue XDH + XO activity paralleled release of XDH + XO. The XDH + XO activity predicted to appear in the circulation after hepatic ischemia was sufficient, when supplied with substrate, to produce severe vascular endothelial injury in vitro, even in the presence of serum or whole blood. These results suggest that massive quantities of XDH and XO are released into the circulation after hepatic ischemia and that the resulting reactive oxygen metabolites could produce widespread tissue injury.

Topics: Alcohol Dehydrogenase; Animals; Aspartate Aminotransferases; In Vitro Techniques; Ischemia; Ketone Oxidoreductases; Liver; Liver Circulation; Male; Perfusion; Rats; Rats, Inbred Strains; Reference Values; Xanthine Dehydrogenase; Xanthine Oxidase

Studies demonstrating protective effects of allopurinol in intestinal ischemia have been carried out using i.v. allopurinol (presently unavailable for human use) or enteral allopurinol at supra-normal doses and, therefore, have questionable clinical relevance. We evaluated the protective effects of clinically used doses of enteral allopurinol in rats with intestinal ischemia. One hundred nine male Sprague-Dawley rats (250-300 gm) received enteral allopurinol (5-30 mg/kg) or water daily for 1 week and were subjected to superior mesenteric artery occlusion for 20, 30, or 45 min. Mortality in water-fed controls after 20 min of mesenteric ischemia was 50%, but there was no mortality in rats pretreated with allopurinol (5, 10, and 20 mg/kg/day) in this group (P = 0.016). There was no reduction in mortality after allopurinol pretreatment at any dose in rats with 30 or 45 min of ischemia. We concluded that 1) prolonged intestinal ischemia causes lethal damage during the hypoperfusion phase that cannot be prevented by allopurinol pretreatment even at supra-normal doses, and 2) allopurinol at recommended enteral doses (5-10 mg/kg/day) can reduce morality from reperfusion injury when the phase of hypoperfusion is not, in itself, lethal. Allopurinol is effective in reducing reperfusion injury in the currently available enteral form in dose ranges that should not cause prohibitive side effects.

Topics: Allopurinol; Animals; Dose-Response Relationship, Drug; Intestinal Diseases; Intestines; Ischemia; Male; Rats; Rats, Inbred Strains

Ischaemia has been implicated in the pathogenesis of gastric mucosal disorders. The aim of this investigation was to study the gastric mucosal electrical potential difference (PD), pH, blood flow and morphology during hypoxia, gastric ischaemia, and gastric ischaemia following inhibition of free radical formation with allopurinol. PD and pH were measured simultaneously with an intragastric microelectrode, and the PD values were corrected for the liquid junction potentials created by the intragastric pH variation. Blood flow was measured by the radiolabelled microsphere technique in 18 anaesthetized dogs. Short general hypoxia and short ischaemia caused reversible declines in PD, increases in pH, and no morphological damage. Ischaemia for 1 h caused a significant decline in PD persistent after reperfusion, an increase in pH, and morphological PD, but after reperfusion PD was normalized. Gross morphology was normal, and histology showed only minor damage. The results therefore support the hypothesis that oxygen-derived free radicals are involved in gastric mucosal injury occurring during ischaemia and reperfusion.

Topics: Allopurinol; Animals; Dogs; Electrophysiology; Female; Gastric Mucosa; Hydrogen; Hydrogen-Ion Concentration; Hypoxia; Ischemia; Male; Regional Blood Flow; Stomach; Time Factors

Skeletal muscle edema secondary to an increase in capillary permeability after reflow is an important cause of the compartment syndrome after acute arterial revascularization. The purpose of this study was to investigate the possible role of oxygen free radicals, generated at reperfusion, in the pathogenesis of the compartment syndrome secondary to acute arterial ischemia/reperfusion. A reproducible model of this syndrome was produced in anesthetized rabbits by femoral artery occlusion after surgical devascularization of collateral branches from the aorta to the popliteal artery. Increasing periods of ischemia from 6 to 12 hours, followed by 2 hours of reperfusion, were associated with corresponding increases in the anterior muscle compartment hydrostatic pressure and inversely proportional decreases in tibialis anterior muscle blood flow within that compartment as assessed by xenon 133 washout (n = 46) (r = -0.62, p less than 0.001). Anterior compartment pressure increased from 5 +/- 1 to 48 +/- 5 mm Hg (n = 46) (p less than 0.001) after 7 hours of total arterial ischemia and 2 hours of reperfusion. Ablation of free radicals generated from xanthine oxidase with either allopurinol (n = 8) or oxypurinol (n = 8), by scavenging the superoxide radical at reperfusion with superoxide dismutase (n = 8), or by blocking secondary hydroxyl radical formation with deferoxamine (n = 8) significantly ameliorated the rise in compartment pressure (p less than 0.05) in each case; it also significantly improved muscle perfusion in the superoxide dismutase-, allopurinol-, and deferoxamine-treated animals (p less than 0.05). These findings indicate that development of the compartment syndrome after acute arterial revascularization may be due, at least in part, to microvascular injury mediated by oxygen-derived free radicals generated from xanthine oxidase at reperfusion.

Topics: Allopurinol; Animals; Blood Pressure; Compartment Syndromes; Deferoxamine; Free Radicals; Ischemia; Oxygen; Oxypurinol; Rabbits; Regional Blood Flow; Reperfusion Injury; Superoxide Dismutase

Cardiac transplantation remains constrained by poor graft tolerance of prolonged cold ischemia. University of Wisconsin solution has remarkably extended ischemic preservation in pancreas, kidney, and liver transplantation. To assess its efficacy in cardiac preservation, modified University of Wisconsin solution flush and storage were tested against St. Thomas' cardioplegia flush and normal saline solution storage after six hours of ischemia at 0 degrees C in 46 isolated rat hearts. After ischemia, groups were compared before and after reperfusion. After ischemia but before reperfusion, University of Wisconsin solution hearts had significantly less tissue water (3.8%), superior tissue sodium, potassium, calcium, and magnesium profiles, and elevated adenosine and inosine levels, and tended toward better histological preservation. After reperfusion, University of Wisconsin solution more effectively preserved left ventricular compliance (75% versus 35% of baseline), developed pressure (71% versus 45% of baseline), histological integrity, and tissue potassium and calcium profiles than St. Thomas' solution. The University of Wisconsin solution provided superior preservation of systolic and diastolic ventricular function, tissue histology, tissue water, and tissue electrolytes than did St. Thomas' cardioplegia and normal saline solution storage in this experimental model, and might result in improved graft tolerance of ischemia in clinical cardiac transplantation.

Topics: Adenine Nucleotides; Adenosine; Allopurinol; Animals; Bicarbonates; Blood Pressure; Body Water; Calcium; Calcium Chloride; Cardioplegic Solutions; Cryopreservation; Glutathione; Heart; Heart Transplantation; Insulin; Ischemia; Magnesium; Myocardial Contraction; Myocardium; Organ Preservation Solutions; Potassium; Potassium Chloride; Raffinose; Rats; Rats, Inbred Strains; Sodium Chloride; Solutions; Spectrophotometry, Atomic; Tissue Preservation

The major objective of this study was to develop an in vitro model of ischemia/reperfusion (I/R)-induced microvascular injury. Cultured venular endothelial cells were grown to confluency, labeled with 51Cr, and exposed to different durations of anoxia (0.5, 1, 2, 3, and 4 h). 51Cr release and cell detachment (indexes of cell injury) were determined at different times after reoxygenation (1, 2, 4, 6, 8, and 18 h). Because in vivo studies have implicated neutrophils in I/R injury, in some experiments human neutrophils were added to the endothelial cells upon reoxygenation. Periods of anoxia greater than or equal to 2 h resulted in 70-80% 51Cr release and 80-95% cell detachment upon reoxygenation. Under these conditions (near maximal injury), the addition of neutrophils produced negligible effects. Periods of anoxia less than or equal to 1 h resulted in 30-40% 51Cr release and 50-60% cell detachment. Under these conditions (moderate cell injury), addition of neutrophils enhanced endothelial cell injury. Using a 30-min period of anoxia, we also assessed the effects of superoxide dismutase (SOD; 300 U/ml) and allopurinol (20 microM) on anoxia/reoxygenation (A/R)-induced injury in the presence or absence of neutrophils. In the absence of neutrophils, SOD or allopurinol did not protect against A/R-induced injury. However, in the presence of neutrophils, both SOD and allopurinol attenuated the increases in 51Cr release. The results derived using this in vitro model of I/R injury are largely consistent with published in vivo studies. Thus this in vitro model may provide further insights regarding the mechanisms involved in I/R injury.

Topics: Allopurinol; Animals; Cattle; Coronary Vessels; Endothelium, Vascular; Humans; Hypoxia; In Vitro Techniques; Ischemia; Microcirculation; Neutrophils; Pancreatic Elastase; Reperfusion Injury; Superoxide Dismutase; Venules

Prolonged ischemia to skeletal muscle as occurs after an acute arterial occlusion results in alterations in adenine nucleotide metabolism. Adenosine triphosphate continues to be used for cellular functions, and an ischemia-induced degradation of phosphorylated adenine nucleotides is initiated. In this experiment we demonstrated the time-dependent aspect of adenine nucleotide depletion during ischemia and the production of large quantities of soluble precursors. In addition, we studied the rate of conversion of xanthine dehydrogenase to xanthine oxidase, a potential source of oxygen-free radicals, after controlled periods of total normothermic ischemia (4 hours and 5 hours) and during the reperfusion phase. During ischemia complete depletion of creatine phosphate occurred in both groups, and adenosine triphosphate fell from 22.1 +/- 1.3 to 10.3 +/- 1.4 mumol/gm dry weight after 4 hours and from 21.6 +/- 0.7 to 3.9 +/- 0.8 mumol/gm dry weight after 5 hours (p less than 0.05). During reperfusion, creatine phosphokinase resynthesis occurred in both groups, but adenosine triphosphate levels were not significantly increased (p greater than 0.05). A washout of lipid soluble products of adenine nucleotide metabolism occurred equally in both groups. The relationship between phosphorylated adenine nucleotides as measured by the energy charge potential fell significantly in both groups (p less than 0.05), but after the shorter period of ischemia (4 hours it returned to normal during early reperfusion but did not after 5 hours of ischemia. There was 21% +/- 4% necrosis after 4 hours and 51% +/- 8% after 5 hours of ischemic stress when assessed at 48 hours. In conclusion, the degree of adenine nucleotide degeneration as determined primarily by the length of the ischemic period, may be the most important determinant of the ultimate extent of skeletal muscle ischemic necrosis that results from an acute interruption of circulation.

Topics: Adenine Nucleotides; Animals; Dogs; In Vitro Techniques; Ischemia; Muscles; Phosphocreatine; Purines; Xanthine Dehydrogenase; Xanthine Oxidase

The effect of allopurinol was studied in a normothermic liver ischemia rat model. Functional (bile flow) and biochemical parameters (high-energy phosphates, ATP, ADP, AMP), energy charge, hypoxanthine and xanthine were determined prior to and during 60 min of ischemia followed by 120 min of reperfusion. Allopurinol given in the preischemic period (50%) and as a bolus (50%) prior to reperfusion improved liver function significantly, whereas allopurinol given in the preischemic period (50%) and after start of reperfusion (50%) had no effect. The data indicates that allopurinol given prior to reperfusion saved hypoxanthine which was used for ATP resynthesis during reperfusion.

Topics: Adenosine Triphosphate; Allopurinol; Animals; Bile; Body Temperature; Energy Metabolism; Hypoxanthine; Hypoxanthines; Ischemia; Liver; Male; Osmolar Concentration; Rats; Regional Blood Flow; Time Factors; Xanthine; Xanthines

The purpose of this study was to determine whether gamma-hydroxybutyrate provides protection against intestinal ischemia/reperfusion injury and to compare its effect with that of allopurinol and vitamin E. Thirty minutes of total regional ischemia, followed by 3 hours of reperfusion, produced intestinal damage that was completely prevented by gamma-hydroxybutyrate pretreatment. Naloxone partially blocked this protective effect. Allopurinol provided only partial protection against this injury, whereas vitamin E provided none. Treatment with gamma-hydroxybutyrate after ischemia but before reperfusion also provided significant protection. This study clearly demonstrates that gamma-hydroxybutyrate provides significant protection against intestinal ischemic injury and that it may do so via an opiate receptor-mediated mechanism.

Topics: Allopurinol; Animals; Cricetinae; Hydroxybutyrates; Intestines; Ischemia; Male; Mesocricetus; Naloxone; Reperfusion Injury; Sodium Oxybate; Vitamin E

Recently, oxygen free radicals have appeared to play a major role in injury after ischemia, especially that followed by normoxic reperfusion. To clarify the mechanisms of reperfusion injury, the activities of both oxygen radical producing enzymes and radical scavenging enzymes were measured in the ischemic rat kidney followed by reperfusion. All defensive enzymes activities significantly decreased; superoxide dismutase 2.15 +/- 0.14----1.71 +/- 0.11, catalase 186.6 +/- 12.7----116.5 +/- 7.1, glutathione peroxidase 30.0 +/- 2.6----19.1 +/- 2.9, glutathione reductase 118 +/- 5.1----39.9 +/- 6.8 (U/mg protein). Conversion from xanthine dehydrogenase to xanthine oxidase was only 12% of total activity, and all of them were reversible type oxidase. However, it was suggested by the electron spin resonance method that the tissue xanthine oxidase freed of superoxide dismutase could produce oxygen free radicals. In conclusion, reperfusion injury is caused not only by the increase of oxygen free radicals but by the destruction of scavenging systems.

Topics: Animals; Catalase; Free Radicals; Glutathione Peroxidase; Ischemia; Kidney; Oxygen; Rats; Rats, Inbred Strains; Reperfusion Injury; Superoxide Dismutase; Xanthine Oxidase

We have previously described a chronic, in vivo biochemical and histologic model of ischemia and reperfusion injury and wished to test the ability of superoxide dismutase, catalase and allopurinol to protect against the hepatocellular injury demonstrated by this model. Xanthine oxidase inhibitors given preoperatively produced a significant hepatocellular protective effect when compared with a comparable insult delivered to a cohort of control rats. The protection given seemed greater than that produced by pretreatment with free radical scavengers. Possible mechanisms for this observation are discussed. Investigations combining free radical scavengers with xanthine oxidase inhibitors may further define protection for warm hepatic ischemia and reperfusion injury.

