白细胞介素1受体相关激酶4活性在皮瓣缺血再灌注损伤中的作用

摘要

BACKGROUND:Interleukin-1 receptor-associated kinase 4 activity-induced inflammations and infection have been extensively accepted. However, there was no report concerning its effects on flap ischemia-reperfusion injury. OBJECTIVE:To explore the significance of interleukin-1 receptor-associated kinase 4 activity in flap ischemia-reperfusion injury. METHODS:A total of 36 adult male Sprague-Dawley rats were randomized into sham-operated group (n=12), ischemia-reperfusion group (n=12) and interleukin-1 receptor-associated kinase 4 group (n=12). The models of right lower abdominal island flap ischemia-reperfusion injury were set up. Interleukin-1 receptor-associated kinase 4 group was intraperitoneal y injected with 1 mL of interleukin-1 receptor-associated kinase 4 (100μmol/L) before reperfusion. The flaps were col ected at 1, 2, 4, and 6 hours after ischemia-reperfusion injury for histopathhological observation. At 1 hour after ischemia-reperfusion, protein expression of interleukin-1 receptor-associated kinase 4 was detected in flaps. The proportion of flap survival was calculated at 7 days after surgery.RESULTS AND CONCLUSION:Histopathological observation demonstrated that compared with the ischemia-reperfusion injury group, neutrophil infiltration and edema was evidently improved, and the protein expression of interleukin-1 receptor-associated kinase 4 was gradual y reduced in the interleukin-1 receptor-associated kinase 4 group. Flap survival proportions were respectively (51.70 ±7.62)%and (86.56±12.23)%in the ischemia-reperfusion injury group and interleukin-1 receptor-associated kinase 4 group at 7 days after surgery. There were significant differences in the flap survival proportion between the two groups (P<0.01). These results showed that after flap ischemia-reperfusion injury, the inhibition of interleukin-1 receptor-associated kinase 4 activities could elevate the survival rate of transplanted flap.%背景：白细胞介素1受体相关激酶4活性引发炎症及感染的作用已得到广泛认可，但其对皮瓣缺血再灌注损伤是否有影响尚无文献报道。目的：探讨白细胞介素1受体相关激酶4活性在皮瓣缺血再灌注损伤中的意义。方法：将36只雄性SD大鼠按随机数字表法分为假手术组、缺血再灌注损伤组、白细胞介素1受体相关激酶4抑制剂组，每组12只。制备右下腹岛状皮瓣缺血再灌注损伤模型，白细胞介素1受体相关激酶4抑制剂处理组于再灌注前腹腔注射1 mL白细胞介素1受体相关激酶1/4抑制剂(100μmol/L)，分别采集缺血再灌注后1，2，4，6 h的皮瓣行组织病理学观察，取缺血再灌注后1 h的皮瓣组织行白细胞介素1受体相关激酶4的蛋白表达量，并于术后7d计算皮瓣存活比例。结果与结论：组织病理学观察显示，与缺血再灌注损伤组相比，白细胞介素1受体相关激酶4抑制剂组中性粒细胞浸润及组织水肿程度明显改善，白细胞介素1受体相关激酶4的蛋白表达量逐渐降低。术后7d缺血再灌注损伤组皮瓣存活比例为(51.70±7.62)%，白细胞介素1受体相关激酶4抑制剂组皮瓣存活比例高达(86.56±12.23)%，两组比较差异有显著性意义(P<0.01)。提示大鼠皮瓣缺血再灌注损伤后，可以通过抑制白细胞介素1受体相关激酶4活化提高移植皮瓣的成活率。