Postconditioning: “Toll-erating” mesenteric ischemia-reperfusion injury?

Olivér Rosero, Péter Ónody, Tibor Kovács, Dávid Molnár, András Fülöp, Gábor Lotz, László Harsányi, Attila Szijártó

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Background Postconditioning may prove to be a suitable method to decrease ischemia-reperfusion injury of intestine after mesenteric arterial occlusion. Toll-like-receptor-4 is involved in the pathophysiology of organ damage after ischemia-reperfusion; therefore, the aim of our study was to investigate the effect of postconditioning on the mucosal expression of toll-like-receptor-4. Methods Male Wistar rats (n = 10/group) underwent 60 minutes of superior mesenteric artery occlusion followed by 6 hours of reperfusion in 3 groups: sham-operated, ischemia-reperfusion, and a postconditioned group. Postconditioning was performed by 6 alternating cycles of 10 seconds of reperfusion/reocclusion. Blood and tissue samples were collected at the end of reperfusion. Intestinal histopathologic changes and immunohistochemical expression of mucosal caspase-3, antioxidant status, and protein levels of high-mobility group box-1 and toll-like-receptor-4 were assessed. Immunofluorescent labeling and confocal microscopic analysis of toll-like-receptor-4 were performed. Mucosal and serum levels of interleukin-6 and tumor necrosis factor-α protein were measured. Results Histologic alterations in the postconditioned group were associated with decreased caspase-3 positivity, less toll-like-receptor-4 mRNA, and less protein expression of high-mobility group box-1 and toll-like-receptor-4 in the intestinal villi compared with the ischemia-reperfusion group. Furthermore, a significantly improved antioxidant state of the intestinal mucosa and less mucosal and serum protein levels of interleukin-6 and tumor necrosis factor-α were detected in the postconditioned group. Conclusion Small intestinal ischemia-reperfusion injury in male Wistar rats caused by the occlusion of the superior mesenteric artery was ameliorated by the use of postconditioning, showing a more favorable inflammatory response, which may be attributed to the decreased mucosal expression of toll-like-receptor-4.

Original languageEnglish
Pages (from-to)1004-1015
Number of pages12
JournalSurgery (United States)
Issue number4
Publication statusPublished - Apr 1 2017


ASJC Scopus subject areas

  • Surgery

Cite this

Rosero, O., Ónody, P., Kovács, T., Molnár, D., Fülöp, A., Lotz, G., Harsányi, L., & Szijártó, A. (2017). Postconditioning: “Toll-erating” mesenteric ischemia-reperfusion injury? Surgery (United States), 161(4), 1004-1015.