Topics: Allopurinol; Animals; Catalase; Free Radicals; Ischemia; Liver; Male; Rats; Rats, Inbred Strains; Reperfusion Injury; Superoxide Dismutase

Toxic oxygen metabolites can damage endothelial cells and may play an important role in the initiation and progression of atherosclerotic lesions. Since the antithrombotic drug heparin, interacts with endothelium, we wished to determine if heparin would protect endothelial cells from free radical injury. Endothelial cell injury was produced by the addition of xanthine and xanthine oxidase to cultured cells and assessed by changes in cell viability and release of lactate dehydrogenase (LDH) to the media. Pretreatment with heparin 24 h prior to addition of xanthine and xanthine oxidase significantly decreased cell damage. We suggest that heparin (and related compounds) can protect endothelium from free radical damage, and is therefore prophylactic for ischemic and inflammatory injury, and the development and progression of atheroma.

Topics: Animals; Arteriosclerosis; Cells, Cultured; Endothelium, Vascular; Free Radicals; Heparin; Ischemia; Swine; Xanthine Oxidase; Xanthines

Previous studies demonstrating protective effects of allopurinol in intestinal ischemia have evaluated intravenous allopurinol (presently unavailable for human use) or enteral allopurinol at supranormal doses and, therefore, have questionable clinical relevance. To address this problem, we evaluated the protective effects of clinically used doses of enteral allopurinol in rats with intestinal ischemia. Forty male Sprague-Dawley rats (weighing 300 to 400 g) received enteral allopurinol (10 mg/kg) or water daily for 1 week. Rats were then subjected to superior mesenteric artery occlusion with interruption of collateral flow for 20 minutes to produce ischemic injury to the intestine. Segmental small bowel resections were performed in 10 control rats and 10 allopurinol-treated rats before and after reperfusion to identify histopathologic evidence of reperfusion injury. Mucosal injury was quantitated using a grading scale of 0 to 5 (5 being most severe). The remaining 20 rats (10 in each group) were observed for mortality (death within 7 days) after reperfusion. Mucosal injury after reperfusion was graded at 4.4 +/- 0.20 in controls versus 2.3 +/- 0.23 in the treated group (P less than .001). In addition, there was a significant increase in mucosal damage in the control group when postreperfusion specimens were compared with specimens taken before reperfusion (2.8 +/- 0.19 before and 4.4 +/- 0.20 after reperfusion, P less than .001). Injury score for the allopurinol-treated group did not significantly increase after reperfusion. Survival was 50% in the water-fed control group compared with 100% survival in allopurinol-treated rats (P = .016). We conclude that enteral allopurinol in the presently available form and dose is effective in reducing mesenteric reperfusion injury.

Topics: Administration, Oral; Allopurinol; Animals; Intestinal Mucosa; Ischemia; Male; Mesentery; Rats; Rats, Inbred Strains; Reperfusion Injury; Splanchnic Circulation; Survival Rate; Time Factors

Acute mesenteric ischemia is highly lethal and therefore a serious problem for surgery and intensive care medicine; accordingly its pathophysiology warrants further study. Oxygen free radicals (OFR) play a role in the intestinal mucosal damage that develops during reperfusion after ischemia. Histamine (H) is generally released in various types of tissue ischemia. The link between H release and OFR has only been studied in in vitro systems. We tested the hypothesis that OFR may be involved in H release following reperfusion of the ischemic gut. The artery supplying a segment of the ileum was occluded for 1 or 2 h in anesthetized dogs. On reperfusion, a release of H into the venous effluent of the segment was demonstrated. Pretreatment of the animals with allopurinol (an inhibitor of xanthine oxidase), or with MTDQ-DA [6,6'-methylene-bis(2,2-dimethyl-4-methanesulfonic acid sodium-1,2-dihydroquinoline)], a superoxide anion scavenger, or with a combination of allopurinol and MTDQ-DA resulted in an inhibition of H release. We conclude that OFR may play a role in the local H release following intestinal ischemia.

Topics: Allopurinol; Animals; Antioxidants; Dogs; Female; Free Radicals; Histamine; Histamine Release; Ileum; Ischemia; Male; Mesenteric Vascular Occlusion; Oxygen; Quinolines; Reperfusion Injury

Lower torso ischemia leads during reperfusion to leukocyte (white blood cell)-dependent lung injury. This study tests the intermediary role of oxygen free radicals (OFRs) in mediating this event. Chronically instrumented anesthetized sheep underwent 2 hours of bilateral hindlimb ischemia. In untreated control animals (n = 7), 1 minute after tourniquet release, mean pulmonary artery pressure rose from 13 to 38 mm Hg (p less than 0.05), whereas pulmonary artery wedge pressure was unchanged from 4 mm Hg. The pulmonary hypertension was temporally related to an increase in plasma thromboxane (Tx) B2 levels from 211 to 735 pg/ml (p less than 0.05). At 30 minutes of reperfusion lung-lymph TxB2 levels rose from 400 to 1005 pg/ml (p less than 0.05). This coincided with an increase in lung-lymph flow from 4.3 to 8.3 ml/30 min (p less than 0.05), which remained elevated for 2 hours, an unchanged lymph/plasma protein ratio, and a rise in lymph protein clearance from 2.6 to 4.6 ml/30 min (p less than 0.05). These changes are consistent with increased lung microvascular permeability. White blood cell count fell during the first hour of reperfusion from 6853 to 3793/mm3 (p less than 0.05), and lung histologic findings showed marked leukosequestration relative to sham animals (n = 3). Pretreatment with the OFR scavengers, superoxide dismutase and catalase both conjugated to polyethylene glycol (n = 6) blunted the rise in mean pulmonary artery pressure to 19 mm Hg (P less than 0.05) and prevented the increase in plasma and lymph TxB2 lymph flow, and lymph protein clearance (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Allopurinol; Animals; Catalase; Female; Free Radicals; Hemodynamics; Hindlimb; Ischemia; Leukocyte Count; Lung; Neutrophils; Platelet Count; Sheep; Superoxide Dismutase; Superoxides; Thromboxane B2

In this study the role of free radicals, lipid peroxidation, and neutrophil infiltration as mediators of ischemia and reperfusion-induced intestinal mucosal damage were investigated. We used a rat experimental model in which a ligated loop of the distal ileum was subjected to ischemia and reperfusion and the ensuing mucosal damage was assessed by means of lysosomal enzyme release and intestinal permeability measurements. We also determined the mucosal content of malondialdehyde, a lipid peroxidation product, and the mucosal activity of myeloperoxidase, a neutrophil granulocyte marker. Ischemia and revascularization alone caused increased mucosal permeability to sodium fluorescein, increased N-acetyl-beta-glucosaminidase release from the mucosa into the lumen, increased malondialdehyde content in the mucosa, and increased myeloperoxidase activity in the mucosa. Intravenous injection of enzymatic antioxidant, superoxide dismutase, together with xanthine oxidase inhibitor, allopurinol, prevented the malondialdehyde accumulation and caused attenuation of all the other effects of ischemia. Intravenous pretreatment of hydrocortisone sodium succinate (Solu-Cortef), a steroid and also a nonenzymatic antioxidant, prevented not only malondialdehyde accumulation but also neutrophil infiltration and mucosal damage. These data support a concept that neutrophil infiltration is an important element in ischemic mucosal damage. In addition, the blocking of this phenomenon may have clinical significance in attempts to modulate the potential damaging effects of the increased neutrophil infiltration associated with small-intestinal ischemia.

Topics: Acetylglucosaminidase; Allopurinol; Animals; Disease Models, Animal; Fluoresceins; Free Radicals; Hydrocortisone; Intestinal Absorption; Intestinal Mucosa; Ischemia; Lipid Peroxidation; Malondialdehyde; Neutrophils; Oxygen; Peroxidase; Rats; Reperfusion Injury; Superoxide Dismutase

Previous reports indicate that allopurinol, a xanthine oxidase inhibitor, attenuates the microvascular injury produced by reperfusion of ischemic skeletal muscle. To further assess the role of xanthine oxidase in ischemia/reperfusion (I/R) injury, we examined the effect of xanthine oxidase depletion or inhibition on the increase in microvascular permeability produced by I/R. Changes in vascular permeability were assessed by measurement of the solvent drag reflection coefficient for total plasma proteins (sigma) in rat hindquarters subjected to 2 h of ischemia and 30 min of reperfusion in xanthine oxidase-replete and -depleted animals and in animals pretreated with the xanthine oxidase inhibitor oxypurinol. Xanthine oxidase depletion was accomplished by administration of a tungsten-supplemented (0.7 g/kg diet), molybdenum-deficient diet. In animals fed the tungsten diet, muscle total xanthine dehydrogenase plus xanthine oxidase activity was decreased to less than 10% of control values. Estimates of sigma averaged 0.85 +/- 0.04 in nonischemic (continuous perfusion for 2.5 h) hindquarters, whereas muscle xanthine oxidase activity averaged 3.3 +/- 0.4 mU/g wet wt. I/R was associated with a marked decrease in sigma (0.54 +/- 0.02), whereas xanthine oxidase activity was increased to 5.8 +/- 0.5 mU/g wet wt. These results indicate that I/R produced a dramatic increase in vascular permeability coincident with an increase in muscle xanthine oxidase activity. Xanthine oxidase depletion with the tungsten diet or pretreatment with oxypurinol attenuated this permeability increase (sigma = 0.72 +/- 0.03 and 0.77 +/- 0.7, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Blood Proteins; Capillary Permeability; Ischemia; Male; Muscles; Neutrophils; Rats; Rats, Inbred Strains; Reference Values; Regional Blood Flow; Superoxides; Vascular Resistance; Xanthine Oxidase

During the last few years, the scientific field has focused its attention on the pathogenic role of free radicals in the process of ischemia-revascularization. It is a well-known fact that xanthine oxidase is an important source of tissular free radicals. Bearing this in mind, we designed an experimental protocol to analyse the effect of allopurinol (a xanthine oxidase inhibitor) in the survival of rats after the occlusion of the superior mesenteric artery during a period of 90 minutes and its action on the superoxide radical liberation. The concentration of oxipurinol and allopurinol in the ischemic area (intestine), liver and blood were measured. We concluded that the administration of allopurinol increased the survival rate, which is correlated to higher concentrations of allopurinol and oxipurinol in the inner part of the intestinal cells. A correlation between the survival rate and superoxide radicals was not found.

Topics: Acute Disease; Allopurinol; Animals; Female; Free Radicals; Intestines; Ischemia; Male; Oxypurinol; Prognosis; Purines; Rats; Rats, Inbred Strains; Reperfusion Injury; Superoxides; Xanthine Oxidase

Oxygen-derived free radicals have been implicated as possible mediators in the development of tissue injury induced by ischemia and reperfusion. Clamping of the celiac artery in rats reduced the gastric mucosal blood flow to 10% of that measured before the clamping. The area of gastric erosions and thiobarbituric acid (TBA) reactants in gastric mucosa were significantly increased 60 and 90 min after clamping. These changes were inhibited by treatment with SOD and catalase. Thirty and 60 min after reoxygenation. produced by removal of the clamps following 30 min of ischemia, gastric mucosal injury and the increase in TBA reactants were markedly aggravated compared with those induced by ischemia alone. SOD and catalase significantly inhibited these changes. The serum alpha-tocopherol/cholesterol ratio, an index of in vivo lipid peroxidation, was significantly decreased after long periods of ischemia (60 and 90 min), or after 30 and 60 min of reperfusion following 30 min of ischemia. These results indicated that active oxygen species and lipid peroxidation may play a role in the pathogenesis of gastric mucosal injury induced by both ischemia alone and ischemia-reperfusion. Although, allopurinol inhibited the formation of gastric mucosal injury and the increase in TBA reactants in gastric mucosa, the depletion of polymorphonuclear leukocytes (PMN) counts induced by an injection of anti-rat PMN antibody did not inhibit these changes. As compared with the hypoxanthine-xanthine oxidase system. PMN seem to play a relatively small part in the formation of gastric mucosal injury induced by ischemia-reperfusion.

Topics: Allopurinol; Animals; Catalase; Cholesterol; Free Radicals; Gastric Mucosa; Ischemia; Lipid Peroxidation; Male; Neutrophils; Oxygen; Rats; Rats, Inbred Strains; Reperfusion Injury; Superoxide Dismutase; Vitamin E; Xanthine Oxidase

Xanthine oxidase-derived oxidants and leukocytes have been implicated in the microvascular injury associated with reperfusion of ischemic intestine. The objective of this study was to determine whether xanthine oxidase-derived oxidants play a role in the leukocyte-microvascular interactions initiated by ischemia-reperfusion. Adherence and extravasation of leukocytes were monitored in cat mesenteric venules subjected to 1 h of ischemia (blood flow reduced to 20% of control) and reperfusion. Leukocyte rolling velocity, vessel diameter, and red cell velocity were also measured in control (untreated) animals and in animals pretreated with either allopurinol or superoxide dismutase. The responses of venular blood flow, wall shear rate, and leukocyte rolling velocity to ischemia and reperfusion did not differ between the three experimental groups. In control animals, 1 h of ischemia was associated with significant adherence and extravasation of leukocytes with reperfusion greatly enhancing these responses. Allopurinol treatment did not alter the responses to ischemia per se, yet it largely prevented the further increment in adherence and extravasation associated with reperfusion. Superoxide dismutase treatment attenuated the leukocyte responses elicited by both ischemia and reperfusion. Our observations that both allopurinol and superoxide dismutase attenuate reperfusion-induced leukocyte adherence and extravasation are consistent with the hypothesis that xanthine oxidase-derived oxidants initiate the leukocyte infiltration induced by reperfusion of ischemic intestine.

