Methylene blue attenuates ischemia--reperfusion injury in lung transplantation

J Surg Res. 2014 Dec;192(2):635-41. doi: 10.1016/j.jss.2014.07.043. Epub 2014 Jul 24.

Abstract

Background: Ischemia-reperfusion injury (IRI) is one of the principal obstacles for the lung transplantation (LTx) success. Several strategies have been adopted to minimize the effects of IRI in lungs, including ex vivo conditioning of the grafts and the use of antioxidant drugs, such as methylene blue (MB). We hypothesized that MB could minimize the effects of IRI in a LTx rodent model.

Methods: Forty rats were divided into four groups (n = 10) according to treatment (saline solution or MB) and graft cold ischemic time (3 or 6 h). All animals underwent unilateral LTx. Recipients received 2 mL of saline or MB intraperitoneally before transplantation. After 2 h of reperfusion, arterial blood and exhaled nitric oxide samples were collected and bronchoalveolar lavage performed. Then animals were euthanized, and histopathology analysis as well as cell counts and cytokine levels measurements in bronchoalveolar lavage fluid were performed.

Results: There was a significant decrease in exhaled nitric oxide, neutrophils, interleukin-6, and tumor necrosis factor-α in MB-treated animals. PaO2 and uric acid levels were higher in MB group.

Conclusions: MB was able in attenuating IRI in this LTx model.

Keywords: Animal model; Ischemia–reperfusion injury; Lung transplantation; Methylene blue.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antioxidants / pharmacology*
  • Bronchoalveolar Lavage Fluid
  • Cold Ischemia
  • Cytokines / metabolism
  • Disease Models, Animal
  • Enzyme Inhibitors / pharmacology
  • Female
  • Hemorrhage / drug therapy
  • Hemorrhage / metabolism
  • Hemorrhage / surgery
  • Lung Transplantation / methods*
  • Methylene Blue / pharmacology*
  • Nitric Oxide / metabolism
  • Oxygen / blood
  • Partial Pressure
  • Pulmonary Edema / drug therapy
  • Pulmonary Edema / metabolism
  • Pulmonary Edema / surgery
  • Rats, Sprague-Dawley
  • Reperfusion Injury / drug therapy*
  • Reperfusion Injury / metabolism
  • Reperfusion Injury / surgery*
  • Sodium Chloride
  • Uric Acid / blood

Substances

  • Antioxidants
  • Cytokines
  • Enzyme Inhibitors
  • Uric Acid
  • Nitric Oxide
  • Sodium Chloride
  • Oxygen
  • Methylene Blue