Effects of the anti-ICAM-1 monoclonal antibody, allopurinol, and methylene blue on intestinal reperfusion injury.
OBJECTIVE
The aim of this study was to evaluate the effect of allopurinol, methylene blue, and a monoclonal antibody to the adhesion molecule ICAM-1 in intestinal ischemia and reperfusion injury.


METHODS
The rats were divided into 5 groups. CG (n = 8) was untreated controls, SISG (n = 11) received sterile isotonic saline solution, ICAMG (n = 12) received a monoclonal antibody to rat ICAM-1, ALLOG (n = 12) received allopurinol, and MBG (n = 14) received methylene blue. Intestinal ischemia was performed for 60 minutes followed by 60 minutes of reperfusion. The agents were injected 10 minutes before the reperfusion to animals. After 60 minutes of reperfusion, the plasma samples for myeloperoxidase (MPO) activity, tumor necrosis factor alpha (TNF-alpha) and uric acid levels, and the intestinal biopsies of ileum and jejunum for histopathologic examination were taken.


RESULTS
The mucosal damage was attenuated, and TNF-alpha level significantly decreased in ALLOG and ICAMG compared with SISG. The MPO activity was the lowest in ICAMG, and uric acid level was significantly decreased in ALLOG compared with the other groups. Methylene blue decreased TNF-alpha response to reperfusion injury but significantly increased the grade of the mucosal damage and the MPO activity.


CONCLUSIONS
This study shows that prereperfusion application of allopurinol and monoclonal antibody to the adhesion molecule ICAM-1 may attenuate the damage caused by intestinal ischemia and reperfusion, but the different time-points for application, the effects observed in the different ischemia and reperfusion durations, and the long-term results also should be investigated in the same experimental model before the final conclusion. Methylene blue was not effective to prevent or attenuate the intestinal tissue injury, but because this was the first study examining the effect of methylene blue on intestinal reperfusion injury, further studies with the different doses, ischemic duration, and application times will be needed.
Ilhan
Huseyin
H
Department of Pediatric Surgery, Osmangazi University, School of Medicine, Eskisehir, Turkey.
Alatas
Ozkan
O
Tokar
Baran
B
çOlak
Omer
O
Paşaoĝlu
Ozgül
O
Koku
Naim
N
D000493:Allopurinol / Q000627:therapeutic use*; D000818:Animals; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000627:therapeutic use*; D004353:Drug Evaluation, Preclinical; D007082:Ileum / Q000473:pathology; D018799:Intercellular Adhesion Molecule-1 / Q000276:immunology*; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000188:drug therapy* / Q000378:metabolism; D007583:Jejunum / Q000473:pathology; D008297:Male; D008751:Methylene Blue / Q000627:therapeutic use*; D009195:Peroxidase / Q000097:blood; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000378:metabolism / Q000517:prevention & control*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014527:Uric Acid / Q000097:blood
D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D018799:Intercellular Adhesion Molecule-1; D014527:Uric Acid; D000493:Allopurinol; D009195:Peroxidase; D008751:Methylene Blue