title: Protective effect of heparin in the end organ ischemia/reperfusion injury of the lungs and heart.
abstract: BACKGROUND
  Ischemia/reperfusion (I/R) injury is harmful to the cardiovascular system and is responsible for the inflammatory response and multiple organ dysfunctions. In this study we investigated the effect of activated clotting time level on the aortic cross-clamping triggers a systemic inflammatory response and it effects to lungs and heart.
  
  
  METHODS
  End organ concentrations of interleukin-6 (IL-6), myeloperoxidase (MPO) and heat shock protein 70 (HSP-70) were determined in four groups of Spraque Dawley rats: ischemic control (operation with cross clamping received IP of 0.9% saline at 2 ml/kg n=7) Sham (operation without cross clamping, n=7), heparin (ACT level about 200), High dose heparin (ACT level up to 600) The infrarenal aorta was clamped for 45 minutes by a mini cross clamp approximately 1cm below the renal artery and 1cm iliac bifurcation in all groups without sham group. Heparin was given intraperitoneal (IP) before the procedure. All rats were sacrificed 48 h later. In a second experiment, the effects of I/R on remote organs (lungs and heart) were harvested for analysis. We evaluated tissue levels of myeloperoxidase, interleukin-6, and heat shock protein (HSP-70) were analyzed as markers oxidative stress and inflammation. Histological analyses of the organs were performed.
  
  
  RESULTS
  The lungs paranchymal MPO and HSP-70 levels significantly decreased (p<0.05), but IL-6 level was not significant (p>0.05) in heparinized and high dose heparinized groups when compared to ischemic control group. Histopathological evaluation as edema, cell degeneration, inflammation statistically significantly decreased in both group heparinized and high dose heparinized compared with ischemic control group (p<0.05). The heart paranchymal MPO levels significantly decreased in heparinized and high dose heparinized groups when compared to ischemic control group (p=0.023). IL-6, HSP-70 levels were not significant heparinized and high dose heparinized groups when compared to ischemic control group (p=0.0489, p=0.0143). Histopathological evaluation as degeneration statistically significantly decreased in both group heparinized and High dose heparinized compared with ischemic control group (p=0.005).
  
  
  CONCLUSIONS
  Heparin decreased remote organs injury on the lung and heart after ischemia/reperfusion of infra-renal section of the body in the rat model. So, we should be balance to act level for avoid to I/R injury per operative and early post operative period as providing ACT level nearly 200.
authors.affiliation: Cardiovascular Surgery Department of Ankara Numune Education and Research Hospital, Talatpasa Bulvari, Ankara, Turkey. drselcukg@hotmail.com
authors.forename: Hikmet Selcuk
authors.initials: HS
authors.lastname: Gedik
authors.forename: Kemal
authors.initials: K
authors.lastname: Korkmaz
authors.forename: Havva
authors.initials: H
authors.lastname: Erdem
authors.forename: Evvah
authors.initials: E
authors.lastname: Karakilic
authors.forename: Gokhan
authors.initials: G
authors.lastname: Lafci
authors.forename: Handan
authors.initials: H
authors.lastname: Ankarali
mesh_terms: D000818:Animals; D003331:Coronary Vessels / Q000187:drug effects; D018840:HSP70 Heat-Shock Proteins / Q000737:chemistry / Q000378:metabolism; D006321:Heart / Q000187:drug effects; D006493:Heparin / Q000494:pharmacology*; D007150:Immunohistochemistry; D015850:Interleukin-6 / Q000737:chemistry / Q000378:metabolism; D008168:Lung / Q000098:blood supply* / Q000737:chemistry / Q000187:drug effects / Q000473:pathology; D008297:Male; D015428:Myocardial Reperfusion Injury / Q000378:metabolism / Q000517:prevention & control*; D009206:Myocardium / Q000737:chemistry / Q000473:pathology; D009195:Peroxidase / Q000737:chemistry / Q000378:metabolism; D020011:Protective Agents / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000378:metabolism / Q000517:prevention & control*
chemical_list: D018840:HSP70 Heat-Shock Proteins; D015850:Interleukin-6; D020011:Protective Agents; D006493:Heparin; D009195:Peroxidase