leukotriene-b4 and Ischemia

Skeletal muscle reperfusion injury following revascularization of an acutely ischaemic limb undoubtedly contributes to the morbidity and mortality of this surgical emergency. This article reviews the experimental evidence which has defined the biochemical events responsible for the pathogenesis of this injury, with particular emphasis on the roles played by free radicals, neutrophils and products of lipid peroxidation. Finally, the clinical relevance of both the local and systemic effects of the injury is considered, together with suggestions for potential therapeutic strategies based on the results of laboratory work.

Topics: Free Radicals; Humans; Ischemia; Leukotriene B4; Lipid Peroxidation; Muscles; Neutrophils; Reactive Oxygen Species; Reperfusion Injury; Thromboxane A2

Several important eicosanoids are produced during ischemic and shock states that may mediate much of the pathogenesis of these disorders. The primary substances of interest are the thromboxanes (e.g., TxA2), and the peptide leukotrienes (e.g., LTC4 and LTD4). TxA2 and the peptide leukotrienes fulfill all the criteria for a mediator in ischemia and shock. They are potent agents that exhibit a multiplicity of serious pathogenic actions. Moreover, inhibition of the formation or actions of TxA2 and the LTs is salutary in shock. TxA2 and the peptide leukotrienes therefore should be considered as important mediators of ischemia and shock, and probably as potent mediators as any known humoral substances in shock.

Topics: Animals; Fatty Acids; Humans; Ischemia; Leukotriene B4; Shock; SRS-A; Thromboxane A2

A variety of eicosanoids are produced in ischemic and circulatory shock. Many of these constrict arteries, induce platelet aggregation or adherence of other blood cells to the vasculature, and contribute to increased membrane permeability. Thromboxane A2, leukotriene C4, and leukotriene D4 fulfill all the criteria stipulated for humoral mediators of ischemia and shock. Moreover, pharmacologic modulation of these mediators by either specific inhibition of their synthesis or antagonism of their arteries at their receptor sites protects against tissue and cell damage during ischemia and shock as well as enhances survival in these life-threatening states.

Topics: Animals; Humans; Ischemia; Leukotriene B4; Prostaglandins; Shock; SRS-A; Thromboxanes; Vasoconstriction

The role of 5-lipoxygenase (5-LOX) in the pathophysiology of renal ischemia/reperfusion (I/R) injury is not known. Here we investigate the effects of 1) the 5-LOX inhibitor zileuton and 2) 5-LOX gene knockout (5-LOX(-/-)) mice on renal dysfunction and injury caused by I/R of the kidney in mice. Wild-type mice treated with zileuton (3 mg/kg i.v.) or 5-LOX(-/-) mice were subjected to bilateral renal artery occlusion (30 min) followed by reperfusion (24 h). Plasma urea, creatinine, and aspartate aminotransferase (AST) were measured as markers of renal dysfunction and reperfusion injury. Kidneys were used for histological evaluation of renal injury. Renal myeloperoxidase activity was measured and used as an indicator of polymorphonuclear leukocyte (PMN) infiltration and renal expression of intercellular adhesion molecule-1 (ICAM-1) was determined using immunohistochemistry. Administration of zileuton before I/R significantly reduced the degree of renal dysfunction (urea, creatinine) and injury (AST, histology). In addition, zileuton reduced the expression of ICAM-1 and the associated PMN infiltration caused by I/R of the mouse kidney. Compared with wild-type mice, the degree of renal dysfunction, injury, and inflammation caused by I/R in 5-LOX(-/-) mice was also significantly reduced, confirming the pathophysiological role of 5-LOX in the development of renal I/R injury. We propose that 1) endogenous 5-LOX metabolites enhance the degree of renal injury, dysfunction, and inflammation caused by I/R of the kidney by promoting the expression of adhesion molecules, and 2) inhibitors of 5-LOX may be useful in the treatment of conditions associated with I/R of the kidney.

Topics: Animals; Arachidonate 5-Lipoxygenase; Disease Models, Animal; Hydroxyurea; Inflammation; Intercellular Adhesion Molecule-1; Ischemia; Kidney Diseases; Leukotriene B4; Lipoxygenase Inhibitors; Mice; Mice, Knockout; Neutrophils; Peroxidase; Reperfusion Injury

Nitric oxide (NO) modulation of ischemia-reperfusion injury was investigated by measuring lipid peroxide and neutrophil accumulation in rat stomachs treated with NG-nitro-L-arginine (L-NNA), a specific NO synthase inhibitor. Ischemia-reperfusion injury was induced in the rat stomach. Treatment with L-NNA for 3 days at a dose of 3 mg/kg/day significantly enhanced this injury. This enhancement was reversed by the simultaneous administration of L-arginine at a dose of 30 mg/kg/day. Both thiobarbituric acid (TBA)-reactive substances, an index of lipid peroxidation, and myeloperoxidase (MPO) activity, an index of tissue-associated neutrophil accumulation, were increased in the gastric mucosa after ischemia-reperfusion. L-NNA treatment enhanced these increases in TBA-reactive substances and MPO activity. The increase in the area of gastric erosions correlated closely with accumulation of TBA-reactive substances as well as the increase in MPO activity. Enhancement of ischemia-reperfusion injury by L-NNA treatment was inhibited by injection with anti-neutrophil antibody, anti-platelet activating factor (PAF) antagonist, and anti-leukotriene B4 (LTB4) receptor antagonist. In addition, the increase in TBA-reactive substances and MPO activity was decreased by these antibodies or antagonists. Enhancement of reperfusion-induced gastric mucosal injury associated with inhibition of NO synthesis may involve neutrophil infiltration and lipid peroxide accumulation in the gastric mucosa, mediated by PAF and LTB4.

