Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2013.09.007
Brazilian Journal of Anesthesiology
Scientific Article

Pretreatment with remifentanil protects against the reduced-intestinal contractility related to the ischemia and reperfusion injury in rat

Pré-tratamento com remifentanil protege contra a redução da contratilidade intestinal relacionada à lesão de isquemia e reperfusão em ratos

Hale Sayan-Ozacmak; Veysel Haktan Ozacmak; Inci Turan; Figen Barut; Volkan Hanci

Downloads: 0
Views: 674

Abstract

BACKGROUND AND OBJECTIVES: Serious functional and structural alterations of gastrointestinal tract are observed in failure of blood supply, leading to gastrointestinal dismotility. Activation of opioid receptors provides cardioprotective effect against ischemia-reperfusion (I/R) injury. The aim of the present study was to determine whether or not remifentanil could reduce I/R injury of small intestine. METHODS: Male Wistar Albino rats were subjected to mesenteric ischemia (30 min) followed by reperfusion (3 h). Four groups were designed: sham control; remifentanil alone; I/R control; and remifentanil + I/R. Animals in remifentanil + I/R group were subjected to infusion of remifentanil (2 ug kg-1 min-1) for 60 min, half of which started before inducing ischemia. Collecting the ileum tissues, evaluation of damage was based on contractile responses to carbachol, levels of lipid peroxidation and neutrophil infiltration, and observation of histopathological features in intestinal tissue. RESULTS: Following reperfusion, a significant decrease in carbachol-induced contractile response, a remarkable increase in both lipid peroxidation and neutrophil infiltration, and a significant injury in mucosa were observed. An average contractile response of remifentanil + I/R group was significantly different from that of the I/R group. Lipid peroxidation and neutrophil infiltration were also significantly suppressed by the treatment. The tissue samples of the I/R group were grade 4 in histopathological evaluation. In remifentanil + I/R group, on the other hand, the mucosal damage was moderate, staging as grade 1. CONCLUSIONS: The pretreatment with remifentanil can attenuate the intestinal I/R injury at a remarkable degree possibly by lowering lipid peroxidation and leukocyte infiltration.

Keywords

Intestinal contractility, Intestinal ischemia-reperfusion injury, Rat, Remifentanil

Resumo

JUSTIFICATIVA E OBJETIVOS: Alterações funcionais e estruturais sérias do trato gastrointestinal são observadas na insuficiência de irrigação sanguínea, levando a alterações da motilidade gastrointestinal. A ativação dos receptores opioides proporciona um efeito cardioprotetor contra a lesão de isquemia/reperfusão (I/R). O objetivo do presente estudo foi determinar se remifentanil pode ou não reduzir a lesão de I/R do intestino delgado. MÉTODOS: Ratos machos albinos, da linhagem Wistar, foram submetidos à isquemia mesentérica (30 minutos) seguida de reperfusão (3 horas). Quatro grupos foram designados: sham controle; remifentanil isolado; controle I/R; remifentanil + I/R. Os animais do grupo remifentanil + I/R foram submetidos à infusão de remifentanil (2 µg kg-1 min-1) por 60 min, metade dos quais iniciou antes da indução da isquemia. Coletando os tecidos do íleo, a avaliação dos danos foi baseada nas respostas contráteis ao carbacol, nos níveis de peroxidação lipídica e infiltração de neutrófilos e na observação das características histopatológicas no tecido intestinal. RESULTADOS: Após a reperfusão, uma diminuição significativa da resposta contrátil induzida por carbacol, um notável aumento tanto da peroxidação lipídica quanto da infiltração de neutrófilos e uma lesão significativa da mucosa foram observados. A média da resposta contrátil no grupo remifentanil + I/R foi significativamente diferente daquela do grupo I/R. A peroxidação lipídica e a infiltração de neutrófilos também foram significativamente suprimidas pelo tratamento. As amostras de tecido do grupo I/R apresentaram grau 4 na avaliação histopatológica. No grupo remifentanil + I/R, por outro lado, a lesão da mucosa foi moderada, apresentando estadiamento de grau 1. CONCLUSÕES: O pré-tratamento com remifentanil pode atenuar a lesão intestinal de I/R em um grau notável, possivelmente pela redução da peroxidação lipídica e da infiltração leucocitária.

Palavras-chave

Contratilidade intestinal, Lesão intestinal de isquemia/reperfusão, Rato, Remifentanil

References

Peart JN, Gross ER, Gross GJ. Opioid-induced preconditioning: Recent advances and future perspectives. Vascul Pharmacol.. 2005;42:211-8.

