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PMID: 18090739 Published · ppublish English Journal Article

The effect of recombinant human erythropoietin on ischemia-reperfusion injury: an experimental study in a rat TRAM flap model.

Plastic and reconstructive surgery ·Vol. 120 ·No. 7 ·2007-12-00 ·Pages 1774-1781

Kim EK, Hong JP

Abstract

Erythropoietin is traditionally known to regulate erythropoiesis, but recently its protective effect against ischemia-reperfusion injury has been studied in cardiovascular and neuronal systems. This study investigated the effect of recombinant human erythropoietin on ischemia-reperfusion injury in a rat transverse rectus abdominis musculocutaneous (TRAM) flap model. Twenty-four Sprague-Dawley rats were divided into a control group (n = 12) and a group treated with erythropoietin (n = 12). A superiorly based TRAM flap was elevated and ischemic insult was given for 4 hours. Thirty minutes before reperfusion, single-dose recombinant human erythropoietin (5000 IU/kg) was injected through the intraperitoneal route in the treatment group. At 24 hours postoperatively, systemic neutrophil count, tissue myeloperoxidase activity, amount of malondialdehyde, nitric oxide content, tissue water content, and histologic finding of inflammation were evaluated. At day 10 postoperatively, flap survival rate, angiogenesis, and change in hematocrit level were evaluated. The myeloperoxidase activity and tissue water content were significantly lower (p < 0.01 and p < 0.005, respectively), and the tissue nitric oxide level was significantly higher (p < 0.005) in the treatment group 24 hours after reperfusion. Perivascular neutrophil infiltration and intravascular adhesion were marked in the control group. Mean flap survival after 10 days was 69 percent in the treatment group and 47 percent in the control group, demonstrating a significant difference (p < 0.005). Neovascularization in the treatment group was also greater than that in the control group. No significant hematocrit rise was noted 10 days after erythropoietin administration. Recombinant human erythropoietin improved flap survival in ischemia-reperfusion-injured rat TRAM flaps by the possible mechanism of suppressed inflammation, decreased infiltration of neutrophils, increased nitric oxide, and enhanced angiogenesis.

MeSH Terms
Animals Apoptosis/drug effects Chemotaxis, Leukocyte/drug effects Drug Evaluation, Preclinical Erythropoietin/administration & dosage,therapeutic use Hematocrit Humans Inflammation/prevention & control Malondialdehyde/analysis Neovascularization, Physiologic/drug effects Neutrophils/drug effects Nitric Oxide/analysis Peroxidase/analysis Rats Rats, Sprague-Dawley Recombinant Proteins Rectus Abdominis/blood supply,surgery Reperfusion Injury/drug therapy,etiology,prevention & control Surgical Flaps/blood supply
Chemicals
Recombinant Proteins Erythropoietin Nitric Oxide Malondialdehyde Peroxidase
Authors & Affiliations
2 authors, click to expand affiliations / ORCID
Kim Eun Key
Seoul, Korea From the Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center.
Hong Joon Pio
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Article Info
Journal
Plastic and reconstructive surgery
Abbr.
Plast Reconstr Surg
ISSN
1529-4242
DOI
10.1097/01.prs.0000287131.53488.c4
Published
2007-12-00
Pages
1774-1781
Language
English
Region
United States
NLM ID
1306050
Subset
IM
Corrections
CommentIn
PMID: 18626404
External Links
PubMed source DOI: 10.1097/01.prs.0000287131.53488.c4 View journal details
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