Topics: Allopurinol; Animals; Blood Pressure; Cats; Cell Adhesion; Cell Movement; Endothelium, Vascular; Ischemia; Leukocytes; Reperfusion; Splanchnic Circulation; Stress, Mechanical; Superoxide Dismutase; Venules

To assess the effects of xanthine oxidase (XO) inhibition on ischemic injury, rats were pretreated with oxypurinol (OXY, 5 mg/kg) and subjected to 30 min of bilateral renal artery occlusion. OXY's effect on adenine nucleotide-nucleoside-purine base concentrations was determined at 10 and 30 min of ischemia and during reperfusion (5 and 30 min). To assess whether XO-mediated oxidant stress influences the severity of ischemic acute renal failure (IARF), the effects of 1) OXY pretreatment and 2) hypoxanthine infusion were assessed. During ischemia OXY inhibited XO activity (more than fourfold rise in hypoxanthine-xanthine ratios) and induced quantitatively trivial but significant increases in ATP and total adenine nucleotide concentrations (by 30 min). Increased OXY dosage (15 mg/kg) or allopurinol (40 mg/kg) had no greater effects. At 5 min of reflow, OXY maintained XO inhibition but did not influence adenine nucleotide levels. By 30 min of reflow, 17-20% increments in ATP-total adenine nucleotides resulted. Nevertheless, OXY did not lessen the severity of IARF (assessed by azotemia-histology at 24 h). Hypoxanthine infusion increased end-ischemic hypoxanthine concentrations by 47%, but it did not change the severity of renal damage. Conclusions include 1) OXY-allopurinol induces intrarenal XO inhibition; 2) XO inhibitors slightly increase late ischemic-reperfusion adenine nucleotide concentrations; and 3) neither XO inhibition nor intrarenal hypoxanthine loading alters the severity of IARF, suggesting that XO-mediated oxidant stress is not a critical, consistent mediator of ischemic renal injury.

Topics: Acute Kidney Injury; Adenine Nucleotides; Allopurinol; Animals; Female; Hypoxanthine; Hypoxanthines; Inosine; Ischemia; Kidney; Kinetics; Oxypurinol; Pyrimidines; Rats; Rats, Inbred Strains; Renal Artery; Renal Circulation; Reperfusion; Xanthine Oxidase

The relationship between nucleotide catabolism and generation of activated oxygen species was investigated in liver, hepatocytes and small intestine of rats. In severe hypoxia nucleotide degradation via xanthine oxidase and urate oxidase requires about half of the oxygen consumed. Data on the changes of nucleobase compounds in rat hepatocytes and small intestine during ischemia and reoxygenation and the effects of allopurinol and oxypurinol thereon are presented. From EPR measurements it is concluded that OH. radicals induce reactions of allopurinol yielding long-living products which are able to react with DMPO-OH with loss of its radical properties.

Topics: Allopurinol; Animals; Cell Hypoxia; Intestine, Small; Ischemia; Liver; Male; Oxygen; Oxypurinol; Purine Nucleotides; Purines; Pyrimidines; Rats; Rats, Inbred Strains

Xanthine:acceptor oxidoreductase activities were assayed in free skin flaps following prolonged preservation. In normal rat skin, xanthine dehydrogenase transfers electrons to NAD+ and accounts for 73% of total oxidoreductase activity, and xanthine oxidase transfers electrons to molecular oxygen and accounts for the remaining 27%. Xanthine oxidase activity increased significantly in skin flaps during ischemia: approximately 30 and 100% increases after 6 and 24 hr of ischemia, respectively. Allopurinol inhibited xanthine oxidoreductase activity: free skin flaps obtained from allopurinol-treated animals exhibited a low level of xanthine oxidoreductase activity throughout the period of preservation. Systemic allopurinol significantly improved the survival rate from 32 to 75% of free flaps transferred after 24 hr of preservation at room temperature. These observations suggest that the xanthine oxidase system is a major source of oxygen free radicals following ischemia/reperfusion in skin. The increase in xanthine oxidase is attributable to the conversion of xanthine dehydrogenase to oxidase, a conversion which involves sulfhydryl oxidation in skin flaps.

Topics: Allopurinol; Animals; Dithiothreitol; Female; Graft Survival; Ischemia; Ketone Oxidoreductases; Phenylmethylsulfonyl Fluoride; Rats; Rats, Inbred Strains; Skin; Skin Transplantation; Surgical Flaps; Xanthine Dehydrogenase; Xanthine Oxidase

Topics: Allopurinol; Animals; Ischemia; Liver; Liver Transplantation; Oxygen; Rats; Rats, Inbred Strains; Xanthine Oxidase

The role of recipient hemodilution for postischemic renal medullary red cell trapping was investigated after different periods of cold storage in a conventional cold storage solution (Sacks'). At all cold storage times investigated (4, 12, 24, and 48 hr) medullary red cell trapping was reduced by isovolemic hemodilution, with about 50% reduction of recipient hematocrit. Trapping was also reduced when a modification of a new preservation solution (University of Wisconsin solution [UW]) was used and compared with flush-out and storage in a standard preservation solution (Sacks'). The combination of hemodilution and preservation in modified UW solution had additional capacity to reduce medullary red cell trapping. Thus, even after 48 hr of cold storage, only a moderate trapping was observed. The results also indicate that measurements of medullary red cell trapping offers an accurate method of grading postischemic renal damage.

Topics: Adenosine; Allopurinol; Animals; Cold Temperature; Erythrocytes; Glutathione; Hemodilution; Insulin; Ischemia; Kidney; Kidney Transplantation; Male; Organ Preservation; Organ Preservation Solutions; Raffinose; Rats; Rats, Inbred Strains; Solutions

Low level chemiluminescence of exposed rat intestine was measured during occlusive ischaemia and reperfusion. Spontaneous emission of in vivo rat intestine (10 +/- 1 cps/cm2) decreased almost to zero in animals subjected to ischaemia and when the period of ischaemia lasted only two minutes, chemiluminescence increased beyond control levels (39%, three minutes after reperfusion) at intestine deligation. This overshoot did not occur when rats were pretreated with allopurinol (40 + 100 mg/kg bw). The ratio of xanthine dehydrogenase to xanthine oxidase activities was 3.46 in preischaemic intestine samples. The same ratio was changed to 0.35 in samples subjected to two minutes of ischaemia. As chemiluminescence appears to reflect the steady state level of singlet oxygen, which in turn derives from the steady state level of peroxy radicals, these results agree with the view that oxygen radicals derived from the xanthine oxidase reaction are involved in the cellular damage produced after ischaemia and reoxygenation in the intestine.

Topics: Allopurinol; Animals; In Vitro Techniques; Ischemia; Jejunum; Luminescent Measurements; Male; Rats; Rats, Inbred Strains; Reperfusion; Time Factors; Xanthine Dehydrogenase; Xanthine Oxidase

Topics: Allopurinol; Animals; Ischemia; Liver; Liver Circulation; Liver Function Tests; Swine; Xanthine Oxidase

Topics: Adenosine Triphosphate; Allopurinol; Animals; Dogs; Free Radicals; Ischemia; Liver; Liver Circulation; Prostaglandins

The activity of xanthine dehydrogenase in human postmortem tissues is surprisingly high in brain and heart; activity was found in most tissue samples, whereas many samples contained little or no oxidase activity. We have confirmed the high level of oxidase activity in liver in which tissue conversion of dehydrogenase to oxidase appears complete. We have also confirmed the virtual absence of either activity in fresh human placenta. Fresh rabbit tissues similarly show considerable dehydrogenase activity in brain and heart. In view of the stability and generalised distribution of dehydrogenase activity, our results suggest that some modification of existing ideas on the physiological and pathological roles of the enzyme may be needed.

Topics: Animals; Brain; Enzyme Stability; Humans; Ischemia; Ketone Oxidoreductases; Liver; Myocardium; Placenta; Rabbits; Species Specificity; Tissue Extracts; Xanthine Dehydrogenase; Xanthine Oxidase

The study describes regional changes of xanthine oxidase and succinate dehydrogenase activities as shown by the ischemic and reperfused small intestine of the rat. The results are obtained with enzyme histochemical methods, including densitometrical verifications, and are substantiated with biochemical enzyme determinations. The decrease of xanthine oxidase activity was best visible in the anoxic duodenum and jejunum, where the findings of histochemical enzyme determinations agreed with those achieved biochemically. The activities of succinate dehydrogenase as measured densitometrically may serve as a further control, considering also the typical intracellular distribution of the reaction products.

Topics: Animals; Densitometry; Histocytochemistry; Intestinal Mucosa; Intestine, Small; Ischemia; Male; Rats; Rats, Inbred Strains; Reperfusion Injury; Succinate Dehydrogenase; Xanthine Oxidase

Oxygen free radicals have been demonstrated to be important mediators of postischemic reperfusion injury in a broad variety of tissues; however, the cellular source of free radical generation is still unknown. In this study, electron paramagnetic resonance measurements with the spin trap 5,5'-dimethyl-1-pyrroline-N-oxide (DMPO) demonstrate that bovine endothelial cells subjected to anoxia and reoxygenation become potent generators of superoxide and hydroxyl free radicals. A prominent DMPO-OH signal aN = aH = 14.9 G is observed on reoxygenation after 45 min of anoxic incubation. Quantitative measurements of this free radical generation and the time course of radical generation are performed. Both superoxide dismutase and catalase totally abolish this radical signal, suggesting that O2 is sequentially reduced from O2-. to H2O2 to OH.. Addition of ethanol resulted in trapping of the ethoxy radical, further confirming the generation of OH.. Endothelial radical generation was shown to cause cell death, as evidenced by trypan blue uptake. Radical generation was partially inhibited and partially scavenged by the xanthine oxidase inhibitor allopurinol. Marked inhibition of radical generation was observed with the potent xanthine oxidase inhibitor oxypurinol. These studies demonstrate that endothelial cells subjected to anoxia and reoxygenation, conditions observed in ischemic and reperfused tissues, generate a burst of superoxide-derived hydroxyl free radicals that in turn cause cell injury and cell death. Most of this free radical generation appears to be from the enzyme xanthine oxidase. Thus, endothelial cell free radical generation may be a central mechanism of cellular injury in postischemic tissues.

Topics: Animals; Cattle; Cell Survival; Electron Spin Resonance Spectroscopy; Endothelium, Vascular; Free Radicals; Hypoxia; In Vitro Techniques; Ischemia; Oxygen; Time Factors; Xanthine Oxidase

Topics: Allopurinol; Animals; Catalase; Dogs; Free Radicals; Ischemia; Liver; Liver Transplantation; Reperfusion; Superoxide Dismutase; Tissue Preservation; Vitamin E

Topics: Allopurinol; Animals; Creatinine; Cyclosporins; Dose-Response Relationship, Drug; Epoprostenol; Ischemia; Kidney; Kidney Diseases; Mannitol; Microscopy, Electron; Rabbits

To investigate the mechanism of cardiac ischemia reperfusion injury, we fed rats tungsten (3 weeks) to inhibit molybdenum-dependent oxidase enzymes. Tungsten-treated isolated perfusion hearts (Langendorff, ventricular balloon, 37 degrees C) had negligible xanthine oxidase activity (less than 0.3 vs greater than 8.0 U/gm myocardium) and improved recovery of developed pressure (DP), contractility (+dP/dt), and compliance (-dP/dt) after 20 minutes of global ischemia (37 degrees C) and 40 minutes of reperfusion. Furthermore, the addition of dimethylthiourea, a freely diffusible O2 metabolite scavenger, but not equimolar urea, a non-O2 metabolite scavenger, improved recovery. High-dose urea improved recovery more than control but less than dimethylthiourea. Combining tungsten and equimolar urea improved recovery the same as dimethylthiourea. We conclude that: (1) inhibition of myocardial oxidase enzymes (including xanthine oxidase) improves recovery of ventricular function after ischemia and reperfusion in the isolated rat heart, (2) infusion (during reperfusion) of a permeable O2 metabolite scavenger (dimethylthiourea) but not equimolar urea improves recovery of ventricular function, (3) infusion of higher concentrations of urea improves postischemic function, and (4) myocardial reperfusion injury is distinguishable from ischemic injury.

Topics: Animals; Diet; Heart; Ischemia; Male; Myocardial Contraction; Myocardium; Perfusion; Rats; Rats, Inbred Strains; Stroke Volume; Thiourea; Tungsten; Urea; Xanthine Oxidase

Total injury in ischemic skeletal muscle is a function of ischemic damage and reperfusion injury. In an attempt to decrease reperfusion injury, we gave the oxygen-derived free radical scavengers allopurinol, superoxide dismutase, or mannitol during reperfusion of canine gracilis muscle made ischemic for 4 hours. We measured muscle O2 consumption (MVO2), and tissue calcium, water, and adenosine triphosphatase (ATP) before ischemia, after ischemia, and at 5 minutes and 60 minutes of reperfusion. The results at 60 minutes showed no improvement in MVO2 or ATP. In fact, ATP was significantly depressed with allopurinol and superoxide dismutase treatment, and tissue edema did not decrease in any of the groups. We conclude that the simple addition of oxygen-derived free radical scavengers during the initial reperfusion of totally ischemic skeletal muscle does not attenuate reperfusion injury.

Topics: Adenosine Triphosphate; Allopurinol; Animals; Body Water; Calcium; Dogs; Female; Free Radicals; Ischemia; Male; Mannitol; Muscles; Oxygen Consumption; Reperfusion Injury; Superoxide Dismutase

The effect of pretreatment with various substances protecting against oxygen free radicals on the leakage of proteins across the vessel walls of rabbit kidneys induced by ischaemia has been studied. The leakage of proteins was estimated from the difference between the 120-min distribution space of [131I]albumin and the 5-min distribution space of [125I]albumin, the latter mainly measuring the intravascular volume. Neither SOD (superoxide dismutase), catalase, allopurinol or two different Ca2+ channel blockers (nifedipine, felodipine) could alone reduce the leakage induced by ischaemia. A combined pretreatment with SOD, catalase and nifedipine reduced the leakage in the cortex, and pretreatment with mannitol alone reduced the leakage in the cortex and outer stripe of the medulla. The results indicate that oxygen free radicals are involved in the leakage of proteins across the vessel walls induced by ischaemia, but that other mechanisms are involved as well.