Topics: Animals; Enzyme Inhibitors; Gastric Mucosa; Immune Sera; Ischemia; Leukotriene B4; Lipid Peroxidation; Male; Neutrophils; Nitrates; Nitric Oxide; Nitric Oxide Synthase; Nitroarginine; Platelet Aggregation Inhibitors; Rats; Rats, Sprague-Dawley; Reperfusion Injury; Stomach; Thiobarbituric Acid Reactive Substances

Ischemia reperfusion (I/R) injury is one of the leading cause of the transplanted organ loss. In this experimental study, we investigated the effect of captopril on endothelin and eicosanoid release in I/R injury of the kidney. Rats were subjected to 60 min ischemia and 60 min of reperfusion of the left kidney in control and captopril groups. Tissue protein oxidation products, PGE2 and LTB4 levels and plasma endothelin-1 (ET-1) like activity were determined in sham operated, control and captopril groups. There were no differences in the LTB4 levels among the groups. ET-1 and PGE2 levels and protein oxidation products increased in the control group when compared with the sham. Captopril further increased both PGE2 and ET-1 concentrations and prevented protein oxidation. The increased ET-1 concentrations in the captopril treated group may imply the protective role of endothelin as the significant increase in protein oxidation products was reversed by captopril infusion. This has led us to believe that captopril might be useful in preventing I/R injury of the kidney. Also the release of endothelin from the vascular endothelium is increased by captopril and may be mediated by PGE2.

Topics: Animals; Captopril; Dinoprostone; Endothelin-1; Ischemia; Kidney; Leukotriene B4; Male; Oxidative Stress; Proteins; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Reperfusion Injury

To test the hypothesis that ischemia and reperfusion injury may contribute to the cause or nonhealing of venous ulcers, the effects of postural change on the microcirculation of ulcers and on levels of known mediators of reperfusion injury in their venous effluent were studied.. A standard protocol of stabilization (20 minutes), limb dependency (1 hour), and reelevation (2 hours) was used in 10 patients with venous leg ulcers as proven by clinical history, examination, ankle-brachial pressure index, and light reflective rheography. Superficial blood flow in and around ulcers was repeatedly examined with a new laser-Doppler scanning technique. Blood samples from the saphenous vein or a tributary adjacent to the ulcer before dependency and at 0, 10, 30, 60, and 120 minutes after reelevation were analyzed for tumor necrosis factor-alpha, interleukin (IL)-1RA, IL-1 beta, IL-6, platelet-activating factor, thromboxane B2, leukotriene B4, and P-selectin.. Scans showed a consistent pattern of high ulcer blood flow, which decreased on dependency (p < 0.05) and then returned to baseline levels on reelevation and (in 7 of 10) eventually exceeded initial values. Mediator assays showed that levels of platelet-activating factor, IL-1RA, and IL-6 were significantly higher in resting ulcer venous effluent than in systemic venous samples; the reverse was true for P-selectin. There was no statistically significant change in effluent concentration of any mediator as a function of posture, ulcer size, or healing.. Postural vasoregulation causes relative ischemia and reperfusion in venous leg ulcers. However, this is not associated with changes in release of mediators known to be related to reperfusion injury in internal organs.

Topics: Aged; Aged, 80 and over; Blood Pressure; Cytokines; Humans; Interleukin-1; Interleukin-6; Ischemia; Laser-Doppler Flowmetry; Leg; Leukotriene B4; Microcirculation; Middle Aged; P-Selectin; Platelet Activating Factor; Plethysmography, Impedance; Posture; Receptors, Interleukin-1; Regional Blood Flow; Reperfusion Injury; Thromboxane B2; Treatment Outcome; Tumor Necrosis Factor-alpha; Varicose Ulcer; Vasomotor System; Wound Healing

The effects of 48 hr of hypothermic (4 degrees C ischemia) and short-term reperfusion. (I-R) on intestinal function and metabolism were studied in dogs utilizing Collins flush alone or with the putative cytoprotectant amino acid, glycine. Intestinal blood flow after hypothermic ischemia in Collins-flushed segments briefly rose at reperfusion, rapidly declined after 5 min, and plateaued over the 60-minute reperfusion period. Paired intestinal segments flushed with 5 mM glycine demonstrated parallel changes in blood flow over the reperfusion period, but the blood flow values were significantly higher (100-300%), relative to the Collins segments. Intestinal oxygen consumption (VO2) was about 50% of normal nonischemic intestinal segments at all times after reperfusion. The glycine-flushed intestinal segments significantly consumed about 100% more oxygen, relative to the paired control intestines. Intestinal fluid and protein flux into the lumen significantly increased after I-R in both glycine- and Collins-flushed segments. Mucosal tissue myeloperoxidase (MPO) activity, a biochemical marker of neutrophils, significantly increased after 48 hr of cold ischemia with Collins flush and 1 hr of reperfusion, relative to tissue obtained before ischemia. The reperfusion-induced increase in MPO activity was abolished in intestinal segments flushed with glycine. Mucosal synthesis of the chemoattractant leukotriene B4 (LTB4) significantly increased after I-R and glycine flush abolished these increases. Nitric oxide synthesis by mucosal tissue in Collins-flushed segments subjected to 48 hr of hypothermic ischemia and 1 hr of reperfusion was significantly higher, compared with nonischemic tissue or mucosal tissue subjected to cold ischemia without reperfusion. Glycine flush did not alter this pattern of NO synthesis. Light microscopic analysis in both Collins- and glycine-flushed segments revealed that intestinal hypothermic ischemia and reperfusion caused significant morphologic changes characterized by loss of villus epithelium, decreased villus height, and venous congestion. These data indicate that glycine significantly improve oxygenation after hypothermic ischemia and reperfusion and prevented the I-R-induced increase in tissue neutrophil infiltration and leukotriene synthesis.

Topics: Animals; Dogs; Glycine; Hypertonic Solutions; Hypothermia, Induced; Intestinal Mucosa; Intestine, Small; Ischemia; Leukotriene B4; Neutrophils; Nitric Oxide; Organ Preservation; Peroxidase; Reperfusion Injury

The role of nitric oxide in lipoxygenase metabolism after a process of ischemia-reperfusion in pancreas transplantation has been evaluated in this study. Sprague-Dawley rats were randomized into three groups, as follows: Group I--Control animals not surgically manipulated; Group II.--Pancreas transplantation, after 12 h of organ preservation; Group III.--Same as II but with administration of NG-nitro-L-arginine methyl esther (a nitric oxide synthase inhibitor) (10 mg/Kg) prior to organ revascularization. The results show post-transplantation increases in leukotriene B4 and 12-hydroxyeicosatraenoic acid levels in pancreatic tissue. Nitric oxide synthase inhibition reversed the increases in 12-hydroxyeicosatetraenoic acid, but was unable to modify leukotriene B4 increases suggesting the existence of a direct effect of nitric oxide on the 12-lipoxygenase metabolism in pancreas transplantation.

