Prevention of ischemia-reperfusion injury in a rat skill flap model: The role of mast cells, cromolyn sodium, and histamine receptor blockade Journal Article

Authors: Cordeiro, P. G.; Lee, J. J.; Mastorakos, D.; Hu, Q. Y.; Pinto, J. T.; Santamaria, E.
Article Title: Prevention of ischemia-reperfusion injury in a rat skill flap model: The role of mast cells, cromolyn sodium, and histamine receptor blockade
Abstract: The objective of this study was to examine the role of mast cells and their principal product, histamine, in ischemia/reperfusion injury. Cromolyn sodium, diphenhydramine, and cimetidine were administered to ischemic flaps just before repel-fusion and evaluated for flap survival, mast cell count, neutrophil count, and myeloperoxidase levels. Epigastric island skin flaps were elevated in 49 rats; they were rendered ischemic by clamping the artery for 10 hours. Thirty minutes before reperfusion, the rats were treated with intraperitoneal saline (n = 11), cimetidine (n = 11), diphenhydramine (n = 11), or cromolyn sodium (n = 10). Flap survival was evaluated at 7 days. Neutrophil counts, mast cell counts, and myeloper-oxidase levels were evaluated 12 hours after reperfusion. Flap necrosis in the sham group of animals (n = 6) was 0.0 percent, as expected, whereas the control group (saline-treated animals) had 47.3 +/- 33.4 percent necrosis. Animals treated with diphenhydramine and cimetidine demonstrated a significant decrease in flap necrosis to 17.7 +/- 8.8 percent and 19.4 +/- 14.7 percent, respectively. This protective effect was not seen with cromolyn sodium (44.3 +/- 35.6 percent). Both neutrophil and mast cell counts were significantly decreased in flaps from antihistamine-treated and sham animals versus both saline- and cromolyn sodium-treated groups. The administration of diphenhydramine and cimetidine before reperfusion can significantly reduce the extent of flap necrosis and the neutrophil and mast cell counts caused by ischemia/reperfusion. This protective effect is not seen with cromolyn sodium. The protective effect of antihistamines on flap necrosis might be related to the decrease in neutrophils and, possibly, mast cells within the flap.
Keywords: lung; leukocyte; nitric-oxide; heterogeneity; release; adherence; free-radicals; myocutaneous flaps; postischemic skeletal-muscle; xanthine-oxidase; h-1 antagonist
Journal Title: Plastic and Reconstructive Surgery
Volume: 105
Issue: 2
ISSN: 0032-1052
Publisher: Lippincott Williams & Wilkins  
Date Published: 2000-02-01
Start Page: 654
End Page: 659
Language: English
ACCESSION: WOS:000085332700026
DOI: 10.1097/00006534-200002000-00026
PUBMED: 10697173
Notes: Presented at the Annual Meeting of the Plastic Surgery Research Council; New York, NY; 1999 May 16 -- Source: Wos
Citation Impact
MSK Authors
  1. James J Lee
    1 Lee
  2. Peter G Cordeiro
    269 Cordeiro
  3. Qun Ying Hu
    27 Hu
  4. John   Pinto
    59 Pinto