Topics: Allopurinol; Animals; Calcium Channel Blockers; Capillary Permeability; Catalase; Felodipine; Free Radicals; Ischemia; Kidney; Mannitol; Nifedipine; Nitrendipine; Oxygen; Rabbits; Serum Albumin, Radio-Iodinated; Superoxide Dismutase; Xanthine Oxidase

The reversible and irreversible conversion of xanthine dehydrogenase to xanthine oxidase during ischemia/reperfusion and oxidative stress induced by hydrogen peroxide or diamide and its relationship with glutathione and protein SH groups were studied. The direct spectrophotometric measurement of the various forms of the xanthine-converting enzyme indicates that, in the fresh rat heart or after normoxic perfusion, there always is a basal level of 80% xanthine dehydrogenase and 20% of xanthine oxidase (15% irreversible and 5% reversible) that could contribute to the background production of free radicals. There is no significant increase of irreversible xanthine oxidase during ischemia nor during reperfusion. After global ischemia the reversible oxidase shows almost no increase while, when ischemia is followed by reperfusion, there is a limited increase (less then 9%) of the reversible xanthine oxidase. In the latter conditions there is a decrease of glutathione and of SH groups of about 70% and 25%, respectively. Perfusion for 1 h with oxidizing agents like hydrogen peroxide (60 microM) or diamide (100 microM) determines a marked conversion of xanthine dehydrogenase to reversible xanthine oxidase of about 40% and 60%, respectively; this oxidase activity partially reconverts to the dehydrogenase after withdrawing the oxidizing agents from the perfusion medium. The level of irreversible xanthine oxidase remains unchanged in all the conditions tested. Both hydrogen peroxide and diamide induce a strong decrease in SH groups and depletion of glutathione. The xanthine dehydrogenase----xanthine oxidase conversion thus appears to be sensitive to the redox state of thiol groups.

Topics: Animals; Coronary Circulation; Free Radicals; Glutathione; In Vitro Techniques; Ischemia; Ketone Oxidoreductases; Myocardium; Perfusion; Rats; Sulfhydryl Compounds; Xanthine Dehydrogenase; Xanthine Oxidase

Previous studies have proposed and supported a role for the proteolytic, irreversible conversion of xanthine dehydrogenase to xanthine oxidase (XO) in postischemic injury in a wide variety of organs. A second mechanism of conversion, due to sulfhydryl modification and reversible with dithiothreitol (DTT), is potentially important but has not been well investigated. In this study rat liver and kidney were found to produce significant amounts of DTT-reversible XO during normothermic global ischemia. Formation of reversible XO precedes that of irreversible XO by approximately 0.5 h with a strong correlation (r = 0.92) existing between the rate of irreversible XO formation and the concentration of reversible XO. The formation of reversible XO is preceded by a depletion of glutathione with concentrations of glutathione during ischemia correlating (r = 0.85) with the observed concentration of reversible XO. While a large increase in the extent of liver damage occurs concurrently with conversion in an in vivo liver model of liver ischemia, an ischemia-reperfusion regimen (1 h of ischemia plus 0.5 h of reperfusion) that resulted in no conversion caused significant elevations in serum glutamic pyruvic transaminase and serum glutamic-oxaloacetic transaminase. Rats depleted of XO by tungsten dieting release 65% less enzyme after the same insult, suggesting that endogenous XO may also participate in the damage process independent of any conversion.

Topics: Animals; Dithiothreitol; Ischemia; Ketone Oxidoreductases; Kidney; Kinetics; Liver; Male; Perfusion; Rats; Rats, Inbred Strains; Xanthine Dehydrogenase; Xanthine Oxidase

Oxygen radicals derived from xanthine oxidase (XO) are important mediators of the cellular injury associated with reperfusion of ischemic intestine, stomach, liver, kidney, and pancreas. XO exists in nonischemic tissue predominantly as xanthine dehydrogenase (XDH) and converts to oxygen radical-producing XO with ischemia. Grinding intestine under liquid nitrogen and placing the powder in phosphate buffer (pH 7.0) containing thiol reductants and protease inhibitors adequately preserved total XDH + XO activity and the percentage in the oxidase form (%XO) for 24 h. Total activity in nonischemic intestine ranged from 374 nmol.min-1.g-1 in duodenum to 138 nmol.min-1.g-1 in ileum, while XO activity was approximately 19% of total activity throughout the entire small intestine. The rate of XDH conversion to XO during normothermic ischemia varied only slightly throughout the intestine, increasing 13% per hour to 34, 46, and 61% XO after 1, 2, and 3 h of ischemia, respectively. Our results contrast with previous reports where XDH conversion to XO occurred within 60 s ischemia but are consistent with physiological and morphological evidence of ischemic injury and provide further support for involvement of XO in intestinal injury associated with ischemia.

Topics: Animals; Dithiothreitol; Free Radicals; Hydrogen-Ion Concentration; Intestines; Ischemia; Ketone Oxidoreductases; Male; Protease Inhibitors; Rats; Rats, Inbred Strains; Xanthine Dehydrogenase; Xanthine Oxidase

Topics: Allopurinol; Animals; Glutathione; Intestinal Mucosa; Intestines; Ischemia; Male; Muscle, Smooth; Oxidation-Reduction; Rats; Rats, Inbred Strains; Reperfusion; Thiobarbiturates

Topics: Allopurinol; Animals; Creatine Kinase; Deferoxamine; Disease Models, Animal; Heart Arrest; Ischemia; Rats; Reperfusion Injury; Resuscitation

Based on work from our laboratory and studies by others, we propose the following hypothesis to explain the interaction among xanthine oxidase, PMNs, and tissue injury in the postischemic small intestine (Figure 2). During the ischemic period, ATP is catabolized to yield hypoxanthine. The hypoxic stress also triggers the conversion of NAD-reducing xanthine dehydrogenase to the oxygen radical-producing xanthine oxidase via a protease. When the intestine is reperfused, molecular oxygen is reintroduced into the tissue where it reacts with hypoxanthine and xanthine oxidase to produce a burst of superoxide anion and hydrogen peroxide. In the presence of ferric iron, superoxide anion and hydrogen peroxide react via the Haber-Weiss reaction to form hydroxyl radicals. This highly reactive and cytoxic free radical then initiates lipid peroxidation of cell membrane components and the subsequent release of substances that activate, attract, and promote the adherence of PMN to microvascular endothelium. The adherent PMN then causes further endothelial cell injury via the release of superoxide and various proteases.

Topics: Animals; Chemotaxis, Leukocyte; Free Radicals; Intestine, Small; Ischemia; Microcirculation; Neutrophils; Reperfusion Injury; Xanthine Oxidase

Topics: Allopurinol; Animals; Female; Free Radicals; Gastric Mucosa; Ischemia; Necrosis; Platelet Activating Factor; Rats; Rats, Inbred Strains; Reference Values; Reperfusion Injury; Stomach; Superoxide Dismutase

Intravascular complement activation with either zymosan or cobra venom factor (CVF) impairs hepatic blood flow. Oxygen radical scavengers given at the time of complement activation attenuate the resulting hepatic ischemia. It is not clear whether complement-stimulated phagocytes or transiently ischemic then reperfused endothelial and parenchymal cells generated the toxic oxygen radicals. In this study, a group of rats were given allopurinol (50 mg/kg/day postoperatively X 3 days plus 100 mg/kg iv at t = 0), a specific inhibitor of xanthine oxidase, prior to complement activation with CVF (20 units/kg iv at t = 30 and 60 min) to determine whether xanthine oxidase-derived oxygen radicals contributed significantly to the hepatic perfusion abnormalities. Additional rats received lodoxamide tromethamine (10 mg/kg iv bolus at t = 0 followed by 20 mg/kg/hr iv infusion), a novel and potent inhibitor of mast cell release and inhibitor of xanthine oxidase, prior to the same CVF challenge to determine whether mast cell mediators were involved in the flow disturbance. Thermodilution cardiac output, mean arterial pressure, heart rate, hematocrit, and effective hepatic blood flow (EHBF) by galactose clearance were determined at t = 2 hr. The percentage change in total hemolytic complement activity (% delta CH50) was determined between serum obtained prior to sacrifice and at t = 0. Systemic hemodynamics and HCT were for the most part unaffected regardless of pretreatment group or challenge with CVF or saline. CVF challenge produced a 25% reduction (P less than 0.05) in EHBF in vehicle-pretreated rats compared to saline challenge. Neither allopurinol nor lodoxamide tromethamine significantly improved EHBF when given prior to CVF challenge.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Allopurinol; Amino Acids; Animals; Complement Activation; Complement System Proteins; Elapid Venoms; Hemodynamics; Ischemia; Liver Circulation; Nitriles; Oxamic Acid; Tromethamine

Postischemic renal failure is a severe problem following cadaveric renal transplantation, especially if the kidney has been harvested from a non-heartbeating donor, and thereby subjected to periods of both warm and cold ischemia. It is well established that a substantial component of postischemic injury is produced by oxygen-derived free radicals generated from xanthine oxidase at reperfusion. However, the clinical potential of free radical ablative therapy is dependent upon the proportion of the total injury caused by this reperfusion mechanism, compared with the proportion resulting from ischemic injury per se. Therefore, we quantitatively evaluated these proportions in porcine kidneys subjected to various periods of warm (renal artery occlusion in situ), cold (harvest, cold preservation, and allotransplantation), and combined warm and cold ischemia. Experiments were paired, one kidney treated with either superoxide dismutase (SOD) or allopurinol for free radical ablation, the contralateral kidney serving as a control. Creatinine clearance (Ccr) was measured separately for each kidney 48 hr after reperfusion. After 1 and 2 hr of warm ischemia, Ccr dropped to 50% and 36% of normal, respectively. This was improved to 110% and 55% when SOD was given into the renal artery at reperfusion. Similarly, after 24 and 48 hr of cold ischemia, kidney function was significantly improved from 30% and 18% to 72% and 47% of normal, respectively, when allopurinol was added to the preservation solution. SOD used at harvest and again at reperfusion was particularly effective following combined warm and cold ischemia, in a situation mimicking the harvest of cadaver kidneys from a non-heartbeating donor. These findings suggest that the ablation of free radical-mediated reperfusion injury may improve posttransplant renal function sufficiently to allow expansion of the cadaveric donor pool to include non-heartbeating donors.

Topics: Allopurinol; Animals; Cold Temperature; Free Radicals; Heart Arrest, Induced; Hot Temperature; Ischemia; Kidney; Kidney Transplantation; Organ Preservation; Perfusion; Superoxide Dismutase; Swine; Time Factors; Tissue Donors

Skin-flap ischemia has been associated with the presence of free radicals. In this study, two enzyme systems involved in free-radical metabolism were used to compare a distal skin flap to a skin graft. Forty-two rats were divided into several test groups. A 10 X 3 cm dorsal rat flap was used, and tissue biopsies for xanthine oxidase and malonyldialdehyde (MDA) were obtained 2.5, 5.5, and 8.5 cm from the base of the flap at the hours given. In group I (control), the flap was outlined but not elevated, and biopsies were obtained. In group II, the flap was elevated, and biopsies were obtained at 6 hours. In group III, the flap was elevated, the distal 4 X 3 cm was amputated and replaced as a full-thickness skin graft, and biopsies were obtained at 6 hours. In group IV, the flap was elevated, and biopsies were obtained at 12 hours. In group V, the flap was treated as in group III, and biopsies were obtained at 12 hours. In group VI, the flap was elevated, and biopsies were obtained at 24 hours. In group VII, the flap was treated as in group III, and biopsies were obtained at 24 hours.. Xanthine oxidase was significantly higher in all distal biopsies compared to proximal biopsies. Xanthine oxidase also increased with time. Malonyldialdehyde increased over time as well as with distance from the flap base. Distal flap biopsies at 24 hours had greatly increased levels of malonyldialdehyde compared to skin grafts (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Analysis of Variance; Animals; Free Radicals; Ischemia; Malondialdehyde; Necrosis; Rats; Rats, Inbred Strains; Skin; Surgical Flaps; Xanthine Oxidase

Topics: Allopurinol; Female; Free Radicals; Humans; Infant; Ischemia; Leg

The separate roles of exogenous acid, ischemia, and retransfusion of shed blood on gastric lesion formation in the rat hemorrhagic shock model were studied. In addition, the role of oxyradicals in lesion formation in this model was studied. Intragastric HCl increased gastric mucosal lesion formation in a dose-dependent manner. Even in the absence of intragastric HCl, ischemia followed by retransfusion of shed blood caused histologic mucosal injury in the corpus and antrum. Allopurinol, a xanthine oxidase inhibitor that prevents oxyradical formation, slightly, but significantly, reduced the gastric mucosal injury induced by ischemia-reperfusion but not that induced by ischemia alone. There was no significant difference in the extent of damage caused by ischemia-reperfusion and ischemia alone. We conclude that exogenous acid, ischemia, and oxyradical formation after retransfusion of shed blood are all important interacting factors in the rat hemorrhagic shock model of gastric mucosal injury. Allopurinol, by inhibiting formation of the oxyradical component, significantly protects against the injury.

Topics: Allopurinol; Animals; Blood Transfusion, Autologous; Free Radicals; Gastric Mucosa; Hydrochloric Acid; Ischemia; Male; Oxygen; Rats; Rats, Inbred Strains; Regional Blood Flow; Shock, Hemorrhagic

Ischemic-reperfusion lung injury is a factor potentially limiting the usefulness of distant organ procurement for heart-lung transplantation. Toxic oxygen metabolites are considered a major etiologic factor in reperfusion injury. Although oxygen-free radicals may be generated by many mechanisms, we investigated the role of xanthine oxidase in this injury process by using lodoxamide, a xanthine oxidase inhibitor, to inhibit ischemic-reperfusion injury in an isolated rat lung model. Isolated rat lungs were perfused with physiologic salt solution (PSS) osmotically stabilized with Ficoll until circulating blood elements were nondetectable in the pulmonary venous effluent. Lungs were rendered ischemic by interrupting ventilation and perfusion for 2 hr at 37 degrees C. After the ischemic interval, the lungs were reperfused with whole blood and lung injury was determined by measuring the accumulation of 125I-bovine serum albumin in lung parenchyma and alveolar lavage fluid as well as by gravimetric measurements. Lung effluent was collected immediately pre- and postischemia for analysis of uric acid by high-pressure liquid chromatography. Lodoxamide (1 mM) caused significant attenuation of postischemic lung injury. Uric acid levels in the lung effluent confirmed inhibition of xanthine oxidase. Protection from injury was not complete, however, implying that additional mechanisms may contribute to ischemic-reperfusion injury in the lung.

