Altering effects of caffeic acid phenethyl ester (CAPE) and ischemia/reperfusion injury: an experimental study in a rat
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EXPERIMENTAL STUDY
Altering effects of caffeic acid phenethyl ester (CAPE) and ischemia/reperfusion injury: an experimental study in a rat TRAM flap model Mehmet Emre YEĞİN 1 & Ufuk Bilkay 1 & Yiğit Özer TİFTİKÇİOĞLU 1 & Yiğit Uyanikgil 2 & Türker ÇAVUŞOĞLU 2 & Gülinnaz Ercan 3 & Mehmet Gürdal 3 Received: 23 October 2019 / Accepted: 14 February 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Many studies have been performed since the discovery of ischemia-reperfusion injury (I/R) to find substances that reverse its effects on flaps. However, because of minor or major side effects these substances are mostly failed to be put in clinical practice. In this study, the mitigation effects of caffeic acid phenethyl ester (CAPE) were investigated for its protective effects on flap necrosis in a rat model. Methods Forty-two randomized male Sprague-Dawley rats weighing between 250 and 300 g were assigned to the regular flap (G1) (n = 14), ischemic flap (G2) (n = 14), and ischemic flap + CAPE (G3) (n = 14) groups. Bilateral pedicled TRAM flaps were designed for the first seven rats of each group,; bilateral-free TRAM flaps were designed for the remaining rats in each group and referred as subgroup 1 and 2 (S1 and S2), respectively. In G1, flaps were returned to their original locations without clamping or injection. In G2 and G3, a 2-h ischemia was performed. Before the ischemic process, intraperitoneal saline and CAPE solution was administered intraperitoneally in the second and third groups, respectively. On day 7 after the operation, all flaps were harvested and subjected to biochemical (malondialdehyde, superoxide dismutase, and catalase levels) and histological examinations (hematoxylin & eosin, Mallory-Azan, anti-VEGF, anti-BAX, anti Bcl-2, and anti-iNOS stainings), respectively. Enzyme levels and the Verhofstadt scores showed a statistically significant difference in flaps among the groups. Less injury was noted in G3 than in G2 (p < 0.01). Conclusions In this experimental model, CAPE was effective in protecting tissues against ischemia-reperfusion injury. Level of evidence: no ratable Keywords Caffeic acid phenethyl ester . Flap . Ischemia-reperfusion injury
Introduction Flap surgery is one of the main pillars of plastic surgery. Ischemia-reperfusion injury (I/R) has been a main concern since the basics of flap surgery were understood. Overcoming this problem has been one of the main focuses
* Mehmet Emre YEĞİN [email protected] 1
Ege University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, 35100 Izmir, Turkey
2
Ege University, Faculty of Medicine, Department of Histology, 35100 Izmir, Turkey
3
Ege University, Faculty of Medicine, Department of Biochemistry, 35100 Izmir, Turkey
of researchers. Several attempts have been made to discover feasible techniques and material. Nevertheless, a complete, clinical-based solution has not yet been identified. Propolis (CAS No. 9009-62-5) (sometimes also referred to “bee glue”) is the gener
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