Topics: 12-Hydroxy-5,8,10,14-eicosatetraenoic Acid; Acute Disease; Animals; Arachidonate 12-Lipoxygenase; Enzyme Activation; Enzyme Inhibitors; Free Radicals; Gene Expression Regulation; Ischemia; Leukotriene B4; Male; NG-Nitroarginine Methyl Ester; Nitric Oxide; Nitric Oxide Synthase; Organ Preservation; Pancreas; Pancreas Transplantation; Pancreatitis; Rats; Rats, Sprague-Dawley; Reperfusion Injury

Topics: Animals; Cell Adhesion; Endothelium, Vascular; Free Radicals; Humans; Intestine, Small; Ischemia; Leukocytes; Leukotriene B4; Microcirculation; Models, Biological; Nitrates; Nitric Oxide; Phospholipases A; Platelet Activating Factor; Reperfusion; Superoxides

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

Reperfusion of ischemic tissues leads to eicosanoid- and polymorphonuclear leukocyte (PMN)-dependent injury. The present experiments were undertaken to examine the effect of myocutaneous flap ischemia-reperfusion on neutrophil 5-lipoxygenase activity and to define the role of leukotriene B4 (LTB4) in postischemic PMN infiltration into such composite tissue grafts. Anesthetized Yorkshire pigs underwent 6 h of rectus abdominis myocutaneous flap ischemia or sham ischemia, and LTB4 generation was measured in calcium ionophore-stimulated neutrophils isolated from the circulation. At 30 min of reperfusion, neutrophil generation of LTB4 increased from a baseline value of 31.0 +/- 6.8 to 98.5 +/- 5.1 ng/5 x 10(6) PMN (P < 0.01) and was significantly greater than those neutrophils isolated from animals subjected to sham ischemia and reperfusion (54.3 +/- 4.1 ng/5 x 10(6) PMN; P < 0.01). Pretreatment of animals with the LTB4-receptor antagonist, SC-41930 (n = 5), significantly attenuated reperfusion-associated 5-lipoxygenase activation (60.3 +/- 11.6 ng LTB4/5 x 10(6) PMN; P < 0.01), suggesting the presence of a positive feedback mechanism for eicosanoid biosynthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Arachidonate 5-Lipoxygenase; Benzopyrans; Blood Pressure; Enzyme Activation; Female; Heart Rate; Ischemia; Leukocyte Count; Leukotriene B4; Lipoxygenase Inhibitors; Muscle, Skeletal; Neutrophils; Receptors, Leukotriene B4; Reperfusion; Skin; Surgical Flaps; Swine

The effects of 5- and 15-lipoxygenase products, leukotriene B4 (LTB4) and (8R,15S)-dihydroxyeicosa(5E-9,11,13Z)tetraenoic acid (8R,15S-diHETE), on ischemically sensitive abdominal visceral C fiber afferents were evaluated, because this system is important in sensitizing cutaneous afferents. Single-unit activity of abdominal visceral C fiber afferents was recorded from the right thoracic sympathetic chain of anesthetized cats during 5 min of ischemia. Inhibition of 5-lipoxygenase with WY-50295 tromethamine (5 mg/kg iv) augmented the impulse activity from 0.48 +/- 0.15 to 0.79 +/- 0.24 impulses/s (P < 0.05) in seven ischemically sensitive afferents. Conversely, topical application of LTB4 (125 ng) directly onto the receptive field attenuated impulse activity of 10 ischemically sensitive C fiber afferents from 0.82 +/- 0.23 to 0.42 +/- 0.10 impulses/s (P < 0.05). In additional cats, application of 8R,15S-diHETE (125 ng) onto the receptive field augmented the impulse activity of nine ischemically sensitive C fiber afferents (from 0.48 +/- 0.15 to 0.70 +/- 0.15 impulses/s, P < 0.05) and significantly decreased the mechanical threshold of these nine afferents, whereas application of 8S,15S-diHETE (125 ng), a stereoisomer of 8R,15S-diHETE, attenuated the impulse activity from 0.77 +/- 0.48 to 0.45 +/- 0.13 impulses/s (P < 0.05) in six additional ischemically sensitive C fiber afferents. In animals pretreated with aspirin (50 mg/kg iv, n = 6) or 8S,15S-diHETE (125 ng, n = 6), WY-50295 tromethamine (5 mg/kg iv) still potentiated the impulse activity of ischemically sensitive C fiber afferents. These data indicate that 8R,15S-diHETE interacts with stereospecific receptors to sensitize, whereas LTB4 reduces, the response of abdominal visceral afferents to ischemia. Furthermore the data suggest that the augmented response of afferents to abdominal ischemia after inhibition of 5-lipoxygenase is, at least in part, independent of shunting to the cyclooxygenase or 15-lipoxygenase system.

Topics: Abdomen; Animals; Aspirin; Cats; Electrophysiology; Ischemia; Leukotriene B4; Lipoxygenase; Naphthaleneacetic Acids; Neurons, Afferent; Quinolines; Viscera

During revascularization of skeletal muscle lipid mediators are released that may have a role in the pathogenesis of reperfusion injury. This study investigated the efficacy of the lipid mediator antagonists U74500A (a lipid peroxidation inhibitor), GR32191 (a thromboxane A2 receptor antagonist) and SC41930 (a leukotriene B4 (LTB4) receptor antagonist) in altering muscle viability and oedema, in a rat hindlimb model of 6-h ischaemia and 4-h reperfusion. Study groups comprised normal, ischaemic (6-h ischaemia) and control rats, and animals receiving the lipid mediator antagonists. Ischaemia itself did not result in muscle oedema or necrosis but both occurred following reperfusion (P < 0.01). Muscle viability was preserved by all lipid mediator antagonists (P < 0.01 versus controls, P not significant versus normal and ischaemia), with the LTB4 receptor antagonist ameliorating limb oedema (P < 0.01 versus controls). These results demonstrate a role for lipid mediators in reperfusion injury and suggest that their antagonists might aid the management of acute limb ischaemia.

Topics: Animals; Benzopyrans; Biphenyl Compounds; Edema; Heptanoic Acids; Infarction; Ischemia; Leukotriene B4; Lipid Peroxides; Male; Muscle, Skeletal; Pregnatrienes; Rats; Rats, Sprague-Dawley; Receptors, Thromboxane; Reperfusion Injury

Intravital videomicroscopy was used to monitor the migration of leukocytes in rat mesenteric interstitium following exposure of the mesentery to either N-formylmethionyl-leucyl-phenylalanine (FMLP), leukotriene B4 (LTB4), platelet-activating factor (PAF), or ischemia-reperfusion (I-R). All inflammatory stimuli resulted in interstitial migration rates that were higher than those measured in unstimulated extravasated leukocytes. The median migration rate of cells stimulated with FMLP was significantly higher than those observed during superfusion with either LTB4 or PAF or following exposure to I-R. The enhanced leukocyte migration rates elicited by I-R were not attenuated by treatment with PAF- and LTB4-receptor antagonists, suggesting that these lipid mediators are not the inflammatory mediators responsible for I-R-induced leukocyte migration. Additional experiments revealed that the rate of leukocyte migration associated with FMLP stimulation was not significantly altered by either inhibitors of neutrophilic elastase and cathepsin G, a monoclonal antibody directed against the leukocyte adhesion glycoprotein CD11/CD18, or by altering interstitial hydration. This in vivo model provides a useful new approach for defining the factors that modulate leukocyte migration within the extravascular compartment.

Topics: Animals; Antibodies, Monoclonal; CD18 Antigens; Cephalosporins; Chemotaxis, Leukocyte; Ischemia; Leukocytes; Leukotriene B4; Male; Microscopy, Video; N-Formylmethionine Leucyl-Phenylalanine; Pancreatic Elastase; Platelet Activating Factor; Pyrrolidines; Rats; Rats, Sprague-Dawley; Reperfusion; Serpins; Serum Albumin; Splanchnic Circulation; Time Factors

Six patients undergoing vascular reconstructive surgery were examined for evidence of oxygen-derived free radical (ORF) damage to the protein, immunoglobulin G (IgG). OFR damage was determined as an increase in the fluorescence (ex 360 nm em 454 nm) to ultraviolet absorption (280 nm) ratio of IgG, representing N-Formyl kynurenine and other as yet unidentified fluorophores. The IgG ratio was found to increase slightly during ischaemia and to undergo marked elevation upon reperfusion (275 +/- 405% baseline value at 40 min post-clamp; mean +/- sd). A high ratio was maintained post-reperfusion, even after 60 min reperfusion. Determination of thromboxane B2, (TXB2), leukotriene B4, (LTB4) and 6-keto prostaglandin F1 alpha, (PGF1a), revealed a decrease in their concentrations during ischaemia and a transient, marked increase on reperfusion. Only TXB2 concentrations were found to correlate with the IgG ratio (negative correlation, p < 0.05). No correlation was observed between von Willebrand antigen factor, a marker of endothelial cell damage and fluorescent IgG ratio. However, levels of the factor increased slightly during ischaemia and more sharply upon reperfusion. These preliminary results therefore suggest that a more likely source of the OFRs responsible for IgG damage is endothelial cell xanthine oxidase, rather than cyclo-oxygenase or lipoxygenase.

Topics: Aged; Free Radicals; Humans; Immunoglobulin G; Ischemia; Leg; Leukotriene B4; Middle Aged; Prostaglandins F; Reperfusion Injury; Thromboxane B2; Vascular Surgical Procedures; von Willebrand Factor

The implication of eicosanoid metabolism and its relationship with oxygen free radical production in the process of ischemia-reperfusion associated with rat pancreas transplantation has been explored in this study. For this purpose male Sprague-Dawley rats were classified as follows: group I, control animals not surgically manipulated; group II, pancreas transplantation, after 30 min preservation in UW solution; group III, pancreas transplantation after 12 h preservation under the same conditions; group IV, same as group III but with administration of SOD 5 min prior to organ revascularization. The results show post-transplantation increases in 6-keto-PGF1 alpha, TXB2, LTB4 and 12-HETE in pancreatic tissue independent of preservation time. The fact that SOD administration could reverse these increases even though an efficient xanthine oxidase irreversible inhibitor such as allopurinol was present in the preservation solution suggests that eicosanoid generation in the recipient rat would be mediated by an oxygen free radical dependent mechanism not exclusively dependent on endothelial xanthine oxidase activity.

Topics: 12-Hydroxy-5,8,10,14-eicosatetraenoic Acid; 6-Ketoprostaglandin F1 alpha; Animals; Arachidonic Acid; Cold Temperature; Free Radicals; Hydroxyeicosatetraenoic Acids; Ischemia; Leukotriene B4; Male; Organ Preservation; Pancreas; Pancreas Transplantation; Rats; Rats, Sprague-Dawley; Reperfusion; Superoxide Dismutase; Thromboxane B2

Thromboxane A2, leukotriene B4, and NE are all released from ischemic muscle during reperfusion. Thromboxane A2 levels peaked at 10 min and this potent vasoconstrictor may be responsible for low reflow. Neutrophil elastase levels did not rise until 240 min of reperfusion, following that of leukotriene B4 at 120 min, indicating that neutrophil recruitment and activation is a relatively late event following revascularization. In conclusion, it would appear that endothelial factors have a significant role in the vasomotor changes that account for low reflow. Equally altered neutrophil function almost certainly contributes to the final development of reperfusion injury.

Topics: Animals; Endothelium, Vascular; Ischemia; Leukocyte Elastase; Leukotriene B4; Muscles; Neutrophils; Pancreatic Elastase; Rats; Regional Blood Flow; Reperfusion Injury; Thromboxane B2

Topics: Aortic Aneurysm; Humans; Ischemia; Leukotriene B4; Lung; Lung Diseases; Male; Neutrophils

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

Mesenteric ischemia stimulates both A delta- and C-fiber afferents to reflexly activate the cardiovascular system. Leukotriene B4 (LTB4) concentration is increased in intestinal mucosa following prolonged ischemia (3 h) followed by reperfusion. Because LTB4 sensitizes afferent nerve endings in the skin, we determined whether LTB4 is produced during brief mesenteric ischemia and thus would be present to sensitize afferent nerve endings in the abdominal visceral region. Cannulas were placed in the portal vein and in a mesenteric lymphatic vessel distal to the lymph node. Mesenteric lymph and portal venous immunoreactive LTB4 (iLTB4) and immunoreactive thromboxane B2 (iTxB2) concentrations were measured before, during, and after 5-7 min of ischemia induced by occlusion of the descending thoracic aorta in cats. Simultaneously, lymph and plasma lactate concentrations were measured. During arterial occlusion, femoral arterial pressure dropped to less than 30 mmHg, and portal venous and mesenteric lymph lactate concentrations were increased significantly (3.3 +/- 0.6 to 6.3 +/- 1.0 mM and 5.2 +/- 0.9 to 7.2 +/- 1.1 mM, respectively, P less than 0.05). During ischemia, iLTB4 concentration increased in lymph from 261 +/- 70 to 424 +/- 102 pg/0.1 ml (P less than 0.05) but did not increase in portal venous blood (135 +/- 26 vs. 168 +/- 44 pg/0.1 ml, control vs. ischemia). iTxB2 concentration was not increased during ischemia in either portal venous blood or lymph (12 +/- 4 to 24 +/- 9 pg/0.1 ml and 19 +/- 7 to 24 +/- 11 pg/0.1 ml, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Cats; Intestinal Mucosa; Intestines; Ischemia; Leukotriene B4; Lymph; Osmolar Concentration; Portal Vein; Thromboxane B2; Time Factors

