title: Minocycline inhibits apoptotic cell death in a murine model of partial flap loss.
abstract: For breast reconstruction, the deep inferior epigastric perforator (DIEP) flap has become standard therapy. A feared complication is partial or even total flap loss. In a novel murine model of partial DIEP flap loss, the contribution of apoptotis to flap loss was investigated. The clinically available apoptosis-inhibiting compound minocycline was tested for its ability to reduce cell death. The effect of minocycline on cell proliferation was studied in cell cultures of breast carcinoma. In 12 mice, pedicled DIEP flaps were raised, which were subjected to 15 minutes of ischemia and 4 days of reperfusion. Six mice were treated with minocycline 2 hours before surgery and every 24 hours for 4 days. Apoptosis was revealed by injecting annexin A5 30 minutes before sacrifice. Annexin A5 binds to phosphatidylserines, which are expressed on the cell membrane during apoptotis. Prior to sacrifice, necrosis was measured using planimetry. Minocycline reduced cell death after 4 days from 35.9% (standard deviation = 10.6) to 13.9% (standard deviation = 8.0; P < 0.05). Apoptosis, as shown by annexin A5 binding in nontreated animals, was abundant. Minocycline did not influence tumor growth in cell cultures of human breast cancer. Minocycline treatment leads to increased DIEP flap viability in mice. This study widens the perspective in the improvement of free flap survival in patients.
authors.affiliation: Department of Plastic, Reconstructive, and Hand Surgery, Jeroen Bosch Hospital, Den Bosch, The Netherlands. EwaldDumont@gmail.com
authors.forename: Ewald A W J
authors.initials: EA
authors.lastname: Dumont
authors.forename: Suzanne P M
authors.initials: SP
authors.lastname: Lutgens
authors.forename: Christopher P M
authors.initials: CP
authors.lastname: Reutelingsperger
authors.forename: Gerard M J
authors.initials: GM
authors.lastname: Bos
authors.forename: Lenoard
authors.initials: L
authors.lastname: Hofstra
mesh_terms: D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D016923:Cell Death / Q000187:drug effects*; D045744:Cell Line, Tumor / Q000187:drug effects; D004195:Disease Models, Animal; D019074:Epigastric Arteries / Q000637:transplantation; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D007150:Immunohistochemistry; D007279:Injections, Subcutaneous; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D051379:Mice; D008911:Minocycline / Q000494:pharmacology*; D011897:Random Allocation; D017568:Rectus Abdominis / Q000098:blood supply*; D012016:Reference Values; D012039:Regional Blood Flow; D013524:Surgical Flaps / Q000009:adverse effects / Q000098:blood supply*
chemical_list: D008911:Minocycline