TÇCD 2013 31st Annual Congress of Turkish Pediatric Surgical Association

Aim: To evaluate protective effect of sildenafil on the liver injury induced by intestinal ischemia-reperfusion.

Materials and Methods: Forty female Sprague Dawley rats were divided into 4 groups: as sham-control (SC), ischemia (I), ischemia-reperfusion (IR), ischemia-reperfusion+sildenafil (SIL). Ischemia and reperfusion period was 2 hours by clamping superior mesenteric artery. In SIL group, sildenafil was additionally gavaged as 50 mg/kg before the operation. At the end of the experiment, plasma and tissue samples were harvested, and then all rats were sacrificed. Liver function tests, alanine and aspartate aminotransferase, (ALT, AST, respectively) were performed in plasma samples and malondialdehyde (MDA) levels were measured in intestinal and liver samples. Histological examination was performed to investigate tissue damage in intestinal and liver tissue samples in all groups. Immunohistochemical staining was also performed against endothelial nitric oxide synthase (eNOS) and proliferating cell nuclear antigen (PCNA) on liver samples.

Results: The highest ALT and AST levels were found in IR group. Both ALT and AST were lower in SIL group than IR group (p<0,05). In intestinal tissue, MDA levels in IR group were higher than I and SC groups (p<0,05) and were lower than SIL group. Similar findings were observed for liver tissue samples. Intestinal damage was found more severe in IR group than SIL group according to Chiu scoring system (p<0,05). The most severe tissue damage was seen in IR group in liver tissue samples. It was found that sildenafil treatment reduced liver tissue damage when compared the IR group by histologically. Furthermore, sildenafil pretreatment resulted in increased eNOS and PCNA immunreactivity in liver tissue.

Conclusion: It is thought that sildenafil has a protective effect on intestinal ischemia/reperfusion-induced liver injury in rats. This aspect may occur by systemic effects of the drug such as decreasing vascular resistance via increasing nitric oxide levels in liver tissue.

AMAÇ: Bu çalışmanın amacı MESNA’nın (2-merkaptoetan sulfonat) ince bağırsak iskemi-reperfüzyonuna bağlı olarak gelişen sistemik hasara etkisinin ultrastrüktürel düzeyde incelenmesidir.

MATERYAL ve METOD: 32 adet erkek Wistar albino sıçan dört gruba ayrıldı. Grup A sham-kontrol grubu olarak kullanıldı. Grup B (iskemi), Grup C (iskemi -reperfüzyon) (I/R) ve Grup D iskemi -reperfüzyon + MESNA. Tüm gruplara histopatolojik ve elektron mikroskopik değerlendirmeler yapıldı Buna ek olarak, doku örneklerinde süperoksid dismutaz, glutatyon peroksidaz katalaz, ve total protein seviyeleri ölçüldü. Ayrıca dokularda eNOS ve iNOS immunreaktivitesi tayin edildi.

BULGULAR: En ciddi lokal ve sistemik hasarlanma iskemi-reperfüzyon grubunda görüldü ve bu hasarlanma MESNA uygulamasıyla biyokimyasal olarak azalırken mikroskopik düzeyde yapılan değerlendirmelerde geri dönmemişti.

SONUÇ: Bağırsak iskemi reperfüzyon hasarında MESNA uygulaması sistemik olarak biyokimyasal parametreler üzerine olumlu etki yaparken, mikroskopik göstergeleri iyileştirici etki göstermemiştir.