Reperfusion of ischemic hindlimbs leads to leukotriene B4 (LTB4) and polymorphonuclear neutrophil (PMN)-dependent lung injury. Pulmonary mast cells are capable of synthesizing LTB4 and are potential mediators of this inflammatory response. This study tests their role in PMN sequestration and pulmonary edema after hindlimb ischemia. Anesthetized, mast cell-sufficient mice (n = 8) or their congeneic mast cell-deficient strain (n = 8) were subjected to 3 hours of hindlimb ischemia. After another 3 hours of reperfusion, plasma LTB4 levels rose to 651 pg/ml, higher than sham ischemic control (n = 8) values of 202 pg/ml (p less than 0.05). At this time there was sequestration of neutrophils in the pulmonary microcirculation (54 PMN/10 high-power fields [HPF]) and an increase in lung wet/dry weight ratio (W/D) of 4.4. Both these values were higher (p less than 0.05) than those in sham ischemic animals that showed sequestration of 18 PMN/10 HPF and a lung W/D of 3.1. In contrast, mast cell-deficient mice showed an attenuation of ischemia- and reperfusion-induced rise in plasma LTB4 (507 pg/ml), fewer sequestered neutrophils (34 PMNs/10 HPF), and a reduction in lung W/D to 3.9 (all p less than 0.05). To test the role of lung LTB4 in determining PMN sequestration, rats (n = 78) were subjected to 3 hours of hindlimb ischemia. After 3 hours of reperfusion, plasma and bronchoalveolar lavage (BAL) LTB4 concentrations rose to 956 and 211 pg/ml, respectively--higher than sham values of 460 and 121 pg/ml (both p less than 0.05). After 4 hours, plasma LTB4 levels had returned to baseline, whereas BAL LTB4 had increased further to 658 pg/ml, indicating lung origin. Treatment of other rats by localized lung lavage of the lipoxygenase inhibitor diethylcarbamazine (80 mg/kg in 0.1 ml twice) prevented the ischemia- and reperfusion-induced rise in BAL LTB4 (267 pg/ml) and limited local neutrophil sequestration (from 51 PMN/10 HPF after saline aspiration to 36 PMN/10 HPF) and lung W/D (from 4.5 to 4.1) (all p less than 0.05). The data indicate that after hindlimb ischemia pulmonary mast cells and localized LTB4 synthesis mediate, in part, the lung inflammatory response.

Topics: Animals; Bronchoalveolar Lavage Fluid; Cell Count; Diethylcarbamazine; Hindlimb; Ischemia; Leukotriene B4; Male; Mast Cells; Mice; Mice, Inbred Strains; Mice, Mutant Strains; Neutrophils; Pulmonary Edema; Rats; Rats, Inbred Strains; Reperfusion

Epidemiologic observations and experimental studies have demonstrated a protective effect of dietary fish oil on the clinical manifestations of ischemia-reperfusion injury. To investigate the underlying mechanisms, we used the dorsal skinfold chamber model for intravital fluorescence microscopy of the microcirculation in striated muscle of awake hamsters. In control hamsters (n = 7), reperfusion after a 4-hr pressure-induced ischemia to the muscle tissue elicited the adhesion of fluorescently stained leukocytes to the endothelium of postcapillary venules, capillary obstruction, and the break-down of endothelial integrity. These microvascular manifestations of ischemia-reperfusion injury were significantly attenuated in animals (n = 7) when fed with a fish oil-enriched diet for 4 weeks prior to the experiments. In leukocyte total lipids, the fish oil diet resulted in a substantial displacement of arachidonic acid, the precursor of the potent adhesion-promoting leukotriene (LT) B4, by fish oil-derived eicosapentaenoic acid, the precursor of biologically less potent LTB5, emphasizing the mediator role of LTB4 in ischemia-reperfusion injury. These results suggest that the preservation of microvascular perfusion by dietary fish oil contributes to its protective effects on the clinical manifestations of ischemia-reperfusion injury.

Topics: Animals; Blood Viscosity; Cricetinae; Dietary Fats; Fibrinogen; Fish Oils; Hemodynamics; Ischemia; Leukotriene B4; Mesocricetus; Microcirculation; Muscles; Partial Thromboplastin Time; Reperfusion Injury

Pentobarbital-anesthetized rats were subjected to occlusion of both the celiac and superior mesenteric arteries for 90 min followed by reperfusion for 2 h. All seven rats given only the vehicle died within 2 h of reperfusion, whereas rats treated with LY-255283 (3 or 10 mg/kg iv), a leukotriene B4 (LTB4) receptor antagonist given 10 min before reperfusion, exhibited significantly higher survival rates of 57% (4 out of 7) and 75% (6 out of 8), respectively, 2 h after reperfusion. Rats given 1 mg/kg of LY-255283 showed no significant improvement in survival. Splanchnic artery occlusion (SAO)-shock rats treated with LY-255283 (3 or 10 mg/kg) exhibited significantly attenuated accumulation of plasma free amino-nitrogenous compounds and of a myocardial depressant factor. Treatment with LY-255283 (10 mg/kg) markedly (P less than 0.01) ameliorated the deficits of endothelium-dependent relaxation of isolated superior mesenteric artery (SMA) rings in untreated SAO-shock rats. LY-255283 at 10 mg/kg significantly attenuated the increased myeloperoxidase activity in the intestinal tissue of SAO-shock rats. Moreover, LY-189444, a closely related compound having no LTB4 antagonist activity, did not protect rats in SAO shock, whereas a lipoxygenase inhibitor confirmed protection in SAO shock. These results suggest that LTB4 plays a pivotal role in endothelial dysfunction occurring in SAO-shock rats by chemoattraction and activation of neutrophils on the surface of vascular endothelial cells. Moreover, LY-255283 but not LY-189444 inhibited the adherence of rat neutrophils to isolated SMA endothelium.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Arteries; Blood Pressure; Cathepsin D; Constriction; Endothelium, Vascular; Ileum; Ischemia; Leukotriene B4; Male; Neutrophils; Peroxidase; Rats; Rats, Inbred Strains; Reperfusion; Splanchnic Circulation; Tetrazoles

