Reperfusion injury after focal myocardial ischaemia: polymorphonuclear leukocyte activation and its clinical implications.
The only way to rescue ischaemic tissue is to re-instate the oxygen supply to the tissue. However reperfusion of the ischaemic area not only oxygenates the tissue but also initiates a cascade of processes, which may in some cases result in temporary dysfunction of the myocardium. In order to devise protective measures, it is essential to understand the mechanisms and the triggers of this reperfusion phenomenon. In this review we will mainly focus on the inflammatory response caused by reperfusion. We will cover the different steps of polymorphonuclear leukocyte activation and will briefly discuss the molecular biology of the receptors involved. The currently used pharmacological medications in acute cardiology will be reviewed and in particular their actions on polymorphonuclear leukocyte activation, adhesion and degranulation. This review is a compilation of the current knowledge in the field and the therapeutic progress in the prevention of reperfusion injury made today.
Vermeiren
G L
GL
Department of Intensive Care, University Hospital of Antwerp, Belgium.
Claeys
M J
MJ
Van Bockstaele
D
D
Grobben
B
B
Slegers
H
H
Bossaert
L
L
Jorens
P G
PG
D000241:Adenosine / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002448:Cell Adhesion / Q000502:physiology; D002633:Chemotaxis; D015936:Complement C5a / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D005609:Free Radicals / Q000378:metabolism; D006801:Humans; D007975:Leukotriene B4 / Q000378:metabolism; D008213:Lymphocyte Activation / Q000187:drug effects; D015428:Myocardial Reperfusion Injury / Q000276:immunology* / Q000503:physiopathology / Q000517:prevention & control; D009504:Neutrophils / Q000187:drug effects / Q000502:physiology*; D009566:Nitrates / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015912:Thrombolytic Therapy
D000319:Adrenergic beta-Antagonists; D016207:Cytokines; D005609:Free Radicals; D009566:Nitrates; D010975:Platelet Aggregation Inhibitors; D007975:Leukotriene B4; D015936:Complement C5a; D000241:Adenosine