Review
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World J Gastrointest Pathophysiol. Oct 15, 2010; 1(4): 137-143
Published online Oct 15, 2010. doi: 10.4291/wjgp.v1.i4.137
Ischemic post-conditioning to counteract intestinal ischemia/reperfusion injury
Yan-Fang Guan, Timothy A Pritts, Marshall H Montrose
Yan-Fang Guan, Marshall H Montrose, Department of Molecular and Cellular Physiology, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267, United States
Timothy A Pritts, Department of Surgery, University of Cincinnati Medical Arts Building, 222 Piedmont Avenue, Cincinnati, OH 45219, United States
Author contributions: Guan Y performed the literature search and drafted the paper; and Pritts TA and Montrose MH reviewed and edited the manuscript.
Supported by NIH R21 DK074976 (MHM)
Correspondence to: Yan-Fang Guan, MD, Department of Molecular and Cellular Physiology, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267, United States. guan@uc.edu
Telephone: +1-513-5583791 Fax: +1-513-5585738
Received: June 21, 2010
Revised: September 29, 2010
Accepted: October 6, 2010
Published online: October 15, 2010
Abstract

Intestinal ischemia is a severe disorder with a variety of causes. Reperfusion is a common occurrence during treatment of acute intestinal ischemia but the injury resulting from ischemia/reperfusion (IR) may lead to even more serious complications from intestinal atrophy to multiple organ failure and death. The susceptibility of the intestine to IR-induced injury (IRI) appears from various experimental studies and clinical settings such as cardiac and major vascular surgery and organ transplantation. Whereas oxygen free radicals, activation of leukocytes, failure of microvascular perfusion, cellular acidosis and disturbance of intracellular homeostasis have been implicated as important factors in the pathogenesis of intestinal IRI, the mechanisms underlying this disorder are not well known. To date, increasing attention is being paid in animal studies to potential pre- and post-ischemia treatments that protect against intestinal IRI such as drug interference with IR-induced apoptosis and inflammation processes and ischemic pre-conditioning. However, better insight is needed into the molecular and cellular events associated with reperfusion-induced damage to develop effective clinical protection protocols to combat this disorder. In this respect, the use of ischemic post-conditioning in combination with experimentally prolonged acidosis blocking deleterious reperfusion actions may turn out to have particular clinical relevance.

Keywords: Acidosis; Intestinal ischemia/reperfusion injury; In vivo models; Ischemic post-conditioning