Inosine Modulates Gut Barrier Dysfunction and End Organ Damage in a Model of Ischemia–Reperfusion Injury

• Published in: The Journal of surgical research 2002-11, Vol.108 (1), p.61-68
• Main Authors: Dowdall, J.F., Winter, D.C., Bouchier-Hayes, D.J.
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Dextrans - pharmacokinetics; Disease Models, Animal; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Fluorescein-5-isothiocyanate - analogs & derivatives; Fluorescein-5-isothiocyanate - pharmacokinetics; Gastroenterology. Liver. Pancreas. Abdomen; Heat-Shock Proteins - metabolism; HSP72 Heat-Shock Proteins; inosine; Inosine - pharmacology; Intensive care medicine; Interleukin-6 - blood; Intestinal Absorption - drug effects; Intestinal Mucosa - metabolism; intestine; Intestines - blood supply; Intestines - pathology; ischemia; Lung - blood supply; Lung - enzymology; Lung - pathology; Lung Diseases - drug therapy; Lung Diseases - pathology; Male; Medical sciences; Mesenteric Artery, Superior; Microcirculation; Other diseases. Semiology; permeability; Peroxidase - metabolism; Pulmonary Circulation; Rats; Rats, Sprague-Dawley; reperfusion; Reperfusion Injury - drug therapy; Reperfusion Injury - pathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumor Necrosis Factor-alpha - metabolism
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1006/jsre.2002.6519

Introduction. Gut barrier failure is an important source of morbidity in critically ill patients, and patients undergoing aortic cross-clamp. Inosine, an endogenous purine nucleoside without known side effects, formed from the breakdown of adenosine by adenosine deaminase, has been shown to modify the effects of hypoxia on various tissues, including the heart and the brain. Materials and methods. This study examined the effect of inosine on ischemia–reperfusion-induced gut barrier dysfunction and on the associated lung injury. Twenty-four male Sprague–Dawley rats were divided into three groups. Eight were subjected to 60 min of superior mesenteric artery occlusion followed by 4 h of reperfusion. Eight had 100 mg/kg inosine prior to ischemia–reperfusion and 8 had sham laparotomy with encircling but not occlusion of the superior mesenteric artery. Results. Rats treated with inosine had significantly less gut barrier dysfunction. Rats subjected to SMAO sustained a substantial lung injury and this was attenuated by inosine treatment. Serum cytokine levels were also significantly lower. Conclusion. We conclude that inosine has a beneficial effect in modulating both gut barrier dysfunction and distant organ injury in response to gut ischemia–reperfusion.