Yang LQ, Tao KM, Liu YT. Remifentanil precondition- ing reduces hepatic ischemia-reperfusion injury in rats via inducible nitric oxide synthase expression. Anesthesiology.. 2011;114:1036-47.

Chun KJ, Park YH, Kim JS. Comparison of 5 different remifentanil strategies against myocardial ischemia-reperfusion injury. J Cardiothorac Vasc Anesth.. 2011;25:926-30.

Cosola C, Albrizio M, Guaricci AC. Opioid ago- nist/antagonist effect of naloxone in modulating rabbit jejunum contractility in vitro. J Physiol Pharmacol.. 2006;57:439-49.

Zhang Y, Wu YX, Hao YB. Role of endogenous opioid peptides in protection of ischemic preconditioning in rat small intestine. Life Sci.. 2001;68:1013-9.

Yu CK, Li YH, Wong GT. Remifentanil preconditioning confers delayed cardioprotection in the rat. Br J Anaesth.. 2007;99:632-8.

Zhang Y, Chen ZW, Girwin Met al. Remifentanil mimics car- dioprotective effect of ischemic preconditioning via protein kinase C activation in open chest of rats. Acta Pharmacol Sin.. 2005;26:546-50.

Kim HS, Kim SY, Kwak YL. Hyperglycemia attenu- ates myocardial preconditioning of remifentanil. J Surg Res.. 2011;174:231-7.

Vollmar B, Menger MD. Intestinal ischemia/reperfusion: microcirculatory pathology and functional consequences. Lan- genbecks Arch Surg.. 2011;396:13-29.

Mallick IH, Yang W, Winslet MC. Ischemia-reperfusion injury of the intestine and protective strategies against injury. Dig Dis Sci.. 2004;49:1359-77.

Suto Y, Oshima K, Arakawa K. The effect of nicorandil on small intestinal ischemia-reperfusion injury in a canine model. Dig Dis Sci.. 2011;56:2276-82.

Cámara -Lemarroy CR, Guzmán-de la Garza FJ, Alarcón-Galván G. The effects of NMDA receptor antagonists over intestinal ischemia/reperfusion injury in rats. Eur J Pharmacol.. 2009;621:78-85.

Orsenigo MN, Porta C, Sironi C. Effects of creatine in a rat intestinal model of ischemia/reperfusion injury. Eur J Nutr.. 2011;51:375-84.

Flessas II, Papalois AE, Toutouzas K. Effects of lazaroids on intestinal ischemia and reperfusion injury in experimental models. J Surg Res.. 2011;166:265-74.

Arumugam TV, Arnold N, Proctor LM. Comparative protec- tion against rat intestinal reperfusion injury by a new inhibitor of sPLA2 COX-1 and COX-2 selective inhibitors, and an LTC4 receptor antagonist. Br J Pharmacol.. 2003;140:71-80.

Hsieh YH, McCartney K, Moore TA. Intestinal ischemia-reperfusion injury leads to inflammatory changes in the brain. Shock.. 2011;36:424-30.

Margaritis EV, Yanni AE, Agrogiannis G. Effects of oral administration of (l)-arginine (l)-NAME and allopurinol on intestinal ischemia/reperfusion injury in rats. Life Sci.. 2011;88:1070-6.

Abdeen SM, Mathew TC, Dashti HM. Protective effects of green tea on intestinal ischemia-reperfusion injury. Nutrition.. 2011;27:598-603.

Rivera LR, Thacker M, Pontell L. Deleterious effects of intestinal ischemia/reperfusion injury in the mouse enteric nervous system are associated with protein nitrosylation. Cell Tissue Res.. 2011;344:111-23.

Ballabeni V, Barocelli E, Bertoni S. Alterations of intestinal motor responsiveness in a model of mild mesenteric ischemia/reperfusion in rats. Life Sci.. 2002;71:2025-35.

Ługowska-Umer H, Umer A, Sein-Anand J. Endothe- lin receptor blockers protect against ischemia/reperfusion impairment of gastrointestinal motility in rats. Pharmacol Res.. 2008;57:413-8.

Shimojima N, Nakaki T, Morikawa Y. Interstitial cells of cajal in dysmotility in intestinal ischemia and reperfusion injury in rats. J Surg Res.. 2006;135:255-61.

Ozacmak VH, Sayan H, Arslan SO. Protective effect of melatonin on contractile activity and oxidative injury induced by ischemia and reperfusion of rat ileum. Life Sci.. 2005;76:1575-88.

Yang Q, Dong H, Deng J. Sevoflurane preconditioning induces neuroprotection through reactive oxygen species- mediated up-regulation of antioxidant enzymes in rats. Anesth Analg.. 2011;112:931-7.

