Effects of neutrophil elastase inhibitor on flap survival after venous ischemia

Kotsu, Kunio; Hashimoto, Ichiro; Yamano, Masahiro; Kashiwagi, Keisuke; Abe, Yoshiro; Nakanishi, Hideki
March 2013
European Journal of Plastic Surgery;Mar2013, Vol. 36 Issue 3, p149
Academic Journal
Background: Venous ischemia is more of a threat to tissue viability than is arterial ischemia. The mechanism of injury is complex and involves many factors. Neutrophil activation is thought to be a trigger and final pathway for the tissue injury. Methods: We conducted a two-part animal study to examine the effect of neutrophil elastase inhibitor on ischemia-reperfusion injury. In the first experiment, island abdominal skin flaps were elevated in 20 rabbits (ten treated with neutrophil elastase inhibitor and ten not treated), and the pedicle vein was occluded for 6 h in both groups. Survival rates (i.e., flap survival areas) and histologic findings were compared. In the second experiment, thrombus formation was assessed in arterioles and venules injured by reactive oxygen species. Results: Survival of the treated flaps and non-treated flaps was 91 (46-100) and 0 (0-98) %, respectively, and differed significantly (p < 0.002). Histologically, infiltration of neutrophils was observed 12 h after congestion, and severe obstruction of vessels due to thrombi was observed 48 h after congestion in the non-treatment group, but vessels were not obstructed in the treated group. Thrombi in venules contained leukocytes, but those in arterioles did not. Time to stasis in the venules in the treatment group and non-treatment group was 130.5 (96-197) and 93 (62-133) s, respectively (p < 0.01). Conclusions: Neutrophil elastase inhibitor was shown to maintain flap circulation and thus promote flap survival. This agent may slow thrombus formation in venules by acting on neutrophils in the venules.


Related Articles

  • TLR4 activation mediates kidney ischemia/reperfusion injury. Huiling Wu; Gang Chen; Wyburn, Kate R.; Jianlin Yin; Bertolino, Patrick; Eris, Josette M.; Alexander, Stephen I.; Sharland, Alexandra F.; Chadban, Steven J. // Journal of Clinical Investigation;Oct2007, Vol. 117 Issue 10, p2847 

    Ischemia/reperfusion injury (IRI) may activate innate immunity through the engagement of TLRs by endogenous ligands. TLR4 expressed within the kidney is a potential mediator of innate activation and inflammation. Using a mouse model of kidney IRI, we demonstrated a significant increase in TLR4...

  • Anti-integrin Peptides in Prevention of Reperfusion Injury. Antoniou, E. A.; Liossis, C.; Afford, S.; Howie, A.; McMaster, P.; D'Silva, M. // European Surgical Research;May/Jun2004 Supplement 1, Vol. 36, p33 

    Leukocytes play a major role in reperfusion injury mediated tissue damage. The mechanisms by which leukocytes especially neutrophils are recruited to the graft, are not known, but are likely to involve endothelial activation resulting in enhanced adhesion and transendothelial migration. The...

  • Ischemic Intestinal Injury during Cardiopulmonary Bypass Does Not Show an Association with Neutrophil Activation. Jormalainen, M.; Vento, A. E.; Wartiovaara-Kautto, U.; Suojaranta-Ylinen, R.; Lauronen, J.; Paavonen, T.; Petäjä, J. // European Surgical Research;2009, Vol. 42 Issue 1, p59 

    Background: Neutrophil activation and tissue sequestration are crucial events in intestinal ischemia-reperfusion injury, but their role in the gut wall after clinical cardiopulmonary bypass (CPB) remains unclear. We tested whether local post-CPB inflammatory response in the gut wall would be...

  • Effect of Butylated Hydroxyanisole and Some of Its Derivatives on Human Neutrophil Oxidative Burst: Chemiluminescence Evaluation. Braga, Pier Carlo; Sasso, Monica dal; Bovio, Cinzia; Sgaragli, Gian Pietro // Pharmacology;May2003, Vol. 68 Issue 1, p9 

    An acute inflammatory response begins during the reperfusion phase following an ischemic insult in which polymorphonuclear neutrophils (PMNs) play an important role and the release of reactive oxygen species (ROS) causes further damage and a reduction in endogenous antioxidant storage. The...

  • Methylophiopogonanone A Protects against Cerebral Ischemia/Reperfusion Injury and Attenuates Blood-Brain Barrier Disruption In Vitro. Lin, Mingbao; Sun, Wei; Gong, Wan; Zhou, Zhiyu; Ding, Yasi; Hou, Qi // PLoS ONE;Apr2015, Vol. 10 Issue 4, p1 

    Methylophiopogonanone A (MO-A), an active homoisoflavonoid of the Chinese herb Ophiopogon japonicus which has been shown to have protective effects on cerebral ischemia/reperfusion (I/R) injury, has been demonstrated to have anti-inflammatory and anti-oxidative properties. However, little is...

  • Surfactant pretreatment ameliorates ischemia-reperfusion injury of the lung. van der Kaaij, Niels P.; Haitsma, Jack J.; Kluin, Jolanda; Lambrecht, Bart N.; Lachmann, Burkhard; de Bruin, Ron W.F.; Bogers, Ad J.J.C. // European Journal of Cardio-Thoracic Surgery;May2005, Vol. 27 Issue 5, p774 

    Abstract: Objective: To investigate whether surfactant pretreatment provides lung protection in an animal model of lung ischemia-reperfusion injury (LIRI). Methods: Male Sprague–Dawley rats (n=100) were randomised to receive intratracheally administered surfactant or no pretreatment. One...

  • TRPC1 Deficiency Exacerbates Cerebral Ischemia/Reperfusion-Induced Neurological Injury by Potentiating Nox4-Derived Reactive Oxygen Species Generation. Xu, Ning; Meng, Hao; Liu, Tianyi; Feng, Yingli; Qi, Yuan; Wang, Honglei // Cellular Physiology & Biochemistry (Karger AG);Dec2018, Vol. 51 Issue 4, p1723 

    Background/Aims: Transient receptor potential cation channel 1 (TRPC1)-mediated the calcium (Ca2+) influx plays an important role in several brain disorders. However, the function of TRPC1 in ischemia/reperfusion (I/R)-induced neurological injury is unclear. Methods: Wild-type or TRPC1 knockout...

  • Rho-kinase signalling regulates CXC chemokine formation and leukocyte recruitment in colonic ischemia–reperfusion. Santen, Stefan; Yusheng Wang; Laschke, Matthias W.; Menger, Michael D.; Jeppsson, Bengt; Thorlacius, Henrik // International Journal of Colorectal Disease;Sep2010, Vol. 25 Issue 9, p1063 

    Leukocyte recruitment is a key feature in ischemia–reperfusion (I/R)-induced tissue injury. The aim of the present study was to investigate the effect of Rho-kinase inhibition on I/R-provoked leukocyte recruitment in the colon. C57BL/6 mice were subjected to 30 min of ischemia by clamping...

  • Ischemia-Reperfusion Injury of the Cochlea: Pharmacological Strategies for Cochlear Protection and Implications of Glutamate and Reactive Oxygen Species. Tabuchi, Keiji; Nishimura, Bungo; Tanaka, Shuho; Hayashi, Kentaro; Hirose, Yuki; Hara, Akira // Current Neuropharmacology;Jun2010, Vol. 8 Issue 2, p128 

    A large amount of energy produced by active aerobic metabolism is necessary for the cochlea to maintain its function. This makes the cochlea vulnerable to blockade of cochlear blood flow and interruption of the oxygen supply. Although certain forms of human idiopathic sudden sensorineural...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics