Antioxidant effectiveness in ischemia-reperfusion tissue injury

In summary, much evidence supports the formation of toxic oxygen metabolites in ischemic reperfused tissue. Tissues are equipped with both an intracellular and extracellular antioxidant defense system. The defense system can also be divided into enzymatic and nonenzymatic defenses. Important components of a nonenzymatic antioxidant include alpha-tocopherol, ascorbic acid, and beta-carotene as well as other compounds that can react with radicals to form less reactive products such as sulfur-containing amino acids. Extracellular fluid comprises a second line of defense against oxidant injury. These extracellular antioxidants include ceruloplasmin, albumin, transferrin, haptoglobin, and uric acid. The oxidant injury can potentially occur during ischemia and reperfusion due to (1) an excess production of oxygen free radicals, (2) a decrease in antioxidant defenses, or (3) both. Because antioxidants function by removing the toxic oxygen metabolites, they are generally highly effective in reducing ischemia-reperfusion injury.