Derivatives of arachidonic acid have been found to play a role in the reperfusion injury of various tissues. These compounds have a broad spectrum of activity, including modulation of white blood cell response to injured tissue. This study was designed to determine the effect of thromboxane and lipoxygenase derivatives on the local and systemic response to ischemia and reperfusion of skeletal muscle. Fifteen dogs were separated into three groups and subjected to gracilis muscle ischemia followed by 2 hours of reperfusion. One group served as controls, one group was treated with OKY-046 (a thromboxane synthetase inhibitor), and one group was treated with diethylcarbamazine (a lipoxygenase inhibitor). White blood cell activation as measured by superoxide anion production, and eicosanoid levels were measured both in the gracilis venous effluent and central venous circulation. These results were compared to infarct size in the gracilis muscle. OKY-046 significantly reduced thromboxane production in both the central venous (102 +/- 30 to 31 +/- 9 pg/ml, p less than 0.05) and gracilis samples (107 +/- 22 to 25 +/- 6 pg/ml, p less than 0.005). This was accompanied by a reduced white cell activation in the central venous blood (15 +/- 1 to 10 +/- 1 nmol O2-, p less than 0.05), but did not affect infarct size or white cell activation in the gracilis. Conversely, diethylcarbamazine significantly reduced both white cell activation (16 +/- 1 to 10 +/- 1 nmol O2-, p less than 0.005) and infarct size in the gracilis muscles (61.6% +/- 4.5% to 28.5% +/- 8.6%, p less than 0.01), as well as reduced systemic white blood cell activation.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: 6-Ketoprostaglandin F1 alpha; Animals; Arachidonic Acids; Cell Survival; Diethylcarbamazine; Dogs; Female; Ischemia; Leukotriene B4; Male; Methacrylates; Muscles; Neutrophils; Reperfusion Injury; Superoxides; Thromboxane B2; Thromboxane-A Synthase

The purpose of this study was to evaluate the role of arachidonic acid metabolites in the reimplantation response after lung transplantation in mongrel dogs. The left lung was used and two groups were studied. Group I underwent hilar stripping, while Group II underwent hilar stripping plus warm ischemia for 60 min., achieved by clamping the left pulmonary artery and veins. We measured the lung wet to dry weight ratio (W/D ratio), total pulmonary vascular resistance (TPVR), and blood and bronchoalveolar lavage fluid (BALF) levels of leukotriene B4 and C4 (LTB4,C4) and thromboxane B2 (TXB2). These parameters were measured periodically for 7 days after reperfusion. In group II, the W/D ratio and TPVR were significantly increased in comparison with Group I. The blood LTC4 level was elevated immediately after reperfusion, and BALF level of LTC4 also rose subsequently. These levels changed concomitantly with the W/D ratio. The above results suggest that arachidonic acid metabolism plays an important role in the reimplantation response, especially in pulmonary edema.

Topics: Animals; Arachidonic Acid; Bronchoalveolar Lavage Fluid; Dogs; Ischemia; Leukotriene B4; Lung; Lung Transplantation; Pulmonary Edema; Reperfusion; SRS-A; Thromboxane B2

Isolated segments of cat small intestine were subjected to 3 hr of ischemia followed by 1 hr reperfusion (I/R). Mucosal biopsies were obtained for measurement of myeloperoxidase (MPO) activity, an index of tissue neutrophil count, and leukotriene B4 (LTB4) production. Animals were pretreated with either cyclosporin A (CsA) or FK506, which are potent immunosuppressants. Both agents significantly attenuated the neutrophil infiltration induced by I/R. FK506, but not CsA, reduced the elevated mucosal LTB4 production normally observed following reperfusion. The results of this study suggest that FK506 and CsA may be important agents in modulating neutrophil infiltration in acute inflammatory conditions.

Topics: Animals; Cats; Cyclosporine; In Vitro Techniques; Intestine, Small; Ischemia; Leukocyte Count; Leukotriene B4; Neutrophils; Peroxidase; Reperfusion Injury; Tacrolimus

The objective of this study was to determine whether hydrogen peroxide, iron, and/or hydroxyl radicals play a role in ischemia/reperfusion (I/R)-induced granulocyte infiltration in the feline small intestine and whether a chemoattractant is formed when superoxide or hydrogen peroxide reacts with feline extracellular fluid. In vivo determinations of granulocyte infiltration consisted of measurements of tissue myeloperoxidase activity in either the intestinal mucosa (I/R studies) or dermis (chemotaxis studies), whereas in vitro measurements of granulocyte migration were obtained using a Boyden chamber. Treatment with either catalase or the iron chelator deferoxamine significantly attenuated granulocyte infiltration into the mucosa induced by reperfusion of the ischemic intestine. Two hydroxyl radical scavengers, dimethyl sulfoxide (DMSO) and dimethylthiourea (DMTU), were also evaluated for their ability to modulate I/R-induced granulocyte infiltration. DMTU significantly attenuated the I/R-induced granulocyte accumulation, whereas DMSO had no effect. In other experiments, we were unable to stimulate granulocyte migration with feline plasma exposed to superoxide-generating systems using both in vitro and in vivo models of leukocyte chemotaxis. However, hydrogen peroxide in the presence of either ferrous iron or hemoglobin did significantly increase the chemotactic activity of cat plasma. The results obtained from our studies suggest that either hydrogen peroxide or radical species derived from the interaction of superoxide and hydrogen peroxide with iron elicit I/R-induced granulocyte infiltration in the intestine.

