Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-20T02:25:11.645Z Has data issue: false hasContentIssue false

The effects of propofol and ketamine on gut mucosal epithelial apoptosis in rats after burn injury

Published online by Cambridge University Press:  07 July 2006

H. Yagmurdur
Affiliation:
The Ministry of Health Ankara Research and Training Hospital, Clinics of Anesthesiology and Reanimation, Ankara, Turkey
M. Aksoy
Affiliation:
The Ministry of Health Ankara Research and Training Hospital, Clinics of Plastic and Reconstructive Surgery, Ankara, Turkey
M. Arslan
Affiliation:
The Ministry of Health Ankara Research and Training Hospital, Clinics of Anesthesiology and Reanimation, Ankara, Turkey
B. Baltaci
Affiliation:
The Ministry of Health Ankara Research and Training Hospital, Clinics of Anesthesiology and Reanimation, Ankara, Turkey
Get access

Extract

Summary

Background and objectives: Apoptosis occurs after thermal injury and may result from either ischaemic intestinal insult or inflammatory mediators released after burn injury. The aim of the study was to investigate the effects of propofol and ketamine on gut epithelium apoptosis after burn injury. Methods: Sixty male Wistar Albino rats were randomly assigned into four groups. Anaesthesia was induced and maintained with propofol in Groups 1 and 2, and ketamine in Groups 3 and 4 over 12 h. Groups 2 and 4 received 30% total body surface area burn. Groups 1 and 3 had no burn injury. Mean arterial pressure was maintained within 10% of baseline levels in all animals. At 12 h postburn, animals were sacrificed and tissue samples were taken from small intestine for determination of lipid peroxidation, apoptosis and proliferation. Also blood samples were taken for measurement of serum tumor necrosis factor-alpha (TNF-α) levels. Results: Ileal malondialdehyde (MDA) concentration (extent of lipid peroxidation) increased significantly in Group 4 (112.4 ± 10.2 nmol g−1) compared to Group 3 (48.4 ± 5.6 nmol g−1) and Group 2 (59.8 ± 3.2 nmol g−1). The mean TNF-α level in Group 4 (118.9 ± 10.5 pg mL−1) at 12 h postburn was significantly higher than the mean in Group 2 (56.4 ± 4.3 pg mL−1). Group 4 had the highest mean TUNEL index (terminal deoxyuridine nick-end labelling – an index of extent of apoptosis) of all the groups (265/10). Also the mean TUNEL index value in Group 2 (53/10) was higher than that of Group 1 (3/10) and Group 3 (5/10). The proliferating cell nuclear antigen index (extent of proliferation) remained unchanged among groups. Conclusions: Propofol could offer a protection against apoptosis of enterocytes with a stable tissue MDA and serum TNF-α level compared to ketamine anaesthesia in an animal model of burn injury.