Topics: Animals; Iodine Radioisotopes; Ischemia; Lung; Microscopy, Electron; Oxamic Acid; Regional Blood Flow; Serum Albumin, Bovine; Uric Acid; Xanthine Oxidase

This study assessed the contribution of angiotensin II, oxygen-free radicals, and vasopressin to the mortality of acute mesenteric ischemia in rats. Rats received saline replacement (16 ml/kg/hr) for 3 hr during and after 85 min of superior mesenteric artery (SMA) occlusion. Only 21% of rats that received saline alone (n = 14, control) survived 48 hr, significantly less than the 100% survival of sham-operated rats (no SMA occlusion, n = 5, P less than 0.01). Neither teprotide (an angiotensin converting-enzyme inhibitor), allopurinol (to reduce oxygen-free radical formation), nor a specific vasopressin antagonist [1-(beta-mercapto-beta,beta-cyclopentamethyleneproprionic acid), 2-(O-methyl) tyrosine arginine-vasopressin] improved 48-hr survival, which was 17% in each group (n = 6, each). Survival improved significantly to 86% (n = 7, P less than 0.001) when intravenous glucagon (1.6 micrograms/kg/min) was given for 2 hr after SMA reperfusion. Survival after dopamine infusion (12 micrograms/kg/min iv) was 67% at 48 hr, a nearly significant improvement (n = 9, P less than 0.06). These results suggest that angiotensin II, oxygen-free radicals, and vasopressin do not contribute significantly to the high mortality observed after acute intestinal ischemia in this rat model, but that glucagon, and to a lesser extent, dopamine, are potentially therapeutic.

Topics: Allopurinol; Animals; Arterial Occlusive Diseases; Dopamine; Glucagon; Ischemia; Male; Mesenteric Arteries; Rats; Rats, Inbred Strains; Teprotide

In this study we sought to define the role of oxygen-derived free radicals during ischemia and reperfusion in the production of acute damage to the gastric mucosa of baboons. The protective effect of the xanthine oxidase inhibitor, allopurinol, the superoxide scavenger, superoxide dismutase (SOD), and a long-acting SOD-albumin was determined. Mucosal damage was evaluated using light and scanning electron microscopy. Evidence for oxidative insult to the gastric mucosa was sought by measuring tissue concentrations of reduced (GSH) and oxidized (GSSG) glutathione. Gastric mucosal blood flow was estimated using the microsphere technique. A similar pattern of tissue damage was found at the end of ischemia in all three groups. Thirty minutes after reperfusion, severe mucosal damage (grade 3) increased only in the untreated control. In the two treated groups, grade 3 damage remained unchanged during reperfusion and a decrease in the percentage of moderate damage (grade 2) was seen. Both GSH and GSSG tissue concentrations were lower in the untreated controls as compared to the scavenger-treated groups, making it questionable whether GSH/GSSG tissue levels adequately reflect oxidative stress. We conclude that in our ischemia-reperfusion model the generation of oxygen-derived free radicals produces mucosal damage and prevents the restitution of moderate mucosal damage during reperfusion. In ischemia, factors other than free radicals seem to be responsible for mucosal damage. The protective effect of allopurinol and SOD was not mediated by changes in gastric mucosal blood flow.

Topics: Allopurinol; Animals; Free Radicals; Gastric Mucosa; Glutathione; Glutathione Disulfide; Ischemia; Microscopy, Electron, Scanning; Oxygen; Papio; Shock, Hemorrhagic; Superoxide Dismutase; Time Factors

The role of oxygen derived free radicals in gastric lesions induced by haemorrhagic shock and the protective effect of oxygen radical scavengers, allopurinol and ranitidine, were investigated. Forty five rabbits underwent haemorrhagic shock for 30 minutes and reinfusion of shed blood. They were killed 30 minutes later. The animals were divided in five groups: A (n = 10): Control, B (n = 10): intravenous ranitidine pretreatment, C (n = 10): oral allopurinol, 24 and 2 h before surgery; D (n = 10): intravenous pretreatment with superoxide Dismutase plus catalase, E (n = 5): 60 minute haemorrhagic shock without reinfusion and treatment. Erosions and/or petechiae in all animals in Group A were observed. Three animals in group B and C and 2 in group D (p less than 0.005, p less than 0.001) had gastric lesions. The lesions in the pretreatment groups were significantly smaller than in controls. Oxygen radicals plus HCl play an important role in shock induced gastric lesions. Oxygen radical antagonists show a significant protective role.

Topics: Allopurinol; Animals; Female; Free Radicals; Gastric Mucosa; Ischemia; Oxygen; Rabbits; Ranitidine; Shock, Hemorrhagic

The purpose of this study is to confirm previous evidence for reactive oxygen species (ROS) as critical mediators of postischemic renal injury by documenting lipid peroxidation after ischemic-hypoxic insults and by demonstrating that antioxidants confer protection. Renal malondialdehyde (MDA) concentrations, an index of lipid peroxidation, were measured using uncorrected and tissue-chromagen-corrected methods in 1) cortical (C), outer medullary stripe (OMS), inner medullary (IM) whole renal tissues, and C and OMS mitochondria obtained 15 min after in vivo renal artery occlusion (RAO; x 45 min); 2) C, OMS, and IM whole tissues obtained 15 min after completing 45 min of ischemia in an isolated perfused kidney; and 3) isolated proximal tubular cell (PTC) suspensions after 45 min of hypoxia with 15 min of reoxygenation. Despite significant oxygen deprivation-induced injury in each of these systems, no significant rise in MDA concentrations could be documented, with the sole exception of the in vivo IM region (by uncorrected MDA assay only). The latter rise could be attributed to medullary vascular congestion causing a hemoglobin-induced artifact in the MDA assay. Sixty-minute in vivo RAO plus reflow also did not raise MDA. To validate the MDA assay 4.2 mM H2O2 was added to PTC. An abrupt fourfold rise in MDA resulted. Pretreatment of 30- and 45-min RAO rats with two antioxidants (allopurinol or superoxide dismutase) failed to confer functional or morphological protection. We conclude that ROS may not be critical consistent mediators of in vivo postischemic acute renal failure.

Topics: Acute Kidney Injury; Allopurinol; Animals; Female; In Vitro Techniques; Ischemia; Kidney; Kidney Tubules, Proximal; Lipid Peroxides; Malonates; Malondialdehyde; Mitochondria; Rats; Rats, Inbred Strains; Superoxide Dismutase

The neuroexcitotoxin kainate has been used as a selective lesioning agent to model the etiology of a number of neurodegenerative disorders. Although excitotoxins cause susceptible neurons to undergo prolonged or repeated depolarization, the proximate metabolic pathology responsible for neuronal necrosis has remained elusive. We report here that kainate-induced death of cerebellar neurons in culture is prevented by inhibiting the enzyme xanthine oxidase, a cellular source of cytotoxic superoxide radicals (O2-.). Moreover, neurons are also protected from excitotoxin-induced death by the addition to the culture medium of either superoxide dismutase or mannitol, which scavenge superoxide and hydroxyl radicals, respectively, or serine protease inhibitor, which forestalls formation of xanthine oxidase. These findings indicate that excitotoxin-induced neuronal degeneration is mediated by superoxide radicals generated by xanthine oxidase, a mechanism partially analogous to that proposed for tissue damage seen upon reperfusion of ischemic tissues.

Topics: Allopurinol; Animals; Cell Survival; Cells, Cultured; Cerebellum; Endopeptidases; Hydroxides; Hydroxyl Radical; Ischemia; Kainic Acid; Mannitol; Mice; NADPH Dehydrogenase; Nervous System Diseases; Neurons; Perfusion; Protease Inhibitors; Serine Endopeptidases; Superoxide Dismutase; Superoxides; Xanthine Oxidase

Topics: Allopurinol; Animals; Blood Pressure; Catalase; Cyclic N-Oxides; Dogs; Ischemia; Liver; Liver Circulation; Nitrogen Oxides; Regional Blood Flow; Reperfusion; Spin Labels

In response to global ischemia, tissue xanthine dehydrogenase was converted to xanthine oxidase in all tissues with half-times of conversion at 37 degrees C of approximately 3.6, 6, 7, and 14 h for the liver, kidney, heart, and lung, respectively. The time course of enzyme conversion at 4 degrees C was greatly extended with half-conversion times of 6, 5, 5, and 6 d for the respective tissues. Increases in xanthine oxidase activity were accompanied by the appearance of a distinct new protein species with greater electrophoretic mobility. The oxidase from ischemic rat liver was purified 781-fold and found to migrate with a higher mobility on native gels than the purified native dehydrogenase. Sodium dodecyl sulfate profiles revealed the presence of a single major band of 137 kD for the native dehydrogenase, whereas the oxidase had been partially cleaved generating polypeptides of 127, 91, and 57 kD. Polypeptide patterns for the oxidase resemble those seen following limited in vitro proteolysis of the native dehydrogenase supporting a proteolytic mechanism for the conversion of xanthine dehydrogenase to oxidase in ischemic rat liver.

Topics: Animals; Ischemia; Ketone Oxidoreductases; Kidney; Liver; Lung; Male; Myocardium; Peptide Hydrolases; Protein Processing, Post-Translational; Rats; Rats, Inbred Strains; Temperature; Xanthine Dehydrogenase; Xanthine Oxidase

Topics: Allopurinol; Animals; Catalase; Heart Transplantation; Hemodynamics; Ischemia; Male; Organ Preservation; Perfusion; Rats; Superoxide Dismutase

Recent studies have implicated oxygen free radicals in ischemia-reperfusion injury to the gastric mucosa. The aims of the present study were to test the hypothesis that the enzyme xanthine oxidase is the source of the oxygen radicals in the ischemic stomach and determine the importance of the iron-catalyzed Haber-Weiss reaction in generating the cytotoxic oxygen radicals. Gastric mucosal clearance of 51Cr-labeled red blood cells was measured during a 30-min control period, a 30-min ischemic period (hemorrhage to 25 mmHg arterial pressure), and a 60-80-min reperfusion period (reinfusion of shed blood). In untreated (control) rats, a dramatic rise (100-fold) in the leakage of 51Cr-labeled red blood cells into the gastric lumen was observed only during the reperfusion period. After the reperfusion period, gastric mucosal damage was further assessed using gross lesion area and histology. Rats were placed on a sodium tungstate diet (to inactivate xanthine oxidase), or treated with either deferoxamine (an iron chelating agent) or superoxide dismutase (a superoxide scavenger). All three interventions substantially reduced 51Cr-labeled red blood cell clearance and gross lesion area relative to untreated rats. However, tissue injury assessed histologically was similar in both treated and untreated animals. The results of this study support the hypothesis that oxygen free radicals mediate the hemorrhagic shock-induced extravasation of red blood cells. The data also indicate that xanthine oxidase is the source of the oxy-radicals and that the iron-catalyzed Haber-Weiss reaction is largely responsible for hydroxyl radical generation in this model.

Topics: Animals; Chromium Radioisotopes; Deferoxamine; Erythrocytes; Free Radicals; Gastric Mucosa; Iron; Ischemia; Male; Oxygen Consumption; Rats; Rats, Inbred Strains; Superoxide Dismutase; Time Factors; Tungsten; Tungsten Compounds; Xanthine Oxidase

The macromolecular permeability of renal capillaries and the intravascular red cell aggregation resulting from 45 min of warm ischaemia were investigated. The effects of the xanthine oxidase inhibitor Allopurinol on these factors and also on the post-ischaemic nephron function were also studied. Following ischaemia there was a more than 10-fold increase in the transport from plasma to renal hilar lymph both of plasma proteins and of two isomers of lactate dehydrogenase (LDH)-the nearly neutral LDH-M4 and the negatively charged LDH-H4. The ischaemia also resulted in massive intravascular red cell aggregation, especially in the renal medulla. Through reduction of plasma xanthine oxidase activity from 13.1 +/- 1.1 microU microliter-1 (mean +/- SEM) to essentially zero by Allopurinol, the capillary leakiness was substantially diminished with almost complete normalization after 120 min. At the same time the relative volume of trapped red cells was reduced; in the inner stripe of the outer medulla, for example, it decreased from 11.3 +/- 1.7% in untreated animals to 4.0 +/- 1.1% after treatment with 20 mg of Allopurinol given intravenously 3 h before the ischaemia. Oral feeding with 4 mg of Allopurinol day-1 for one week gave essentially the same result. The net driving force for filtration after treatment with this drug was thus 19 mmHg, as against 26 mmHg in the normal kidney and the resulting SNGFR was half the normal. The total filtration rate was proportionally more reduced to less than 1/3 of the normal. Tubular obstruction was still present but was not as severe as in untreated kidneys (Karlberg et al., 1982b) where the tubular fluid flow and thereby the filtration are essentially zero. It is suggested that oxygen free radicals increased the macromolecular permeability and the adhesiveness of white blood cells and that these two factors combined underlie the aggregation of red blood cells in the medullary vasa recta with consequent persistence of medullary ischaemia.

Topics: Allopurinol; Animals; Blood Proteins; Capillary Permeability; Erythrocyte Aggregation; Glomerular Filtration Rate; Ischemia; L-Lactate Dehydrogenase; Lymph; Male; Nephrons; Rats; Rats, Inbred Strains; Renal Circulation; Xanthine Oxidase

Stress ulceration is frequently encountered after cardiovascular surgery. In this study of 32 male baboons, severe gastric ischaemia was used to produce gastric stress lesions. The occurrence of these lesions was reduced by allopurinol (P = 0.03) and completely prevented by the combination of allopurinol with superoxide dismutase (P = 0.004). A shorter ischaemic period also reduced the number of lesions (P = 0.02). Concurrent with the stress lesion formation, there was a fall in mucosal glutathione and oxidized glutathione levels (P less than 0.05).

Topics: Allopurinol; Animals; Disease Models, Animal; Gastric Mucosa; Ischemia; Male; Papio; Peptic Ulcer; Stress, Physiological; Superoxide Dismutase

Topics: Animals; Biomechanical Phenomena; Ischemia; Lung; Neutrophils; Oxygen; Pulmonary Circulation; Xanthine Oxidase

Recent data suggest that oxygen free radicals are implicated in the pathogenesis of ischemic injury. This study evaluates the effects of allopurinol, a xanthine oxidase (XO) inhibitor, on malonaldehyde generation, free sulfhydryl levels, oxygen consumption, and water contents of rat gastrocnemius muscles of female Sprague-Dawley rats subjected to tourniquet shock and after hind-limb reperfusion. Serum lactic dehydrogenase isozyme patterns after ligature release were also examined. Our results show that the four muscle parameters were not altered during 5 hr of ischemia, but that on hind-limb reperfusion, malonaldehyde production, SH levels, O2 consumption, and water contents were significantly altered in the control animals, but not in those pretreated with allopurinol. LDH serum patterns of the untreated animals showed the presence of all five isoforms; these were much less evident in the drug-protected rats. Our data suggest that following ischemia, the affected muscles are unable to recover their normal function when reperfusion is resumed. The subsequent damage is probably due to the generation of cytotoxic superoxide radicals formed during the XO-catalyzed transformation of hypoxanthine to uric acid on tissue reoxygenation. The severity of tissue damage is related to the duration of the ischemic episode possibly due to hypoxanthine accumulation during ischemia.