Topics: Animals; Catalase; Cats; Chemotaxis, Leukocyte; Deferoxamine; Dimethyl Sulfoxide; Granulocytes; Hydrogen Peroxide; Intestinal Mucosa; Intestine, Small; Ischemia; Leukotriene B4; Muscle, Smooth; Peroxidase; Reperfusion; Superoxide Dismutase; Superoxides; Thiourea; Zymosan

Ischemia and reperfusion lead to eicosanoid- and neutrophil (PMN)-dependent injury. This study tests the role of ischemia-induced lipoxygenase activity in mediating PMN activation and diapedesis. Anesthetized rabbits (n = 8) underwent 3 hours of bilateral hindlimb ischemia. At 10 minutes of reperfusion, leukotriene B4 (LTB4) levels in femoral venous effluent were 0.49 +/- 0.05 ng/ml compared with 0.04 +/- 0.07 ng/ml in sham-treated animals (n = 10) (p less than 0.05). Intracellular H2O2 production of circulating PMNs assayed flow cytometrically by dichlorofluorescein (DCF) oxidation, increased from a preischemic value of 74 +/- 14 femtomoles DCF/cell to 135 +/- 8 fmol DCF/cell (p less than 0.05). PMNs were treated with phorbol myristate acetate (PMA), 10(-7) mol/L. In contrast to a 162% increase in H2O2 production before ischemia, PMNs at 10 minutes of reperfusion had an enhanced response to PMA of 336% (p less than 0.05). Addition of authentic LTB4 (0.5 ng/ml) to PMN from sham-treated animals led to their activation, manifest by an oxidative burst, 127 +/- 12 fmol DCF/cell, and an enhanced response of 337% to PMA stimulation. To study diapedesis, plasma collected at 10 minutes of reperfusion was introduced into plastic chambers taped atop skin abrasions in rabbits (n = 8). After 3 hours, 1610 +/- 246 PMN/mm3 accumulated and LTB4 levels in blister fluid were 0.83 +/- 0.03 ng/ml, higher than values of 44 +/- 23 PMN/mm3 (p less than 0.05) and 0.04 +/- 0.03 ng LTB4/ml (p less than 0.05) with saline solution and 68 +/- 16 PMN/mm3 (p less than 0.05) and 0.19 +/- 0.02 ng/ml (p less than 0.05) with nonischemic plasma. The introduction of LTB4, 3.3 ng/ml, into the chambers resulted in an accumulation of 536 +/- 352 PMN/mm3 (p less than 0.05). Pretreatment of animals before hindlimb ischemia (n = 5) with the lipoxygenase inhibitor diethylcarbamazine abolished PMN activation (51 +/- 12 fmol DCF/cell) and ischemic plasma-induced diapedesis into the plastic chamber (38 +/- 18 PMN/mm3). Pretreatment of nonischemic animals (n = 13) used for the dermabrasion bioassay with diethylcarbamazine abolished diapedesis into the plastic chambers induced by ischemic plasma (n = 5) (32 +/- 24 PMN/mm3) or LTB4 (n = 3) (36 +/- 28 PMN/mm3). These data indicate that PMN activation after reperfusion of ischemic tissue is mediated by a lipoxygenase product, perhaps LTB4, and that both reperfusion plasma and authentic LTB4 induce diapedesis by stimulating de novo lipoxygenase activity.

Topics: Animals; Capillary Permeability; Diethylcarbamazine; Femoral Vein; Flow Cytometry; Hindlimb; Ischemia; Leukotriene B4; Lipoxygenase; Male; Neutrophils; Oxidation-Reduction; Rabbits

Several studies have demonstrated that granulocytes accumulate in the intestinal mucosa following ischemia/reperfusion. It has been suggested that leukotriene B4 may be released during ischemia/reperfusion and consequently may promote granulocyte infiltration into the mucosa. The objectives of this study were to determine whether (a) leukotriene B4 is produced in the gut mucosa during ischemia and reperfusion, and (b) inhibition of leukotriene B4 attenuates granulocyte infiltration into the postischemic intestinal mucosa. Isolated segments of cat intestine were subjected to 3 hours of ischemia and 1 hour of reperfusion. Mucosal samples were obtained during baseline, ischemia at 3 hours and reperfusion at 1 hour. Leukotriene B4 production was determined by radioimmunoassay. Tissue-associated myeloperoxidase activity was used to quantitate granulocyte accumulation in the mucosal samples. In untreated animals, mucosal leukotriene B4 concentration was higher at reperfusion compared with baseline levels. The reperfusion-induced increase in mucosal leukotriene B4 was entirely prevented by pretreatment with either nordihydroguaiaretic acid (Sigma Chemical Co., St. Louis, MO) or L663,536 (Merck-Frosst, Montreal, Quebec, Canada), two potent lipoxygenase inhibitors. Both lipoxygenase inhibitors, as well as leukotriene B4 antagonist (SC-41930) significantly attenuated the reperfusion-induced infiltration of granulocytes. These results indicate that leukotriene B4 plays an important role in mediating the granulocyte accumulation elicited by reperfusion of the ischemic bowel.

Topics: Analysis of Variance; Animals; Benzopyrans; Cats; Granulocytes; Indoles; Intestinal Mucosa; Ischemia; Leukotriene B4; Masoprocol; Radioimmunoassay; Reperfusion Injury

The objective of this study was to determine whether dimethylsulfoxide (DMSO) influences chemoattractant-induced leukocyte adherence in the intestinal microcirculation. The distal colon of Sprague-Dawley rats was prepared for intravital microscopic observation of 25-35 microns diameter venules located in the muscularis externa. The number and average velocity of rolling leukocytes and the number of leukocytes adherent to the venular endothelial surface were determined from recorded video images. After a control period of observation, either N-formyl-methionyl-leucyl-phenylalanine (FMLP) or leukotriene B4 (LTB4) was added to the serosal superfusion solution. Both FMLP (1 microM) and LTB4 (1 microM) consistently caused leukocytes to adhere to venular endothelium. DMSO, at concentrations ranging between 2.5 and 140 mM, inhibited FMLP-induced leukocyte adherence in a dose-related manner. LTB4-induced leukocyte adherence was also significantly attenuated by DMSO. Leukocyte rolling velocity and leukocyte flux were not affected by DMSO. These results indicate that DMSO significantly inhibits leukocyte adherence at concentrations commonly used for its hydroxyl radical scavenging properties.

