Prostaglandins, Leukotrienesand Essential Fatty Acids (1998)59(6), 379-383
© 1998 HarcourtBrace & Co. Ltd
Nitric oxide and endothelin
relationship in intestinal
ischemia/reperfusion injury
(~. U. Durakbasa, ~ T. E. Dagli, ~ H. Mouni, 2 G. Haklar, 2 A. S. Bilsel, 2 M. Yuksel, 2
A. O. Aktan 3
1Department of Pediatric Surgery
=Department of Biochemistry
3Department of General Surgery, Marmara University School of Medicine, ]stanbul, Turkey
Summary Gastrointestinal mucosal blood flow is dependent on a balanced release of vasoactive substances from
endothelium. Nitric oxide (NO) may increase the flow by vasodilatation and/or antiaggregation whereas endothelin
(ET) may decrease it by vasoconstriction and aggregation. NO and ET may have counterbalancing effects on each
other in tissue damage. In order to test this hypothesis, in this study on rats, L-arginine to increase NO levels and
NG-nitro-L-arginine methyl esther (L-NAME) to decrease NO levels have been used in an intestinal ischemia/
reperfusion (I/R) injury model and portal vein ET response was evaluated. Lipid peroxidation product measurements
and chemiluminescence (CL) studies were also carried out in ileal tissue samples. Intestinal I/R injury caused an
increase in portal venous ET levels with levels of 9.4_+0.5 fmol/ml in sham operation and 14.8_+1.6 fmol/ml in I/R group.
ET level of L-NAME-sh group was lower than that of sham-operated group and also ET level of L-NAME-I/R group
was lower than that of I/R group. This yielded the conclusion that inhibition of NO synthesis decreases portal venous
ET levels in this model. Increased NO production by L-arginine caused increased ET levels in sham operated groups
but this effect was not observed in I/R injury state. This study also showed that inhibition of NO synthesis has a
protective role by reducing the reperfusion damage in this model. It is likely that NO and ET have a feedback effect on
each other both under physiologic conditions and I/R injury.
INTRODUCTION
After an ischemic insuk, reperfusion is inevitable if the
organ or system in question is to survive. However, it
has been shown clearly that the damage brought about
by reperfusion is much bigger than ischemia itself. 1,2
The vascular endothelium is very active in regulating
the vascular tonus and endothelial cell dysfunction is
thought to be the 'trigger' of reperfusion injury. 3 Endo-
thelial cells can produce the potent vasoconstrictor and
aggregator endothelin (ET) and also the vasodilator and
antiaggregator nitric oxide (NO)) '4 In different experi-
mental studiest, either NO donors or NO inhibitors have
been shown to be protective? -s In addition, increased
Received 20 August 1998
Accepted 9 October 1998
Correspondence to: A. O. Aktan, Marmara University Hospital, Department of
General Surgery, Attunizade 81190 Istanbul, Turkey.
Fax: +90 216 3250323
levels of ET have been demonstrated in portal venous
blood following intestinal I/R injury. 9 However, the possi-
ble interaction between NO and ET in I/R injury has
not been established.
NO and ET may have counterbalancing effects on each
other in tissue damage. In order to test this hypothesis,
L-arginine to increase NO levels and NC-nitro-L-arginine
methyl esther (L-NAME) to decrease NO levels have been
administered in an intestinal I/R injury model on rats and
ET response was evaluated.
MATERIALS AND METHODS
Experiments were performed on 79 female Wistar Albino
rats (weighing 160-220g) initially anesthetized with
urethane (1.6 mg/kg, i.p.). An intratracheal cannula was
placed through a midline incision and tracheotomy
to facilitate breathing. The right jugular vein was cannu-
lated for infusion. Rats were randomly divided into eight
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