Topics: Allopurinol; Animals; Female; Hindlimb; Injections, Intraperitoneal; Ischemia; Isoenzymes; L-Lactate Dehydrogenase; Lipid Metabolism; Malondialdehyde; Muscles; Oxygen Consumption; Rats; Rats, Inbred Strains; Shock; Sulfhydryl Compounds; Superoxides; Tourniquets; Water

Topics: Animals; Bromides; Chlorides; Free Radicals; Humans; Hydrogen Peroxide; Hydroxides; Hydroxyl Radical; Inflammation; Iodides; Ischemia; Microcirculation; Neutrophils; Oxygen; Peroxidase; Superoxide Dismutase; Xanthine Oxidase

A growing body of experimental data indicates that reactive oxygen metabolites such as superoxide, hydrogen peroxide, and hydroxyl radical may mediate the mucosal injury produced by reperfusion of ischemic intestine. Xanthine oxidase has been proposed as the primary source of these reduced O2 species because pretreatment with xanthine oxidase inhibitors such as allopurinol or pterin aldehyde prevent postischemic mucosal injury. Another potential source of oxygen radicals is the inflammatory neutrophil. To ascertain whether neutrophils could play a role in the pathogenesis of ischemia-reperfusion injury in the small bowel we examined the effect of ischemia and reperfusion on neutrophil infiltration and tissue levels of reduced glutathione, superoxide dismutase, and catalase. Our studies demonstrate that reperfusion of ischemic intestines results in a dramatic increase (1,800%) in neutrophil infiltration and a concurrent loss of reduced glutathione and superoxide dismutase of 60 and 30%, respectively. Catalase activity was unaffected by ischemia-reperfusion. Pretreatment with allopurinol or administration of superoxide dismutase prevented the influx of neutrophils and retarded the drop in reduced glutathione levels. These results suggest a relationship among xanthine oxidase-generated oxy radicals, neutrophil extravasation, and mucosal damage. We propose that ischemia and reperfusion results in xanthine oxidase-generated, superoxide-dependent accumulation of inflammatory neutrophils in the mucosa where neutrophil-derived reactive oxygen metabolites mediate and/or exacerbate intestinal injury.

Topics: Allopurinol; Animals; Cats; Free Radicals; Glutathione; Intestinal Mucosa; Intestines; Ischemia; Neutrophils; Oxygen; Peroxidase; Superoxide Dismutase; Xanthine Oxidase

The effectiveness of 24-hour hypothermic machine perfusion with TP-V (a hyperosmolar colloid solution containing dextrose, sucrose and ATP-MgCl2) alone, or in combination with oxygen free radical scavengers, was evaluated in isolated-perfused canine heart-lungs. Heart-lungs were perfused at 4 degrees C in either TP-V (n = 6), TP-V/Allopurinol (500 mg/L) (n = 6), or TP-V/Allopurinol (500 mg/L) & Catalase (5000 U/L) (n = 5). Lung inflation was maintained with 100% nitrogen. Following preservation, the heart-lungs were perfused with an albumin-mannitol perfusate for 3 hours at 37 degrees C, for functional, hemodynamic, and laboratory determinations. Cold preservation with TP-V/Allopurinol, and TP-V/Allopurinol & Catalase resulted in physiologically normal LDH levels during the 3-hour normothermic isolated perfusion test period. Significantly lower enzyme activity for CPK was evident at 0 (p less than .005) and 3 hours (p less than .05) of perfusion, while no significant differences in lactate production were seen among the groups. In addition, pH, PCO2, PO2, and left ventricular, aortic, and coronary artery pressures all remained within normal physiologic range, with no significant differences seen among the three groups. 99m Technetium scans demonstrated adequate patency among the heart-lungs, with better flow seen in those perfused with TP-V/Allopurinol & Catalase. Histological specimens confirmed a decrease in myocardial and pulmonary damage when Allopurinol and/or Catalase was used. It appears that oxygen free radical scavengers provide some protection from canine heart-lungs which have been hypothermically preserved for 24 hours.

Topics: Allopurinol; Animals; Cardiomyopathies; Catalase; Coronary Vessels; Dogs; Free Radicals; Hypothermia, Induced; Ischemia; Lung; Lung Diseases; Organ Preservation; Oxygen; Perfusion; Superoxides

In ischemia/reperfusion injury, it is hypothesized that superoxide is responsible for the component of injury due to reperfusion. The superoxide is hypothesized to result from the aerobic oxidation of purines produced by the ischemia-mediated breakdown of high-energy phosphates. This oxidation is catalyzed by xanthine oxidase proposed to be rapidly formed as a result of ischemia-mediated protease conversion from xanthine dehydrogenase. In vivo experiments with the intestine of either rats or guinea pigs were unable to confirm the rapid conversion of xanthine dehydrogenase to xanthine oxidase as a result of ischemia. In vitro experiments with isolated guinea pig enterocytes did show a significant increase in xanthine oxidase activity after these cells were first placed in an anaerobic environment for 60 min and then reoxygenated; however, the magnitude of the increase is such that the biological importance of this finding remains uncertain. Using a variety of techniques, including spin trapping, hydroxylamine oxidation, and vanadate NADPH oxidation, we explored the possibility that superoxide was produced as a result of anoxia followed by reoxygenation in the in vitro enterocyte system. From these experiments, we determined that superoxide is generated as a result of anoxia/reoxygenation. However, from xanthine oxidase inhibition experiments using pterinaldehyde, only a small percentage of the total superoxide produced comes from the action of this enzyme on purines.

Topics: Animals; Electron Spin Resonance Spectroscopy; Free Radicals; Guinea Pigs; Hypoxia; Ileum; Ischemia; Ketone Oxidoreductases; Male; Oxidation-Reduction; Oxygen; Purines; Rats; Rats, Inbred F344; Species Specificity; Superoxides; Xanthine Dehydrogenase; Xanthine Oxidase

Renal function and morphology were studied before and after 60 min of renal ischaemia and contralateral nephrectomy in five groups of rabbits. The animals were pretreated with superoxide dismutase, catalase, allopurinol or mannitol. One group was not pretreated and served as a control. A moderate transient increase in serum creatinine concentration was observed in the control rabbits, while a significantly less pronounced increase was noted after pretreatment with superoxide dismutase, catalase and mannitol. Pretreatment with allopurinol did not significantly reduce the postoperative increase in serum creatinine and sodium excretion, but the urine osmolality returned to normal more rapidly than in the control group. The appearance under the light microscope of kidney tissue taken from surviving rabbits was found to be normal irrespective of pretreatment. Severe tubular necrosis was observed in the kidneys from rabbits that died during the observation period.

Topics: Allopurinol; Animals; Catalase; Creatinine; Free Radicals; Ischemia; Kidney; Mannitol; Nephrectomy; Rabbits; Superoxide Dismutase

Previous reports indicate that allopurinol, a xanthine oxidase inhibitor, largely prevents the injury produced by reperfusion of ischemic tissues. In order to further assess the role of xanthine oxidase in ischemia-reperfusion injury, we examined the influence of another inhibitor of the enzyme (pterin aldehyde) on the increased vascular permeability produced by intestinal ischemia. Vascular permeability estimates in autoperfused segments of cat ileum were derived from the relationship between lymph-to-plasma protein concentration ratio and lymph flow. One hour of intestinal ischemia increased vascular permeability to 0.43 +/- 0.02 from a control (nonischemic) value of 0.08 +/- 0.005. In ischemic ileal segments pretreated with purified pterin aldehyde, vascular permeability increased to only 0.15 +/- 0.02. Pretreatment with commercially prepared folic acid, which is contaminated with pterin aldehyde, also attenuated the ischemia-induced increase in vascular permeability (0.16 +/- 0.04). These findings support the hypothesis that xanthine oxidase is a major source of oxygen-free radicals produced during reperfusion of the ischemic small bowel.

Topics: Animals; Blood Proteins; Capillary Permeability; Cats; Folic Acid; Free Radicals; Ileum; Ischemia; Lymph; Pteridines; Pterins; Time Factors; Xanthine Oxidase

Ischemia in a stomach that contains acid may produce severe gastric mucosal injury. The extent to which oxygen-derived free radicals are involved in the pathogenesis of this injury was investigated in the present study. Local gastric ischemia was achieved by reducing celiac artery pressure to 30 mmHg for 1 h. Ischemic injury was assessed by recording the loss of 125I-albumin and 51Cr-red cells across the gastric mucosa. Cats were treated with a xanthine oxidase inhibitor (allopurinol), a superoxide radical scavenging enzyme (superoxide dismutase), and a scavenger of hydroxyl radicals (dimethyl sulfoxide). The damage associated with ischemia only occurred during reperfusion of the stomach and was worst in the antrum. The level of xanthine oxidase in the antrum was twice that of the corpus. Treatment with allopurinol, superoxide dismutase, and dimethyl sulfoxide reduced 51Cr-red cell loss to 15%, 25%, and 21% of control (untreated) animals, respectively. The data indicate that oxygen-derived free radicals play a role in ischemic injury to the stomach and that the hydroxyl radical, a secondary radical produced from the superoxide anion, appears to be the major oxygen radical contributing to ischemic damage.

Topics: Allopurinol; Animals; Cats; Dimethyl Sulfoxide; Free Radicals; Gastric Mucosa; Ischemia; Oxygen; Stomach; Superoxide Dismutase; Xanthine Oxidase

Topics: Animals; Dermatologic Surgical Procedures; Free Radicals; Graft Survival; Hematoma; Ischemia; Male; Malondialdehyde; Necrosis; Rats; Rats, Inbred F344; Skin; Surgical Flaps; Xanthine Oxidase

In an attempt to define why the joint synovial cavity is prone to develop persistent synovial inflammation we show that hypoxia is induced by pressure changes caused by exercise in the presence of an inflammatory effusion. On resting 'reperfusion injury' may take place. The biochemistry of reperfusion injury has only recently been defined and perhaps surprisingly for an insult that has hypoxia as its central ingredient involves the subsequent production of oxygen derived free radical species. We apply the reaction sequences that are believed to occur during hypoxic/reperfusion injury to the joint synovial cavity and, on the basis of reported 'in vivo' observations, suggest novel therapeutic approaches that we believe are applicable to the treatment of persistent synovial inflammation.

Topics: Animals; Cats; Chronic Disease; Free Radicals; Humans; Hypoxia; Ischemia; Knee Joint; Oxygen; Partial Pressure; Perfusion; Physical Exertion; Rats; Synovitis; Xanthine Oxidase; Xanthines

After renal ischemia, oxygen free radicals are formed and produce tissue injury, in large part, through peroxidation of polyunsaturated fatty acids. We used an in vivo method to monitor lipid peroxidation after renal ischemia, the measurement of ethane in expired gas, to determine the time course of lipid peroxidation and the effect of several agents to limit lipid peroxidation after renal ischemia. In anesthetized rats there was no significant increase in ethane production during 60 min of renal ischemia. During the first 10 min of renal reperfusion, there was a prompt increase in ethane production from 2.9 +/- 1.3 to 6.3 +/- 1.9 pmol/min (P less than 0.05). Ethane production was significantly increased during the first 50 min of reperfusion and then rapidly tapered to base-line levels. Preischemic administration of allopurinol to prevent superoxide radical generation or the superoxide radical scavenger superoxide dismutase prevented the increase in ethane production during postischemic reperfusion. These studies confirm that there is increase lipid peroxidation following renal ischemia that can be prevented by agents which limit the formation or accumulation of oxygen free radicals. This in vivo method for measuring lipid peroxidation could also be employed to study the effects of ischemia on lipid peroxidation in other organs, as well as to monitor lipid peroxidation in other forms of injury.

Topics: Allopurinol; Animals; Ethane; Ischemia; Lipid Peroxides; Male; Rats; Rats, Inbred Strains; Renal Circulation; Superoxide Dismutase

Changes in deformability of rabbit and human erythrocytes caused by exposure in vitro to the oxygen free radical generator hypoxanthine and xanthine oxidase were studied. The deformability reduction observed after 30 min of exposure to hypoxanthine-xanthine oxidase could be prevented by pretreatment with SOD, while after only 5 min of such exposure allopurinol and catalase also appeared to have a protective effect. Exposure of human erythrocytes to hypoxanthine and xanthine oxidase in Krebs solution prevented an otherwise occurring hemolysis. Exposure to both substances or to xanthine oxidase alone in Dulbeccos phosphate solution produced a reduction in deformability. The results indicate that exposure of erythrocytes to free oxygen radicals reduces deformability and that this effect may contribute to the myocardial dysfunction and the epicardial erythrostasis observed during open-heart surgery.

Topics: Adult; Animals; Erythrocyte Deformability; Free Radicals; Humans; Hypoxanthine; Hypoxanthines; Ischemia; Male; Oxygen; Rabbits; Superoxide Dismutase; Xanthine Oxidase

Recent experimental work has suggested that oxygen-derived free radicals may play an important role in initiating the early capillary injury in acute pancreatitis. Data from models of ischemic injury in other organs have suggested the enzyme xanthine oxidase is important in generating oxygen-derived free radicals. The present study was performed to determine whether xanthine oxidase is the source of free radical production in experimental pancreatitis. Utilizing the isolated, perfused, ex vivo canine pancreas preparation, three models of pancreatitis were initiated with (1) free fatty acid infusion (FFA), (2) partial duct obstruction and secretin stimulation (POSS), and (3) ischemia (ISCH). In each model, during a 4-hour perfusion, edema developed, weight gain occurred (FFA 120.6 +/- 21.1 gm; POSS 44.5 +/- 6.9 gm; ISCH 63.3 +/- 14.0 gm), and the serum amylase became elevated (FFA 1827 +/- 397 u/dl; POSS 10,171 +/- 1487 u/dl; ISCH 1860 +/- 365 u/dl). When the xanthine oxidase enzyme inhibitor allopurinol was added to the perfusate prior to the 4-hour perfusion, edema formation was absent or minimal, weight gain was significantly less (FFA 15.2 +/- 2.5 gm p less than 0.05; POSS 8.8 +/- 2.7 gm p less than 0.001; ISCH 12.3 +/- 2.8 gm p less than 0.01), and the amylase remained normal or the elevation was significantly decreased (FFA 996 +/- 189 u/dl p less than 0.05; POSS 3021 +/- 1074 u/dl p less than 0.001; ISCH 993 +/- 214 u/dl p less than 0.002). These data confirm that oxygen-derived free radicals play an important role in the pathogenesis of experimental acute pancreatitis, and suggest that the enzyme xanthine oxidase may well be the source of their production.

