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Institut National de la Santé et de la Recherche Médicale, Rouen University Medical School and Rouen University Hospital, Rouen, France 76183
Intestinal
ischemia-reperfusion has been implicated in the systemic
inflammatory response and organ injury in hemorrhagic shock, but the
exact role of the intestine has never been directly demonstrated.
Preconditioning (PC) with brief periods of intermittent ischemia is a known potent anti-ischemic intervention
and thus can be used as a tool to assess the role of local intestinal
ischemia-reperfusion injury in systemic inflammatory response.
Thus rats were first subjected to sham surgery or intestinal
preconditioning with four cycles of 1-min ischemia and 10 min
of reperfusion 24 h before hemorrhagic shock followed by
resuscitation. PC reduced fluid requirements, lung edema, and lactate
and tumor necrosis factor-
production. These effects were abolished
by the heme-oxygenase-1 (HO-1) inhibitor tin protoporphyrin (Sn-PP). PC
induced more than fivefold in intestinal HO-1 expression. These results
suggest that intestinal ischemia-reperfusion is a major trigger
for inflammatory response and organ injury in nonseptic shock. HO-1
appears to play an important role in the protective effect of
intestinal preconditioning.
cytokines; heme-oxygenase-1
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