Carnitine Protects the Intestine Against Reperfusion Injury in Rats

Hosgorler, Ferda Ulviye; Atila, Koray; Terzi, Cem; Akhisaroglu, Serpil Tanriverdi; Oktay, Gulgun; Kupelioglu, Ali; Ergor, Gul; Saydam, Serdar

doi:10.1016/j.jss.2009.03.028

« Previous Next »Journal of Surgical Research
Volume 159, Issue 1 , Pages 603-610, March 2010

Carnitine Protects the Intestine Against Reperfusion Injury in Rats

Ferda Ulviye Hosgorler, M.D.
- Department of Surgery, Dokuz Eylul University, School of Medicine, Izmir, Turkey
Koray Atila, M.D.
- Department of Surgery, Dokuz Eylul University, School of Medicine, Izmir, Turkey
- To whom correspondence and reprint requests should be addressed at Department of Surgery, Dokuz Eylul University, School of Medicine, Korutürk Mahallesi Kauçuk Sokak No:5 D:15, Balçova Izmir 35330, Turkey.
Cem Terzi, M.D.
- Department of Surgery, Dokuz Eylul University, School of Medicine, Izmir, Turkey
Serpil Tanriverdi Akhisaroglu, M.D.
- Department of Biochemistry, Dokuz Eylul University, School of Medicine, Izmir, Turkey
Gulgun Oktay, M.D.
- Department of Biochemistry, Dokuz Eylul University, School of Medicine, Izmir, Turkey
Ali Kupelioglu, M.D.
- Department of Pathology, Dokuz Eylul University, School of Medicine, Izmir, Turkey
Gul Ergor, M.D.
- Department of Public Health and Biostatistics, Dokuz Eylul University, School of Medicine, Izmir, Turkey
Serdar Saydam, M.D.
- Department of Surgery, Dokuz Eylul University, School of Medicine, Izmir, Turkey

Received 16 October 2008 published online 23 April 2009.

Background

Although the negative effects of ischemia on anastomotic healing have been shown in many studies, there is no adequate information on the effects of reperfusion injury. Therefore, in this study, we investigated the effect of ischemia-reperfusion (IR) injury on intestinal anastomosis and the protective efficiency of carnitine in an experimental relatively short intestinal ischemia and long duration reperfusion model.

Methods

Animals were divided into three groups (n=14). Each group was separated into two subgroups. In subgroups A, morphologic injury and the number of perfused intestinal muscular microvessels were analyzed to show “no-reflow phenomenon.” Intestinal resection and anastomosis were performed in subgroups B. Carnitine group (IRCarG) received 200mg/kg intravenous carnitine 2min prior to reperfusion. Malonyldialdehyde, nitric oxide levels in tissue and blood, collagen levels, bursting pressures, and histopathologic evaluation of anastomosis were measured in subgroups B.

Results

Morphologic damage was statistically lower, number of perfused microvessels and epithelial regeneration were statistically higher in IRCarG, compared with ischemia-reperfusion group (P=0.03, P=0.008, P=0.05, respectively).

Conclusion

Carnitine application prior to reperfusion may reduce the severity of the reperfusion injury by preventing the occurrence of no-reflow phenomenon, increase the number of perfused microvessels in the ischemic intestine, and may improve epithelial regeneration in intestinal anastomosis.

Key Words: intestinal ischemia, reperfusion injury, carnitine, intestinal anastomosis