title: Efficacy of iloprost and montelukast combination on spinal cord ischemia/reperfusion injury in a rat model.
abstract: BACKGROUND
  The thoracic or thoracoabdominal aortic aneurysm surgery may cause spinal cord ischemia because of aortic cross-clamping and may result in severe postoperative complications caused by spinal cord injury. Ischemia/reperfusion injury may directly or indirectly be responsible for these complications. In this study we sought to determine whether combination of iloprost and montelukast can reduce the ischemia/reperfusion injury of spinal cord in a rat model.
  
  
  METHODS
  Medulla spinalis tissue concentrations of interleukin-6 (IL-6), myeloperoxidase (MPO) and heat shock protein 70 (HSP-70) were determined in 3 groups of Spraque Dawley rats: control group (operation with cross clamping and intraperitoneal administration of 0.9% saline, n = 7), sham group (operation without cross clamping, n = 7), and study group (operation with cross-clamping and intraperitoneal administration of iloprost (25 ng/kg) and montelukast (1 mg/kg), n = 7). The abdominal aorta was clamped for 45 minutes, with a proximal (just below the left renal artery) and a distal (just above the aortic bifurcation) clip in control and study groups. Hindlimb motor functions were evaluated at 6, 12, 24, and 48 hours using the Motor Deficit Index score. All rats were sacrificed 48 hours after the procedure and spinal cord tissue levels of myeloperoxidase, interleukin-6, and heat shock protein (HSP-70) were evaluated as markers of oxidative stress and inflammation. Histopathological analyses of spinal cord were also performed.
  
  
  RESULTS
  The tissue level of HSP-70 was found to be similar among the 3 groups, however, MPO was highest and IL-6 receptor level was lowest in the control group (p = 0.007 and p = 0.005; respectively). In histopathological examination, there was no significant difference among the groups with respect to the neuronal cell degeneration, edema, or inflammation, but vascular congestion was found to be significantly more prominent in the control group than in the sham or in the study group (p = 0.05). Motor deficit index scores at 24 and 48 hours after ischemia were significantly lower in the study group than in the control group.
  
  
  CONCLUSIONS
  This study suggests that combined use of iloprost and montelukast may reduce ischemic damage in transient spinal cord ischemia and may provide better neurological outcome.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Lafci
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: Omer Faruk
authors.initials: OF
authors.lastname: Cicek
authors.forename: Osman Arikan
authors.initials: OA
authors.lastname: Nacar
authors.forename: Levent
authors.initials: L
authors.lastname: Yildirim
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Kaya
authors.forename: Handan
authors.initials: H
authors.lastname: Ankarali
mesh_terms: D000085:Acetates / Q000627:therapeutic use*; D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D003521:Cyclopropanes; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D016285:Iloprost / Q000627:therapeutic use*; D007274:Injections, Intraperitoneal; D008297:Male; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D018384:Oxidative Stress; D011804:Quinolines / Q000627:therapeutic use*; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D013116:Spinal Cord / Q000378:metabolism / Q000473:pathology; D013119:Spinal Cord Injuries / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D013440:Sulfides; D016896:Treatment Outcome
chemical_list: D000085:Acetates; D015415:Biomarkers; D003521:Cyclopropanes; D018696:Neuroprotective Agents; D011804:Quinolines; D013440:Sulfides; D016285:Iloprost; C093875:montelukast
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