Topics: Acute Disease; Allopurinol; Amylases; Animals; Cholelithiasis; Dogs; Fatty Acids, Nonesterified; Free Radicals; Ischemia; Models, Biological; Organ Size; Oxygen; Pancreas; Pancreatitis; Perfusion; Xanthine Oxidase

This study was designed to determine whether oxygen-derived free radicals play a role in the pathogenesis of gastric lesions produced by hypotensive ischemia in the rat. To achieve this goal, allopurinol, an inhibitor of xanthine oxidase (the enzyme responsible for the formation of superoxide radicals); superoxide dismutase, a scavenger of superoxide radicals (O2-); and dimethyl sulfoxide, a scavenger of hydroxyl radicals (OH) were used. In the anesthetized rat, HCl (0.1 N) was instilled into the pylorus-ligated stomach, and the rat was bled to reduce the blood pressure to less than 30 mmHg. The blood pressure was maintained at less than 30 mmHg for 20 min and then the shed blood was retransfused. Twenty minutes after the retransfusion the rat was killed, the stomach was removed, and the area of gastric mucosal lesions was measured. Both allopurinol and superoxide dismutase, but not dimethyl sulfoxide, significantly protected against hemorrhagic shock-induced gastric lesions. These findings suggest that oxygen-derived free radicals, particularly O2-, play an important role in the formation of gastric lesions produced by ischemia plus HCl.

Topics: Allopurinol; Animals; Blood Pressure; Dimethyl Sulfoxide; Free Radicals; Gastric Mucosa; Hydroxides; Hydroxyl Radical; Ischemia; Male; Rats; Rats, Inbred Strains; Shock, Hemorrhagic; Stomach Diseases; Superoxide Dismutase; Superoxides

Characteristic mucosal lesions develop in the small intestine during ischaemia and hypotension. This tissue damage can be further aggravated in the immediate reperfusion phase, presumably secondary to the generation of oxygen free radicals which have been proposed to be generated in this situation through the hypoxanthine-xanthine oxidase system. This was further investigated in the cat small intestine using a standardized regional intestinal hypotension model in which the effects of allopurinol (a xanthine oxidase inhibitor) were compared to those of an exogenous supply of inosine. The grade of mucosal damage, the nucleotide levels, the concentrations of hypoxanthine, total and oxidized glutathione, and of conjugated dienes were measured in the intestinal tissue. The results indicate that oxygen radicals generated by xanthine oxidase are very important, but not the only significant factor in the small intestinal reperfusion damage.

Topics: Adenosine Diphosphate; Adenosine Monophosphate; Adenosine Triphosphate; Allopurinol; Animals; Cats; Female; Glutathione; Hypotension; Hypoxanthine; Hypoxanthines; Inosine; Inosine Monophosphate; Intestinal Mucosa; Intestine, Small; Ischemia; Male; Oxidation-Reduction; Superoxides

Superoxide anion free radical (O2-.) has been implicated in the pathogenesis of tissue injury consequent to ischemia/reperfusion in several different organs, including heart and bowel. Superoxide dismutase (SOD), an enzyme free radical scavenger specific for O2-., has been used successfully to protect these organs from structural damage during reoxygenation of ischemic tissue. It has been suggested that the catalytic action of xanthine oxidase in injured tissue is an important source of O2-. during reoxygenation. In order to evaluate the potential of SOD to protect against kidney damage resulting from transient ischemia followed by reperfusion with oxygenated blood, a model of warm renal ischemia was studied. LBNF1 rats underwent right nephrectomy and occlusion of the left renal artery for 45 minutes. Survival in the group of ischemic untreated rats (N = 30) was 56% at 7 days and serum creatinine was greatly elevated (p less than 0.01) in rats remaining alive over the full 7-day period. In strong contrast to these results, all of the animals treated with SOD before reperfusion (N = 18) were alive after 7 days similar to sham operated control rats (N = 8). Serum creatinine in the SOD treated rats was significantly elevated only to postoperative day 3 and thereafter returned to normal. Rats treated with inactive SOD (N = 4) or SOD before ischemia (N = 4) had decreased survival rates compared to ischemic untreated animals and prolonged elevation of serum creatinine. When the ischemia time was extended to 60 minutes, only 19% of the untreated animals (N = 16) survived at 7 days whereas nearly 60% of the SOD-treated animals survived (N = 19). Serum creatinine was greatly elevated during the full 7-day observation period in all surviving rats in the untreated ischemic group, whereas serum creatinine returned to normal (p less than 0.05) after 4 days in the surviving rats treated with SOD. To test whether the action of xanthine oxidase contributed to the kidney damage after reoxygenation, 45 min. ischemic rat kidneys were treated with allopurinol. All of the animals treated with allopurinol (N = 12) were alive at 7 days. Serum creatinine values returned to normal after the episode of ischemia and reperfusion but more slowly than after SOD treatment. Histologic evaluation of kidney tissue taken from animals after ischemia alone showed extensive renal tubular damage, which was essentially absent in kidneys from SOD-treated animals.(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Allopurinol; Animals; Free Radicals; Ischemia; Kidney; Male; Oxygen; Rats; Rats, Inbred Strains; Superoxide Dismutase; Xanthine Oxidase

We evaluated the hypothesis that postischemic renal failure is caused primarily at reperfusion by oxygen-derived free radicals in a swine model designed to realistically mimick human cadaveric renal transplantation. Both kidneys were removed, flushed with Euro-Collins solution, stored 24 hr at 4 degrees C, and then transplanted to a second pig. Experiments were paired, each pig receiving one treated and one control kidney. All pigs received the optimal conventional regimen of hydration, phenoxybenzamine, furosemide, and mannitol to allow assessment of free radical treatment superimposed thereupon. Two days later creatinine clearance (CCR) was measured from each kidney via separate ureterostomies. Untreated kidneys developed severe functional impairment, CCR falling from a normal level of 25.5 +/- 6.3 ml/min (n = 8) to 7.7 +/- 0.9 ml/min (n = 14, P less than .05 vs. control). The infusion of 20 mg of the free radical scavenger superoxide dismutase (SOD) into the renal artery at reperfusion substantially ameliorated this injury (CCR = 15.9 +/- 1.7 ml/min, n = 18, P less than 0.05 vs. control). A dose-response curve to SOD showed no effect of doses of 0.2 mg (CCR = 8.0 +/- 1.1 ml/min, n = 4) or 2 mg (CCR = 7.7 +/- 0.9, n = 5), and no greater benefit from 100 mg (CCR = 16.1 +/- 2.1 ml/min, n = 3, P less than 0.05 vs. control). Blocking the generation of superoxide radicals from xanthine oxidase with allopurinol (50 mg/kg) afforded similar protection (CCR = 18.2 +/- 1.8; n = 11, P less than 0.01 vs. control). On the other hand, following an 18-hr period of cold ischemia, little damage was sustained by the untreated (control) kidneys (CCR = 22.1 +/- 0.6 ml/min). Consequently, under these conditions the ablation of free radical generation with allopurinol provided no significant benefit. These findings suggest that after a critical period of cold ischemic preservation, metabolic changes take place within the kidney that lead to free radical generation and consequent tissue injury upon reperfusion, despite optimal preservation by conventional methods. This damage can be prevented by simple nontoxic measures--which, therefore, show great promise for use in the prevention of early renal failure following cadaveric renal transplantation.

Topics: Allopurinol; Animals; Cattle; Cold Temperature; Creatinine; Female; Free Radicals; Ischemia; Kidney; Kidney Transplantation; Superoxide Dismutase; Swine; Tissue Preservation

The effect of allopurinol on protein synthesis, tissue water, and adenine nucleotides in liver tissue during and after a period of liver ischemia was investigated in rats. Ischemia was induced in the left and median liver lobes for 1 hour and experiments were continued for 2 hours after reperfusion. One group of animals (n = 20) received allopurinol (50 mg/kg body weight) intravenously 10 minutes before induction of liver ischemia. Control rats (n = 20) were given a corresponding volume of saline solution. Protein synthesis was measured by determining the rate of amino acid incorporation into protein in incubated liver slices. The reduction of protein synthesis and energy level in liver tissue and the increase of hepatic tissue water were similar in both groups of animals at the end of the ischemic period. During reperfusion the protein synthesis rate was higher and hepatic tissue water was lower in allopurinol-treated animals than in control rats. No significant differences in hepatic adenine nucleotides were found between the two groups of rats during ischemia or after reperfusion. The results demonstrated that improved protein synthesis and reduced tissue water in the postischemic liver after administration of allopurinol were not the result of improved restoration of adenine nucleotides. Inhibited production of oxygen-free radicals might be one mechanism by which allopurinol exerted its beneficial effect after liver ischemia.

Topics: Adenine Nucleotides; Allopurinol; Animals; Biopsy; Extracellular Space; Intracellular Fluid; Ischemia; Leucine; Liver; Male; Perfusion; Protein Biosynthesis; Rats; Rats, Inbred Strains

Previous studies indicate that vascular permeability is increased in skeletal muscle subjected to 4 hours of inflow occlusion. However, the mechanism(s) underlying the increase in permeability are unknown. The aim of this study was to assess the role of oxygen-derived free radicals and histamine as putative mediators of the increased permeability in skeletal muscle subjected to 4 hours of inflow occlusion. The osmotic reflection coefficient for total plasma proteins and isogravimetric capillary pressure were estimated in canine gracilis muscle for the following conditions: control, ischemia, and ischemia plus pretreatment with allopurinol (a xanthine oxidase inhibitor), catalase (a peroxidase that reduces hydrogen peroxide to water and molecular oxygen), superoxide dismutase (a superoxide anion scavenger), dimethyl sulfoxide (a hydroxyl radical scavenger), diphenhydramine (a histamine H1-receptor blocker), or cimetidine (a histamine H2-receptor blocker). Ischemia, followed by reperfusion, significantly reduced the reflection coefficient from 0.94 +/- 0.02 to 0.64 +/- 0.02 and isogravimetric capillary pressure from 13.8 +/- 1.0 mm Hg to 6.9 +/- 0.4 mmHg, indicating a dramatic increase in microvascular permeability. Prior treatment with diphenhydramine or cimetidine did not significantly alter the permeability increase induced by ischemia. However, pretreatment with allopurinol, catalase, superoxide dismutase, or dimethylsulfoxide did significantly attenuate the increase in vascular permeability. The results of this study indicate that oxygen radicals are primarily responsible for the increased vascular permeability produced by ischemia-reperfusion, that the hydroxyl radical may represent the primary damaging radical, and that xanthine oxidase may represent the primary source of oxygen-derived free radicals in ischemic skeletal muscle.

Topics: Allopurinol; Animals; Blood Flow Velocity; Blood Pressure; Capillaries; Capillary Permeability; Catalase; Cimetidine; Dimethyl Sulfoxide; Diphenhydramine; Dogs; Female; Free Radicals; Ischemia; Male; Muscles; Osmotic Pressure; Oxygen; Superoxide Dismutase; Vascular Resistance

Regional intestinal ischemia in cats resulted in an accumulation of hypoxanthine within 2 h, the concentration of which rose from 0.062 to 1.131 nmol/mg protein. A similar rise in AMP content (from 0.5 to 3.2 nmol/mg protein) was observed, but not in the ADP level. In parallel, ATP content decreased from 7.5 to 2.8 nmol/mg protein. Reperfusion of the ischemic tissue was followed by rapid metabolism of the purine metabolites; after 1 h of reperfusion the tissue level of hypoxanthine was 0.186 nmol/mg protein, of AMP 0.7 nmol/mg protein, and of ATP 4.3 nmol/mg protein. The oxidation of hypoxanthine, mediated by xanthine oxidase, is accompanied by the release of superoxide ions. Consequently, the concentration of oxidized glutathione was doubled upon reperfusion, while marked lipid peroxidation took place, as evidenced by the rise in conjugated diene content from 2.8 mumol/g tissue before reperfusion to 5.6 mumol/g tissue after 10 min of reoxygenation. In line with these findings is the fact that histologically observable damage occurred mainly in the presence of oxygen. These data indicate that, at least in our model, rapid reoxygenation is a major cause of "ischemic" tissue damage.

Topics: Adenine Nucleotides; Animals; Cats; Glutathione; Hypoxanthine; Hypoxanthines; Intestine, Small; Ischemia; Lipid Peroxides; Oxygen; Superoxides; Xanthine Oxidase

Topics: Allopurinol; Animals; Cats; Dermatologic Surgical Procedures; Dogs; Free Radicals; Humans; Ischemia; Rats; Superoxide Dismutase; Surgical Flaps

The results of previous studies indicate that oxygen-derived free radicals are responsible for the increased vascular permeability produced by 1 h of intestinal ischemia. The aims of this study were 1) to test the hypothesis that the enzyme xanthine oxidase is the source of oxygen radicals in the ischemic bowel and 2) to assess the role of the hydroxyl radical in the ischemia-induced vascular injury. The capillary osmotic reflection coefficient was estimated from lymphatic protein flux data in the cat ileum for the following conditions: ischemia, ischemia plus pretreatment with allopurinol (a xanthine oxidase inhibitor), and ischemia plus pretreatment with dimethyl sulfoxide (a hydroxyl radical scavenger). The increased vascular permeability produced by ischemia was largely prevented by pretreatment with either allopurinol or dimethyl sulfoxide. These findings support the hypothesis that xanthine oxidase is the source of oxygen radicals produced during ischemia. The results also indicate that hydroxyl radicals, derived from the superoxide anion, are primarily responsible for the vascular injury associated with intestinal ischemia.