Type
Original Article
Copyright
© 2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Jones II WG, Minei JP, Barber AE et al. Bacterial translocation and intestinal atrophy after thermal injury and burn wound sepsis. Ann Surg 1990; 211: 399405.Google Scholar
Chung DH, Evers BM, Townsend CM et al. Burn-induced transcriptional regulation of small intestinal ornithine decarboxylase. Am J Surg 1992; 163: 157163.Google Scholar
Grisham MB, Granger DN. Free radicals: reactive metabolites of oxygen as mediators of post-ischemic reperfusion injury. In: Martson A, Bulkley GB, Fiddian-Green RG, Haglund U (eds). Splanchnic Ischemia and Multiple Organ Failure. St Louis: Mosby, 1989; 135144.
Endo S, Inada K, Yamada Y et al. Plasma tumor necrosis factor-α (TNF-α) levels in patients with burns. Burns 1993; 19: 124127.Google Scholar
Yamada Y, Endo S, Inada K. Plasma cytokine levels in patients with severe burn injury-with reference to the relationship between infection and prognosis. Burns 1996; 22: 587593.Google Scholar
Wolf SE, Ikeda H, Matin S et al. Cutaneous burn increases apoptosis in the epithelium of mice. J Am Coll Surg 1999; 188: 1016.Google Scholar
Murphy PG, Myers DS, Davies MJ et al. The antioxidant potential of propofol (2,6-diisopropylphenol). Br J Anaesth 1992; 68: 613618.Google Scholar
Runzer TD, Ansley DM, Godin DV et al. Tissue antioxidant capacity during anaesthesia: propofol enhances in vivo red cell and tissue antioxidant capacity in a rat model. Anesth Analg 2002; 94: 8993.Google Scholar
Yagmurdur H, Cakan T, Bayrak A et al. The effects of etomidate, thiopental, and propofol in induction on hypoperfusion-reperfusion phenomenon during laparoscopic cholecystectomy. Acta Anaesthesiol Scand 2004; 48: 772777.Google Scholar
Cheng YJ, Wang YP, Chien CT et al. Small dose propofol sedation attenuates the formation of reactive oxygen species in tourniquet-induced ischemia-reperfusion injury under spinal anaesthesia. Anesth Analg 2002; 94: 16171620.Google Scholar
Kang MY, Tsuchiya M, Packer L et al. In vitro study on antioxidant potential of various drugs used in the perioperative period. Acta Anaesthesiol Scand 1998; 42: 412.Google Scholar
Lupp A, Kerst S, Karge E. Evaluation of possible pro-or antioxidative properties and of the interaction capacity with the microsomal cytochrome P450 system of different NMDA-receptor ligands and of taurine in vitro. Exp Toxicol Pathol 2003; 54: 441448.Google Scholar
Yagmurdur H, Akca G, Aksoy M et al. The effects of ketamine and propofol on bacterial translocation in rats after burn injury. Acta Anaesthesiol Scand 2005; 49: 177182.Google Scholar
Gilpin DA. Calculation of a new Meeh constant and experimental determination of burn size. Burns 1996; 22: 607611.Google Scholar
Walker HL, Mason AD. A standard animal burn. J Trauma 1968; 8: 10491054.Google Scholar
Uchiyama M, Mihara M. Determination of malondialdehyde precursers in tissues by thiobarbituric acid test. Ann Biochem 1978; 86: 271278.Google Scholar
Gavrieli Y, Sheman Y, Bensasson SA. Identification of programmed death via specific labeling of nuclear DNA fragmentation. J Cell Biol 1992; 119: 493501.Google Scholar
Hall PA, Levision DA, Woods AL. Proliferating cell nuclear antigen (PCNA) immunolocalisation in paraffin sections: an index of cell proliferation with evidence of deregulated expressions in some neoplasms. J Pathol 1990; 162: 285294.Google Scholar
Varedi M, Greeley Jr GH, Herndon DN et al. A thermal injury-induced circulating factor(s) compromises intestinal cell morphology, proliferation, and migration. Am J Physiol Gastrointest Liver Physiol 1999; 277: G175G182.Google Scholar
Varedi M, Chinery R, Greeley Jr GH et al. Thermal injury effects on intestinal crypt cell proliferation and death are cell position dependent. Am J Physiol Gastrointest Liver Physiol 2001; 280: G157G163.Google Scholar
Spies M, Chappell VL, Dasu MR et al. Role of TNF-α in gut mucosal changes after severe burn. Am J Physiol Gastrointest Liver Physiol 2002; 283: G703G708.Google Scholar
Sun Z, Wang X, Deng X et al. The influence of intestinal ischemia and reperfusion on bidirectional intestinal barrier permeability, cellular membrane integrity, proteinase inhibitors, and cell death in rats. Shock 1998; 10: 203212.Google Scholar
