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Met-enkephalin and catecholamine release during feline intestinal ischemia-reperfusion

A Aneman1, S Medbak, D Watson

  • 1Department of Anesthesiology and Intensive Care and Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.

Insights

Severe intestinal ischemia triggers met-enkephalin-like immunoreactivity (MLI) and sympathetic nervous system activation. This response, linked to norepinephrine, occurs only during circulatory collapse, not with less severe ischemia.

Area of Science:

  • Gastroenterology
  • Physiology
  • Neuroendocrinology

Background:

  • Intestinal ischemia-reperfusion (I/R) injury is a significant clinical concern.
  • The role of endogenous opioids like met-enkephalin in I/R is not fully understood.
  • Sympathoadrenergic responses during intestinal I/R require further elucidation.

Purpose of the Study:

  • To investigate the release of met-enkephalin-like immunoreactivity (MLI) into circulation during feline intestinal I/R.
  • To correlate MLI release with the extent of ischemic tissue and sympathoadrenergic response (norepinephrine and epinephrine levels).
  • To determine the relationship between MLI, norepinephrine, and epinephrine during intestinal I/R.

Main Methods:

  • Feline model of intestinal ischemia (segmental vs. complete) for 90 minutes followed by 180 minutes of reperfusion.
  • Measurement of MLI using radioimmunoassay.
  • Quantification of plasma norepinephrine (NE) and epinephrine (E) using chromatography.
  • Comparison of MLI and catecholamine levels between control, segmental ischemia, and complete ischemia groups.

Main Results:

  • Complete intestinal ischemia induced severe mucosal lesions and cardiovascular decompensation.
  • Increased MLI and NE levels were observed in portal and femoral venous plasma in the complete ischemia group.
  • MLI and NE concentrations were higher in portal than femoral venous plasma, with a correlation during reperfusion in the portal circulation.
  • Epinephrine levels remained unchanged and did not correlate with MLI release.

Conclusions:

  • Intestinal MLI release and sympathetic activation during I/R occur only with severe ischemia leading to circulatory collapse, suggesting an 'on-off' rather than 'dose-response' pattern.
  • MLI and NE release are correlated during intestinal reperfusion, but MLI and E release are not.
  • These findings highlight the complex interplay between endogenous opioids and the sympathetic nervous system in severe intestinal injury.

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