Topics: Allopurinol; Animals; Cats; Dimethyl Sulfoxide; Free Radicals; Hydroxides; Hydroxyl Radical; Ileum; Ischemia; Microcirculation; Xanthine Oxidase

Topics: Cell Membrane; Disease; Electron Transport Complex IV; Free Radicals; Humans; Intestinal Mucosa; Ischemia; Oxygen; Superoxide Dismutase; Xanthine Oxidase

Hemorrhagic lesions in the small intestinal mucosa have been demonstrated in humans and experimental animals following hemorrhagic shock and intestinal ischemia. In order to define the role of superoxide radicals and xanthine oxidase in the pathogenesis of the mucosal lesions, we compared the microscopic mucosal changes produced by 3 h of regional hypotension (intestinal arterial pressure = 30 mmHg) in untreated cats and cats pretreated with either superoxide dismutase or allopurinol. In the untreated animals the mucosa was characterized by massive epithelial lifting down the sides of the villi, completely denuded villi, and most frequently by disintegration of the lamina propria, hemorrhage, and ulceration. Pretreatment with either superoxide dismutase or allopurinol significantly attenuated the necrosis of villus and crypt epithelium produced by 3 h of ischemia. The results of this study suggest that superoxide radicals are involved in the pathogenesis of ischemic mucosal lesions and that the enzyme xanthine oxidase is the source of superoxide radicals in the ischemic small bowel.

Topics: Allopurinol; Animals; Cats; Female; Intestinal Mucosa; Intestine, Small; Ischemia; Male; Oxygen; Premedication; Pressure; Shock, Hemorrhagic; Superoxide Dismutase; Superoxides; Xanthine Oxidase

The superoxide radical plays major roles in the neutrophil-medicated acute inflammatory response and in postischemic tissue injury, although the sources and actions of the radical are quite different in these two pathological states. While neutrophils produce superoxide for the primary purpose of aiding in the killing of ingested microbes, a second useful function has evolved. The superoxide released from actively phagocytosing neutrophils serves to attract more neutrophils by reacting with, and activating, a latent chemotactic factor present in plasma. Superoxide dismutase, by preventing the activation of this superoxide-dependent chemotactic factor, exerts potent anti-inflammatory action. During ischemia, energy-starved tissues catabolize ATP to hypoxanthine. Calcium transients in these cells appear to activate a calmodulin regulated protease which attacks the enzyme xanthine dehydrogenase, converting it to a xanthine oxidase capable of superoxide generation. When the tissue is reperfused and reoxygenated, all the necessary components are present (xanthine oxidase, hypoxanthine, and oxygen) to produce a burst of superoxide which results in extensive tissue damage. Ischemic tissues are protected by superoxide dismutase or allupurinol, an inhibitor of xanthine oxidase.

Topics: Animals; Free Radicals; Humans; In Vitro Techniques; Inflammation; Ischemia; Nephritis; Neutrophils; Oxidation-Reduction; Oxygen; Superoxide Dismutase; Superoxides; Xanthine Oxidase

Mucosal albumin clearance was measured in jejunal segments of dogs under control conditions, after arterial occlusions of varying duration (15 min-4 h), and during intraluminal perfusion with hypoxanthine-xanthine oxidase. Albumin clearance rates were estimated from the luminal perfusion rate and the activity of protein-bound 125I in the perfusate and plasma. Arterial occlusion of 30-min to 4-h duration produced a significant increase in mucosal albumin clearance. The magnitude of the rise in albumin clearance was directly related to the duration of arterial occlusion. Pretreatment with superoxide dismutase, a superoxide radical scavenger, or allopurinol, a xanthine oxidase inhibitor, did not prevent the increased albumin clearance induced by 1 h of occlusion. Intraluminal perfusion with hypoxanthine-xanthine oxidase significantly increased mucosal albumin clearances. This increase was prevented by superoxide dismutase. The results of this study indicate that arterial occlusions and enzymatically generated superoxide radicals increase mucosal albumin clearance.

Topics: Albumins; Animals; Dogs; Female; Free Radicals; Intestinal Mucosa; Iodine Radioisotopes; Ischemia; Male; Metabolic Clearance Rate; Oxygen; Superoxide Dismutase; Time Factors; Xanthine Oxidase

Topics: Adenine Nucleotides; Allopurinol; Animals; Inosine; Ischemia; Kidney; Mannitol; Rabbits

Allopurinol, acting as a metabolic depressant, significantly increases flap survival in high doses, but not at doses that might be acceptable clinically. Prednisolone is highly effective in improving flap survival when the afferent blood supply is provided by small arteries such as are found in the panniculus carnosus of rabbits and in axial pattern flaps. I feel that the study should encourage plastic surgeons to experiment with drugs that sustain metabolism during ischemic periods, as a means of improving flap survival. In situations in which ischemia can be anticipated, its effects may be minimized by using such drugs before the insult.

Topics: Allopurinol; Animals; Graft Survival; Ischemia; Necrosis; Prednisolone; Rabbits; Skin; Surgical Flaps

A new model for the study of ischemic liver lesion on rats has been worked out. Pretreatment with allopurinol, dibenzyline, methylprednisolone, glucagon, ATP-MgCl2 and aspartic acid reduced the overall mortality of ischemic liver injury. Administered after the anoxic hepatic lesion only glucagon and aspartic acid had beneficial effect on the survival rate. Under the influence of 30 minutes of normothermal ischemia the DNA synthetizing ability of the liver decreased. Aspartic acid, glucagon and ATP-MgCl2 significantly enhanced the regeneration of the ischemically damaged liver. These procedures might be suitable for donor pretreatment in liver transplantation, as well as for the treatment of other pathological states, causing a normothermal ischemia of the liver.

Topics: Adenosine Triphosphate; Allopurinol; Animals; Aspartic Acid; Chlorides; Glucagon; Ischemia; Liver; Liver Regeneration; Magnesium; Methylprednisolone; Phenoxybenzamine; Rats

The collapsed left lungs of dogs were subjected to 1 hour of normothermic ischemia in situ followed by immediate ligation of the contralateral pulmonary artery. Adenosine in a dose of 50 mg/kg prolonged the survival of the dogs significantly. In the survivors only transient changes in the chest x-ray were seen, and no changes in arterial oxygenation were observed. The pulmonary architecture was well preserved on histological studies 14 days after operation. Animals whose ischemic lungs were not protected by adenosine showed an immediate drop in arterial oxygenation and a massive infiltrate of the ischemic lung. Histological study of the lungs showed a complete breakdown of the capillary-alveolar barrier. Allopurinol alone was ineffective by itself and was not able to improve the survival achieved with adenosine further. We conclude that it is possible to prolong the tolerance of a deflated lung to normothermic ischemia by pretreatment with adenosine.

Topics: Adenosine; Allopurinol; Animals; Dogs; Female; Ischemia; Ligation; Lung; Lung Transplantation; Male; Models, Biological; Organ Preservation; Pulmonary Artery

A method is described by which plasma or serum concentrations of uric acid and hypoxanthine/xanthine may be determined in a two-step sequential method. The principle of the method is that hydrogen peroxide, liberated by the action of uricase and xanthine oxidase on their substrates, is coupled to the production of a coloured product.

Topics: Humans; Hypoxanthines; Ischemia; Methods; Urate Oxidase; Uric Acid; Xanthine Oxidase; Xanthines

Rats were anesthetized and their lift kidneys were made ischemic for 1 h by clamping of the aorta just above the left renal artery. Mannitol (2.5 g/kg), Dextran 70 (0.6 g/kg), methylprednisolone (50 and 100 mg/kg), and allopurinol (100 mg/kg body weight) were administered before, during, or after the ischemia period in order to test the effect of each of these drugs upon this model of renal injury. At 24 h after the release of the aortic clamp the left kidneys of the drug treated animals wwere perfusion fixed and processed for light and electron microscopy. Dextran administration to animals with ischemic kidneys gave rise to a pronounced vacuolization ("osmotic nephrosis"), in the entire proximal tubule and especially in the pars recta. This was in contrast to dextran administration to rats with nonischemic kidenys, which showed no or very mild "osmotic nephrosis." This demonstrates that ischemia makes rat kidneys more susceptible to the development of "osmotic nephrosis." In controls (no drug treatment) one hour of renal ischemia gave partial necrosis of pars recta of the proximal tubule, while the pars convoluta tubule survived. Mannitol treatment significantly reduced the amount of necrosis of the pars recta, whereas dextran, methylprednisolone, and allopurinol had no or a negative effect on the survival of the cells of the pars recta segment. It is suggested that mannitol protects against the development of necrosis by increasing medullary blood flow in combination with a counteractive influence on the cellular swelling, which is known to occur in ischemia.

Topics: Allopurinol; Animals; Dextrans; Ischemia; Kidney Tubules, Proximal; Male; Mannitol; Methylprednisolone; Microscopy, Electron; Necrosis; Rats; Shock

The function of rat kidneys subjected to 60 minutes of warm ischaemia at body-temperature was notably protected by the prior administration of the purine nucleoside inosine as a 40 mg/ml solution maintained at 37 degrees C. With direct intrarenal arterial perfusion of the kidney at the onset of ischaemia or with intraperitoneal (i.p.) injection 40 minutes before ischaemia, the plasma-creatinine at 24 hours was significantly lower (P less than 0-001) than that of untreated 60-minute-ischaemia controls and not significantly different from that of non-ischaemic unilateral-nephrectomy controls. Intravenous inosine 20 minutes beforehand also afforded significant (P less than 0-01) protection. 7-day survival was 100% in 30 inosine-pretreated rats and 65% in 45 rats with all other types of pre-treatment (P less than 0-001). Although i.p. adenosine was better (P less than 0-05) than no treatment, i.p. inosine was better (P less than 0-02) than i.p. adenosine. Allopurinol, phenoxybenzamine, A.T.P., or cyclic A.M.P. caused no improvement over controls. Kidneys perfused with inosine maintained higher purine-nucleotide levels during ischaemia and rapidly resynthesised A.T.P. when blood-flow was restored in vivo.

Topics: Adenosine; Adenosine Triphosphate; Allopurinol; Animals; Creatinine; Cyclic AMP; Inosine; Ischemia; Kidney; Kidney Transplantation; Organ Preservation; Perfusion; Phenoxybenzamine; Rats; Rats, Inbred Strains; Tissue Preservation; Tissue Survival

We have confirmed earlier findings that treatment with allopurinol offers some protection to the kidney from ischemic damage caused by total interruption of renal circulation. With this evidence, a clinical trial is warranted, particularly when periods of warm ischemia are unavoidable.

Topics: Allopurinol; Animals; Dogs; Female; Ischemia; Kidney; Male

Canine livers ischemically damaged for thirty minutes prior to auxiliary transplantation did not survive for long periods of time unless a combination of isoproterenol, allopurinol, and heparin was administered intravenously to the donor animal before the ischemic damage. These drugs had no protective effect when given individually. Ischemic livers treated with adenosine prior to transplantation also showed no improved recovery of function.

Topics: Adenosine; Allopurinol; Animals; Dogs; Heparin; Ischemia; Isoproterenol; Liver; Liver Circulation; Liver Function Tests; Liver Transplantation; Tissue Donors; Transplantation, Homologous

Topics: Allopurinol; Animals; Creatinine; Dogs; Ischemia; Kidney Transplantation; Transplantation Immunology; Transplantation, Autologous

Topics: Allopurinol; Animals; Dogs; Ischemia; Kidney; Methylprednisolone; Uremia

Topics: Adenosine Triphosphate; Allopurinol; Animals; Body Temperature; Creatinine; Depression, Chemical; Ischemia; Kidney; Potassium; Regional Blood Flow; Swine; Time Factors

Topics: Allopurinol; Animals; Creatinine; Dogs; Drug Therapy, Combination; Graft Rejection; Hypoxanthines; Ischemia; Kidney; Kidney Transplantation; Shock, Hemorrhagic; Transplantation, Homologous; Uric Acid

Topics: Allopurinol; Animals; Cadaver; Cold Temperature; Diuretics; Dogs; Humans; Ischemia; Kidney; Kidney Transplantation; Methylprednisolone; Organ Preservation; Perfusion; Phenoxybenzamine; Phentolamine; Tissue Preservation

Topics: Allopurinol; Animals; Chlorpromazine; Dogs; Hypothermia; Ischemia; Kidney Transplantation; Methylprednisolone; Phenoxybenzamine; Tissue Preservation; Tissue Survival; Transplantation, Autologous

Topics: Adenine Nucleotides; Adenosine Diphosphate; Adenosine Monophosphate; Adenosine Triphosphate; Allopurinol; Animals; Ischemia; Kidney; Rats

Topics: Allopurinol; Animals; Creatinine; Dogs; Ischemia; Kidney; Kidney Transplantation; Perfusion; Postoperative Complications; Premedication; Preoperative Care; Transplantation, Homologous

Topics: Allopurinol; Animals; Chlorpromazine; Dogs; Injections, Intravenous; Intestine, Small; Ischemia; Methylprednisolone; Perfusion; Tissue Preservation; Tissue Survival; Transplantation, Homologous

Topics: Adenosine; Adenosine Monophosphate; Adenosine Triphosphatases; Adenosine Triphosphate; Aminohydrolases; Cesarean Section; Chromatography, Paper; Female; Humans; Hypoxanthines; Inosine; Ischemia; Labor, Obstetric; Nucleotidases; Pentosyltransferases; Phosphotransferases; Placenta; Pregnancy; Spectrophotometry, Ultraviolet; Time Factors; Xanthine Oxidase

Topics: Allopurinol; Animals; Blood Coagulation; Blood Pressure; Cardiac Output; Dogs; Heart; Heart Rate; Heparin; Hindlimb; Hypoxanthines; Hypoxia; Ischemia; Plasma Substitutes; Shock, Hemorrhagic; Tourniquets; Xanthine Oxidase

Topics: Allopurinol; Animals; Aspartate Aminotransferases; Autopsy; Blood Urea Nitrogen; Creatinine; Dogs; Female; Hypoxia; Ischemia; Kidney; L-Lactate Dehydrogenase; Male; Nephrectomy; Radiography; Renal Artery Obstruction; Time Factors; Uric Acid

Topics: Allopurinol; Animals; Blood Pressure; Cardiac Catheterization; Cardiac Output; Coronary Disease; Coronary Vessels; Dogs; Dye Dilution Technique; Electrocardiography; Heart Rate; Ischemia; Myocardium; Phosphorus; Potassium; Sheep; Sodium; Uric Acid; Vascular Resistance; Venous Pressure; Xanthine Oxidase

Topics: Alanine Transaminase; Animals; Aspartate Aminotransferases; Cats; Celiac Artery; Intestine, Small; Ischemia; Mesenteric Arteries; Spectrophotometry; Xanthine Oxidase