Ischaemic postconditioning reduces peroxide formation,cytokine expression and leukocyte activation in reperfusion injury after abdominal aortic surgery in rat model

Objective: We studied the protective effects of ischaemic postconditioning (PS) on ischemia–reperfusion injury of the lower extremities in a rat model of abdominal aortic intervention. We aimed to examine the evoked oxidative stress, cytokine expression and leukocyte activation after revascularisation surgery.

Methods: Anesthetized animals (48 Whistar rats) underwent a 60 min infrarenal aorta cross-clamping. After the ischaemic period, an intermittent 4 times 15 s reperfusion – 15 seconds ischaemic episodes – were applied (ischaemic postconditioning: group PS). Then we started a 120 min reperfusion in the aorta. In untreated group animals underwent a long ischaemia (60 min) and the following reperfusion (group IR). Peripherial blood samples were collected before operation, and in early (5, 10, 15, 30, 60 and 120 min) reperfusion periods. Serum peroxide level, TNF-alpha concentration, myeloperoxidase (MPO) activity and PMA-induced leukocyte ROS production were measured.

Results: In PS group, plasma peroxide level elevation was significantly lower in very early reperfusion (5–30 min) comparing to non-conditioned IR group (10.04±1.9 μM/l vs. 16.91±3.67 μM/l, p<0.05). PS also reduced serum TNF-alpha concentration (167.41±31.26 μg/ml vs. 116.55±12.04 μg/ml, p<0.05), MPO activity (1.759±0.239 μM/ml vs. 1.22±0.126 μM/ml, p<0.05) and leukocyte activation detected by PMA-induced leukocyte ROS production (5.7±0.96 AU/10³ cells vs. 4.63±0.69 AU/10³ cells).

Conclusions: Ischaemic postconditioning could reduce ROI production after IR in early reperfusion period, thus limiting ROI mediated tissue lesion, cytokine–leukocyte activation and inflammatory responses. PS seems to be an effective tool in vascular surgery to reduce reperfusion injuries after revascularization interventions.