Prävention des Ischämie-Reperfusionsschadens durch Erythropoietin am Schweinemodell der Aortenokklusion: Histomorphologie / Histochemie

Abstract

Background: Aortic occlusion causes ischemia/reperfusion injury, kidney and spinal cord being the most vulnerable organs. Erythropoietin improved ischemia/reperfusion injury in rodents, which, however, better tolerate ischemia/reperfusion than larger species. Therefore, we investigated whether erythropoietin attenuates porcine aortic occlusion ischemia/reperfusion injury. Materials and Methods: Before occluding the aorta for 45 mins by inflating intravascular balloons, we randomly infused either erythropoietin (n = 8; 300 IU/kg each over 30 mins before and during the first 4 hrs of reperfusion) or vehicle (n = 6). During aortic occlusion and reperfusion, mean arterial pressure was maintained at 80 % to 120 % of baseline by vasoactive drugs. After 8 hrs of reperfusion, kidney and spinal cord specimens were taken for histology (hematoxylin-eosin, Nissl staining) and immunohistochemistry (TUNEL assay for apoptosis). Results: Parameters of systemic hemodynamics and metabolism were comparable. For lack of detectable histologic damage in the kidney histology and TUNEL staining, there was no effect of EPO observed. Neuronal damage and glial apoptosis were significantly attenuated in the thoracic spinal cord segments by EPO treatment. Conclusion: During porcine aortic occlusion-induced ischemia/reperfusion erythropoietin improved thoracic spinal cord integrity.