Melatonin iskemi/reperfüzyon hasarý sýrasýnda oksidanlar ve anastomoz iyileþmesi üzerine olumlu etkiler gösterir

AMAÇ: Melatoninin iskemi/reperfüzyon hasarýnda (ÝRH) intestinal anastomoz iyileþmesi üzerine etkisini araþtýrmayý amaçladýk.
GEREÇ VE YÖNTEM: Otuz Wistar-Albino sýçan üç gruba (Sham, kontrol ve tedavi) ayrýldý. Süperior mezenterik arter (SMA) klemplenip 30 dakika sonrasýnda açýlarak ÝRH oluþturuldu. Sham grubunda sadece SMA manüplasyonu yapýldý. Tedavi grubuna melatonin (10 mg/kg) ve kontrol grubunda salin verildi. Tedavi ve kontrol gruplarýnda ek olarak 1 cm ileal segment rezeke edilerek anostomoz yapýldý. Ameliyat sonrasý yedinci günde anastomotik patlama basýncý, hidroksiprolin seviyeleri, yara iyileþmesinin histolojik göstergeleri ve oksidatif parametrelerin düzeyleri araþtýrýldý. Ýstatistik için tek yönlü varyans analizi ve ki kare testi kullanýldý.
BULGULAR: Melatonin tedavisi patlama basýncýnda anlamlý yüksekliðe yol açtý (sýrasýyla, p=0.027 ve p<0.00). Katalaz ve süperoksit dismütaz enzim seviyeleri sham ve melatonin gruplarýnda en yüksek, kontrol grubunda ise en düþüktü (sýrasýyla, p=0.001 ve p=0.002). Melatonin tedavisi her iki enzim düzeylerinde anlamlý yüksekliðe yol açtý (sýrasýyla, p=0.026 ve p=0.003). Glutatyon peroksidaz ve total glutatyon düzeylerinde tedavi grubunda hafifçe artýþ görülse de bu fark anlamlý deðildi (sýrasýyla, p=0.205 ve 0.216). Fibroblast infiltrasyonu, kapiller formasyon ve epitelizasyon melatoninle tedavi edilen sýçanlarda anlamlý olarak daha iyiydi. Granülosit ve mononükleer infiltrasyon skorlarý tüm gruplarda benzerdi.
TARTIÞMA: Deneysel modelde ÝRH sýrasýnda melatonin uygulamasýnýn intestinal anastomoz iyileþmesi üzerine belirgin olumlu etkileri olduðunu düþünüyoruz.

Melatonin exhibits supportive effects on oxidantsand anastomotic healing during intestinalischemia/reperfusion injury

BACKGROUND: The aim of this study was to investigate the effects of melatonin on intestinal anastomosis after intestinal ischemia/reperfusion injury (IRI).
METHODS: Thirty Wistar albino rats of both sexes were divided into 3 groups: sham, control, and treatment. IRI was performed by clamping the superior mesenteric artery (SMA) for 30 minutes, followed by reperfusion. The sham rats received only manipulation of the SMA. Melatonin (10 mg/kg) was administered to the treatment group, and the control group was given a vehicle injection. Both the treatment group and the control group further underwent ileal resection of a 1-cm segment and anastomosis. On the postoperative seventh day, the anastomotic burst pressure, hydroxyproline level, histological indices of wound healing, and oxidative parameters of catalase (CAT), superoxide dismutase (SOD), total glutathione (T-GSH), and glutathione peroxidase (GSH-Px) levels were measured. A one-way analysis of variance and chi-square test were used for the categorical data.
RESULTS: Melatonin treatment led to a significantly higher burst pressure (p=0.027 and p<0.001, respectively). The 2 antioxidant enzymes, CAT and SOD, were at the highest level in the sham and melatonin groups and the lowest level in the control group (p=0.001 and p=0.002, respectively). Melatonin treatment resulted in a significantly higher level of both enzymes compared with the control group (p=0.026 and 0.003, respectively). The GSHpx and total GSH levels were slightly elevated in the treated rats, but the difference was not statistically significant (p=0.205 and 0.216, respectively). Fibroblast infiltration, capillary formation, and epithelialization were significantly better in the melatonin-treated animals. The granulocyte and mononuclear infiltration scores were similar between all groups.
CONCLUSION: It was concluded that melatonin had marked effects on intestinal anastomotic healing during intestinal IRI.