Impact of vasoactive intestinal polypeptide and gastrin-releasing peptide on small bowel microcirculation and mucosal injury after hepatic ischemia/reperfusion in rats.
OBJECTIVE
Alterations in microvascular perfusion of the intestine after hepatic ischemia/reperfusion have been suggested as an important cause of postoperative septic complications. We therefore investigated small bowel microcirculation and mucosal injury after liver ischemia/reperfusion in a rat model. Furthermore, we analyzed the effects of the regulatory peptides vasoactive intestinal polypeptide and gastrin-releasing peptide for their splanchnic vasoactivity.


METHODS
Hepatic ischemia was induced by clamping of the left hepatic artery and vein for 40 min, followed by 60 min of reperfusion. The control group was treated similarly, but without clamping of the liver vessels. Ten minutes after clamping of the hepatic vessels, vasoactive intestinal polypeptide or gastrin-releasing peptide, respectively, were continuously infused intravenously in the experimental groups. Small bowel microcirculation and mucosal injury were assessed using intravital microscopy and the Chiu-score, respectively.


RESULTS
The functional capillary density of the small intestine following ischemia and reperfusion of the left hepatic lobe significantly decreased compared to normal controls in both the mucosa and the smooth intestinal muscle. Red blood cell velocity decreased, whereas leukocyte-endothelium adherence, stasis index and the mucosal injury score increased. Administration of vasoactive intestinal polypeptide resulted in an increase of functional capillary density in the mucosa and of the red blood cell velocity and a decrease in the stasis index. The mucosal injury score was significantly higher in reperfused animals without treatment. The application of gastrin-releasing peptide resulted in an isolated increase of the red blood cell velocity. Leukocyte adherences could not be altered by the regulatory peptides.


CONCLUSIONS
We conclude that hepatic ischemia/reperfusion injury leads to significant alterations of small bowel microcirculation and mucosal injury. Vasoactive intestinal polypeptide and gastrin-releasing peptide attenuate the damage in a different manner.
Leister
Ingo
I
Department of General Surgery, Georg August University, Robert-Koch-Strasse 40, 37099 Göttingen, Germany. ileiste@chirurgie-goettingen.de
Sydow
J
J
Stojanovic
T
T
Füzesi
L
L
Sattler
B
B
Heuser
M
M
Becker
H
H
Markus
P M
PM
D000818:Animals; D019886:Gastrin-Releasing Peptide / Q000502:physiology*; D006499:Hepatic Artery; D007413:Intestinal Mucosa / Q000098:blood supply / Q000473:pathology; D007421:Intestine, Small / Q000098:blood supply*; D008099:Liver / Q000098:blood supply / Q000601:surgery; D008297:Male; D008833:Microcirculation; D051381:Rats; D017208:Rats, Wistar; D012039:Regional Blood Flow; D015427:Reperfusion Injury / Q000503:physiopathology* / Q000662:veterinary; D014660:Vasoactive Intestinal Peptide / Q000494:pharmacology*
D014660:Vasoactive Intestinal Peptide; D019886:Gastrin-Releasing Peptide