Ikeda H, Suzuki Y, Suzuki M et al. Apoptosis is a major mode of cell death caused by ischemia and ischemia/reperfusion injury to the rat intestinal epithelium. Gut 1998; 42: 530537.Google Scholar
Ramzy PI, Wolf SE, Irtun O et al. Gut epithelial apoptosis after severe burn: effects of gut hypoperfusion. J Am Coll Surg 2000; 190: 281287.Google Scholar
Zhang C, Sheng ZY, Hu S et al. The role of oxygen-free radical in the apoptosis of enterocytes in scalded rats after delayed resuscitation. J Trauma 2004; 56: 611617.Google Scholar
Tribble DL, Aw TY, Jones DP. The pathophysiological significance of lipid peroxidation in oxidative cell injury. Hepatology 1987; 7: 377383.Google Scholar
Cho K, Adamson LK, Greenhalgh DG. Parallel self-induction of TNF-α and apoptosis in the thymus of mice after burn injury. J Surg Res 2001; 98: 915.Google Scholar
Zhang B, Huang YH, Chen Y et al. Plasma tumor necrosis factor-α, its soluble receptors and interleukin-1β levels in critically burned patients. Burns 1998; 24: 599603.Google Scholar
Wolvekamp MC, Darby IA, Fuller PJ. Cautionary note on the use of end-labelling DNA fragments for detection of apoptosis. Pathology 1998; 30: 267271.Google Scholar
Kelly KJ, Sandoval RM, Dunn KW, Molitoris BA et al. A novel method to determine specifity and sensitivity of the TUNEL reaction in the quantitation of apoptosis. Am J Physiol Cell Physiol 2003; 284: C1309C1318.Google Scholar
Dobke MK, Simoni J, Ninnemann JL et al. Endotoxemia after burn injury: effect of early excision on circulating endotoxin levels. J Burn Care Rehabil 1989; 10: 107111.Google Scholar
Murphy PG, Bennett JR, Myers DS et al. The effect of propofol anaesthesia on free radical-induced lipid peroxidation in rat liver microsomes. Eur J Anaesth 1993; 10: 261266.Google Scholar
Kahraman S, Demiryürek AT. Propofol is a peroxynitrite scavenger. Anesth Analg 1997; 84: 11271129.Google Scholar
Mathy-Hartert M, Mouithys-Mickalad A, Kohnen S et al. Effects of propofol on endothelial cells subjected to a peroxynitrite donor (SIN-1). Anaesthesia 2000; 55: 10661071.Google Scholar
Luo T, Xia Z, Ansley DM et al. Propofol dose-dependently reduces tumor necrosis factor-α-induced human umbilical vein endothelial cell apoptosis: effects on Bcl-2 and Bax expression and nitric oxide generation. Anesth Analg 2005; 100: 16531659.Google Scholar
Acquaviva R, Campisi A, Murabito P et al. Propofol attenuates peroxynitrite-mediated DNA damage and apoptosis in cultured astrocytes. Anesthesiology 2004; 101: 13631371.Google Scholar
Acquaviva R, Campisi A, Raciti G et al. Propofol inhibits caspase-3 in astroglial cells: role of heme oxygenase-1. Curr Neurovasc Res 2005; 2: 141148.Google Scholar
Salgo MG, Pryor WA. Trolox inhibits peroxynitrite-mediated oxidative stress and apoptosis in rat thymocytes. Arch Biochem Biophys 1996; 333: 482488.Google Scholar
Chang H, Tsai SY, Chang Y et al. Therapeutic concentrations of propofol protects mouse macrophages from nitric oxide-induced cell death and apoptosis. Can J Anaesth 2002; 49: 477480.Google Scholar
White PF, Way WL, Trevor AJ. Ketamine: its pharmacology and therapeutic uses. Anesthesiology 1982; 56: 119136.Google Scholar
Takadera T, Ishida A, Ohyashiki T. Ketamine-induced apoptosis in cultured rat cortical neurons. Toxicol Appl Pharmacol 2006; 210: 100107.Google Scholar
Larsen B, Hoff G, Wilhelm W et al. Effect of intravenous anesthetics on spontaneous and endotoxin-stimulated cytokine response in cultured human whole blood. Anesthesiology 1998; 89: 12181227.Google Scholar
Zhang C, Sheng ZY, Hu S et al. The influence of apoptosis of mucosal epithelial cells on intestinal barrier integrity after scald in rats. Burns 2002; 28: 731737.Google Scholar
Sun Z, Wang X, Wallen R et al. The influence of apoptosis on intestinal barrier integrity in rats. Scand J Gastroenterol 1998; 33: 415422.Google Scholar
Al-Ghoul WM, Khan M, Fazal N et al. Mechanisms of postburn intestinal barrier dysfunction in the rat: roles of epithelial cell renewal, E-cadherin, and neutrophil extravasation. Crit Care Med 2004; 32: 17301739.Google Scholar