Tetrandrine ameliorated reperfusion injury of small bowel transplantation.
OBJECTIVE
In small bowel transplantation, the bowel graft is susceptible to reperfusion injury. This study investigated the effects of tetrandrine, a bisbenzylisoquinoline alkaloid, on the development of intestinal reperfusion injury in small bowel transplantation in pigs.


METHODS
Pigs underwent small bowel transplantation and were treated with tetrandrine or a vehicle. Blood and small bowel specimens were harvested at 1, 3, and 24 hours after reperfusion. Histopathologic analysis of the small bowel was assessed for tissue damage. Serum levels of tumor necrosis factor-alpha, interleukin-1beta (IL-1beta), and IL-6 were measured by enzyme-linked immunosorbent assay. Reverse-transcriptase polymerase chain reaction analysis was performed to analyze the expression of proinflammatory cytokines, and immunohistochemical analysis was used to study the expression of intercellular adhesion molecule-1 (ICAM-1) in the small bowel. Myeloperoxidase staining detected neutrophil infiltration in the small bowel and the number of myeloperoxidase positively stained cells was counted.


RESULTS
Pigs receiving small bowel transplantation had elevated serum proinflammatory cytokine levels. The transplanted small bowel showed mucosal damage, increased expression of proinflammatory cytokines and ICAM-1, and prominent neutrophil infiltration. Tetrandrine administration reduced mucosal damage, serum and tissue proinflammatory cytokine levels, ICAM-1 expression, and neutrophil accumulation in the transplanted small bowel.


CONCLUSIONS
Tetrandrine reduced the reperfusion injury in porcine intestinal transplantation during the first 24 hours after the procedure.
Chen
Yun
Y
Department of Surgery, Far Eastern Memorial Hospital, Pan-Chiao, Taipei 220, Taiwan.
Wu
Jiann-Ming
JM
Lin
Tzu-Yu
TY
Wu
Chia-Chan
CC
Chiu
Kuan-Ming
KM
Chang
Bee-Feng
BF
Tseng
Sheng-Hong
SH
Chu
Shu-Hsun
SH
D000818:Animals; D044182:Benzylisoquinolines / Q000627:therapeutic use*; D016207:Cytokines / Q000097:blood; D004195:Disease Models, Animal; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D004797:Enzyme-Linked Immunosorbent Assay; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007421:Intestine, Small / Q000473:pathology / Q000637:transplantation*; D008297:Male; D020556:Neutrophil Infiltration; D015427:Reperfusion Injury / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D013552:Swine
D044182:Benzylisoquinolines; D016207:Cytokines; D004365:Drugs, Chinese Herbal; D053583:Interleukin-1beta; D015850:Interleukin-6; D018799:Intercellular Adhesion Molecule-1; C009438:tetrandrine