Topics: Animals; Arterioles; Cell Adhesion; Chemotaxis, Leukocyte; Colon; Dimethyl Sulfoxide; Female; Ischemia; Kinetics; Leukocytes; Leukotriene B4; Mesenteric Arteries; N-Formylmethionine Leucyl-Phenylalanine; Perfusion; Rats; Rats, Inbred Strains; Reference Values; Venules

Reperfusion after limb ischemia leads to sequestration of polymorphonuclear leukocytes (PMN) in the lungs and to leukocyte- (WBC) and thromboxane- (Tx) dependent respiratory dysfunction. This study examines the intermediary role of the chemoattractants leukotriene (LT)B4 and complement (C) fragments. Anesthetized sheep with chronic lung lymph fistulae underwent 2 hours of tourniquet ischemia of both hind limbs. In untreated controls (n = 7), 1 minute after tourniquet release, mean pulmonary artery pressure (MPAP) rose from 13 to 38 mmHg (p less than 0.05) and returned to baseline within 30 minutes. Pulmonary artery wedge pressure was unchanged from 3.6 mmHg. There were increases in plasma LTB4 levels from 2.46 to 9.34 ng/ml (p less than 0.01), plasma TxB2 levels from 211 to 735 pg/ml (p less than 0.05), and lung lymph TxB2 from 400 to 1005 pg/ml (p less than 0.05). C3 levels were 96% of baseline values. Thirty minutes after reperfusion, lung lymph flow (QL) increased from 4.3 to 8.3 ml/30 minutes (p less than 0.05), lymph/plasma protein ratio was unchanged from 0.6, and the lymph protein clearance increased from 2.6 to 4.6 ml/30 minutes (p less than 0.05), data consistent with increased microvascular permeability. WBC count fell within the first hour from 6853 to 3793/mm3 (p less than 0.01). Lung histology showed leukosequestration, 62 PMN/10 high-power fields (HPF) and proteinaceous exudates. In contrast to this untreated ischemic group, animals treated with the lypoxygenase inhibitor diethylcarbamazine (n = 5) demonstrated a blunted reperfusion-induced rise in MPAP to 17 mmHg (p less than 0.05). There were no increases in LTB4, TxB2, QL or lymph protein clearance (p less than 0.05). WBC count was unchanged and lung leukosequestration was reduced to 40 PMN/10 HPF (p less than 0.05). Decomplementation with cobra venom factor (n = 4) resulted in plasma C3 levels, 10% of baseline, but tourniquet release still led to pulmonary hypertension, elevated LTB4, TxB2 levels, and a decline in WBC count similar to that of untreated ischemic control animals. Histology showed 46 PMN/10 HPF sequestered in the lungs. Further, bilateral hind limb ischemia in either genetically sufficient (n = 10) or deficient (n = 10) C5 mice led to significant lung leukosequestration of 108 and 106 PMN/10 HPF, respectively, compared with 42 and 47 PMN/10 HPF in sham C5(+) and C5 (-) mice (n = 20) (p less than 0.01). These results suggest that the lung leukosequestration and increased mic

Topics: Animals; Capillary Permeability; Complement System Proteins; Female; Hypertension, Pulmonary; Ischemia; Leg; Leukotriene B4; Lung; Mice; Neutrophils; Reperfusion Injury; Sheep

Neutrophils have been implicated as central mediators in myocardial and skeletal muscle ischemia-reperfusion injury. This study tests whether these cellular elements and the chemoattractant leukotriene (LTB4) play a role in postischemic renal failure. Anesthetized rats underwent 45 min of left renal pedicle clamping. Five minutes after reperfusion, LTB4 levels were elevated to 1.42 ng/ml (P less than 0.05); thromboxane (Tx)B2 was 2,840 pg/ml, higher than 503 pg/ml in sham controls (P less than 0.05); renal artery blood flow was 67% of preclamping values at 1 min of reperfusion compared with 111% in sham (P less than 0.05). At 24 h, creatinine levels were 4.6 mg/dl (P less than 0.05). At 24 h, creatinine levels were 4.6 mg/dl (P less than 0.05); histology showed acute tubular necrosis (ATN). Neutrophil depletion by rabbit antiserum (n = 8) led during reperfusion to reduced LTB4 and TxB2 levels, 1.04 ng/ml and 1.043 pg/ml (P less than 0.05); increased renal blood flow of 174% (P less than 0.05); reduced creatinine levels of 1.8 mg/dl (P less than 0.05); and limited ATN. Pretreatment with diethycarbamazine prevented the increases in LTB4 and TxB2 (P less than 0.05), increased renal blood flow (P less than 0.05), minimized creatinine increase to 1.7 mg/dl (P less than 0.05), and reduced ATN. These data indicate that neutrophils and LTB4 play a role in ischemia-induced Tx synthesis and mediate postischemic renal injury.

Topics: 6-Ketoprostaglandin F1 alpha; Animals; Diethylcarbamazine; Ischemia; Kidney; Leukocyte Count; Leukotriene B4; Male; Neutrophils; Rats; Rats, Inbred Strains; Renal Circulation; Renal Veins; Reperfusion; Thromboxane B2

Topics: Animals; Central Nervous System Diseases; Humans; Inflammation; Ischemia; Leukotriene B4; Shock; SRS-A

Leukotrienes have been implicated as mediators of ischemia and shock. Recent evidence has been obtained supporting the four major criteria of acceptance of leukotrienes as mediators of shock, namely (a) increased concentration in body fluids during shock states, (b) ability to exert significant pathophysiologic effects which aggravate ischemia and shock, (c) amelioration of the shock state by leukotriene synthesis inhibitors and leukotriene receptor antagonists, and (d) production of a shock-like state by exogenous administration of leukotrienes. In conclusion, both LTB4 and the peptide leukotrienes (e.g. LTC4, LTD4 and LTE4) also known as the slow reacting substance of anaphylaxis (SRS-A) can be considered as mediators of ischemia and shock. Although difficulties exist with measuring leukotrienes in circulating blood and in obtaining long lasting selective blockers of leukotriene synthesis, innovative experiments measuring leukotrienes in bile and other body fluids and in employing specific leukotriene receptor antagonists have helped in assessing the significance of the leukotrienes in shock states. Additional studies are necessary to evaluate these findings in perspective, and to compare and contrast the role of leukotrienes to that of other vascular mediators including prostaglandins and thromboxanes, as well as non-eicosanoids including serotonin, histamine, angiotensin II and vasopressin, all of which can play a mediator role in ischemia and shock states. Further clarification of these issues promises to open exciting new chapters in shock research.

Topics: Animals; Free Radicals; Humans; Ischemia; Leukotriene B4; Lipoxygenase Inhibitors; Receptors, Immunologic; Receptors, Leukotriene; Receptors, Leukotriene B4; Receptors, Prostaglandin; Shock; SRS-A