title: Ischaemia-reperfusion is an event triggered by immune complexes and complement.
abstract: BACKGROUND
  Reperfusion injury is a common clinical problem that lacks effective therapy. Two decades of research implicating oxygen free radicals and neutrophils has not led to a single successful clinical trial.
  
  
  METHODS
  The aim was to review new clinical and preclinical data pertaining to the alleviation of reperfusion injury. A review of the literature was undertaken by searching the MEDLINE database for the period 1966-2003 without language restrictions.
  
  
  CONCLUSIONS
  Evidence now points to complement and immune complexes as critical players in mediating reperfusion injury. Ischaemia is postulated to induce a phenotypical cellular change through the surface expression of a neoantigen. Preformed circulating natural IgM antibodies are then trapped and complement is activated. Final events leading to reperfusion injury include formation of the membrane attack complex and mast cell degranulation.
authors.affiliation: Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. hhechtman@partners.org
authors.forename: R K
authors.initials: RK
authors.lastname: Chan
authors.forename: S I
authors.initials: SI
authors.lastname: Ibrahim
authors.forename: N
authors.initials: N
authors.lastname: Verna
authors.forename: M
authors.initials: M
authors.lastname: Carroll
authors.forename: F D
authors.initials: FD
authors.lastname: Moore
authors.forename: H B
authors.initials: HB
authors.lastname: Hechtman
mesh_terms: D000936:Antigen-Antibody Complex / Q000276:immunology*; D002986:Clinical Trials as Topic; D003169:Complement Inactivator Proteins / Q000627:therapeutic use; D003165:Complement System Proteins / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology; D008407:Mast Cells / Q000276:immunology; D017382:Reactive Oxygen Species / Q000276:immunology; D015427:Reperfusion Injury / Q000188:drug therapy / Q000276:immunology*; D013373:Substance P / Q000276:immunology
chemical_list: D000936:Antigen-Antibody Complex; D003169:Complement Inactivator Proteins; D007075:Immunoglobulin M; D017382:Reactive Oxygen Species; D013373:Substance P; D003165:Complement System Proteins