THUSHAN DHANANJA GOONERATNE
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Shervanthi Homer-Vanniasinkam
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Serosha Mandika Wijeyaratne
Abstract
Objective The study aimed to investigate the temporal evolution of markers of skeletal muscle ischaemia reperfusion injury (IRI) to shed more light into its pathogenesis towards finding a clinical therapeutic intervention. P-selectin, Myeloperoxidase and TNF-alpha were selected as markers of IRI based on their role in its pathogenesis. An observational study was conducted on patients with skeletal muscle ischaemia requiring revascularization. Loco-regional venous sampling was performed at 0, +2, +4, +6, +12 and +24 hours post-reperfusion to demonstrate the temporal evolution of surrogate markers of IRI.Results Levels of P-Selectin, Myeloperoxidase and TNF-alpha demonstrated a significant peak elevation during 2h - 4h following reperfusion when compared to baseline values. (P-selectin 59.48pg/ml to 125.91pg/ml, p=0.008; Myeloperoxidase 78.84pg/ml to 116.86pg/ml, p=0.051; TNF-alpha 1.80pg/ml to 34.53pg/ml, p=0.002) All three markers gradually subsided with time and reached baseline pre-perfusion values between 6h – 8h from time of reperfusion. The study suggests that skeletal muscle IRI in humans is associated with an early exaggerated pro-inflammatory response, as supported by increased expression of reperfusion injury markers in the venous effluent. They demonstrate potential for use as markers of IRI for future clinical trials.
The protective effect of montelukast against skeletal muscle ischaemia-reperfusion injury: an experimental rat model