Obal D, Dettwiler S, Favoccia C. The influence of mitochondrial KATP-channels in the cardioprotection of precon- ditioning and postconditioning by sevoflurane in the rat in vivo. Anesth Analg.. 2005;101:1252-60.

Assad AR, Delou JM, Fonseca LM. The role of KATP chan- nels on propofol preconditioning in a cellular model of renal ischemia-reperfusion. Anesth Analg.. 2009;109:1486-92.

Xiao YY, Chang YT, Ran K. Delayed preconditioning by sevoflurane elicits changes in the mitochondrial pro- teome in ischemia-reperfused rat hearts. Anesth Analg.. 2011;113:224-32.

Huang Z, Zhong X, Irwin MG. Synergy of isoflurane preconditioning and propofol postconditioning reduces myocar- dial reperfusion injury in patients. Clin Sci (Lond).. 2011;121:57-69.

Cho SSC, Rudloff I, Berger PJ. Remifentanil ameliorates intestinal ischemia-reperfusion injury. BMC Gastroenterol.. 2013;13:69-77.

Hierholzer C, Kalff JC, G Audolfsson. Molecular and functional contractile sequelae of rat intesti nal ischemia/reperfusion injury. Transplantation.. 1999;68:1244-54.

Casini AF, Ferrali M, Pompella A. Lipid peroxidation and cellular damage in extrahepatic tissues of bromobenzene in toxicated mice. Am J Pathol.. 1986;123:520-31.

Bradley PP, Priebat DA, Christensen RD. Measure- ment of cutaneous inflammation: estimation of neutrophil content with an enzyme marker. J Invest Dermatol.. 1982;78:206-9.

Giaroni C, Zanetti E, Giuliani D. Protein kinase c modulates NMDA receptors in the myenteric plexus of the guinea pig ileum during in vitro ischemia and reperfusion. Neurogastroenterol Motil.. 2011;23:e91-103.

Der T, Bercik P, Donnelly G. Interstitial cells of cajal and inflammation-induced motor dysfunction in the mouse small intestine. Gastroenterology.. 2000;119:1590-9.

Alican I, Yegen C, Olcay A. Ischemia-reperfusion-induced delay in intestinal transit Role of endothelins. Digestion.. 1998;59:343-8.

Udassin R, Eimerl D, Schiffman J. Postischemic intestinal motility in rat is inversely correlated to length of ischemia: an in vivo animal model. Dig Dis Sci.. 1995;40:1035-8.

Hassoun HT, Weisbrodt NW, Mercer DW. Inducible nitric oxide synthase mediates gut ischemia/reperfusion- induced ileus only after severe insults. J Surg Res.. 2001;97:150-4.

Hebra A, Hong J, McGowan KL. Bacterial translocation in mesenteric ischemia-reperfusion injury: is dysfunctional motility the link?. J Pediatr Surg.. 1994;29:285-7.

Sayan H, Ozacmak VH, Altaner S. Protective effects of l- arginine on rat terminal ileum subjected to ischemia/reperfusion. J Pediatr Gastroenterol Nutr.. 2008;46:29-35.

Bielefeldt K, Conklin JL. Intestinal motility during hypoxia and reoxygenation in vitro. Dig Dis Sci.. 1997;42:878-84.

Schoenberg MH, Poch B, Younes M. Involvement of neu- trophils in postischaemic damage to the small intestine. Gut.. 1991;32:905-12.

Sayan H, Ozacmak VH, Sen F. Pharmacological pre- conditioning with erythropoietin reduces ischemia-reperfusion injury in the small intestine of rats. Life Sci.. 2009;84:364-71.

Tian XF, Yao JH, Zhang XS. Protective effect of carnosol on lung injury induced by intestinal ischemia/reperfusion. Surg Today.. 2010;40:858-65.

Wong GT, Li R, Jiang LL. Remifentanil post-conditioning attenuates cardiac ischemia-reperfusion injury via kappa or delta opioid receptor activation. Acta Anaesthesiol Scand.. 2010;54:510-8.

Zatta AJ, Kin H, Yoshishige D. Evidence that cardiopro- tection by postconditioning involves preservation of myocardial opioid content and selective opioid receptor activation. Am J Physiol Heart Circ Physiol.. 2008;294:H1444-51.

Jang Y, Xi J, Wang H. Postconditioning prevents reperfusion injury by activating delta-opioid receptors. Anes- thesiology.. 2008;108:243-50.

Chakass D, Philippe D, Erdual E. Micro-opioid receptor activation prevents acute hepatic inflammation and cell death. Gut.. 2007;56:974-81.

5dcd9dce0e88254069bf58f1 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections