Sevoflurane preserves the endothelial glycocalyx against ischaemia–reperfusion injury
- 1 April 2010
- journal article
- Published by Elsevier BV in British Journal of Anaesthesia
- Vol. 104 (4), 414-421
- https://doi.org/10.1093/bja/aeq019
Abstract
Healthy vascular endothelium is coated by the glycocalyx, important in multiple endothelial functions, but destroyed by ischaemia-reperfusion. The impact of volatile anaesthetics on this fragile structure has not been investigated. We evaluated the effect of cardiac pre- and post-conditioning with sevoflurane on integrity of the endothelial glycocalyx in conjunction with coronary vascular function. Isolated guinea pig hearts perfused with Krebs-Henseleit buffer underwent 20 min stopped-flow ischaemia (37 degrees C), either without or with 1 MAC sevoflurane. This was applied for 15 min before, for 20 min after, or both before and after ischaemia. Transudate was collected for assessing coronary net fluid extravasation and histamine release by mast cells. Coronary release of syndecan-1 and heparan sulphate was measured. In additional experiments with and without continuous sevoflurane, cathepsin B and tryptase beta-like protease activity were measured in effluent. Hearts were perfusion-fixed to visualize the endothelial glycocalyx. Ischaemia led to a significant (P<0.05) increase by 70% in transudate formation during reperfusion only in hearts without sevoflurane. This was accompanied by significant (P<0.05) increases in heparan sulphate (four-fold) and syndecan release (6.5-fold), with electron microscopy revealing massive degradation of glycocalyx. After ischaemia, histamine was released into transudate, and cathepsin B activity increased in effluent (P<0.05). Sevoflurane application attenuated all these changes, except for histamine release. Sevoflurane protects the endothelial glycocalyx from ischaemia-reperfusion-induced degradation, with both preconditioning and rapid post-conditioning being successful. The mechanism seems to involve attenuation of lysosomal cathepsin B release and to be independent from tissue mast cell degranulation.Keywords
This publication has 33 references indexed in Scilit:
- Effects of sevoflurane and propofol on ischaemia–reperfusion injury after thoracic-aortic occlusion in pigsBritish Journal of Anaesthesia, 2007
- Differential Protective Effects of Volatile Anesthetics against Renal Ischemia–Reperfusion Injury In VivoAnesthesiology, 2004
- Cardioprotective Properties of Sevoflurane in Patients Undergoing Coronary Surgery with Cardiopulmonary Bypass Are Related to the Modalities of Its AdministrationAnesthesiology, 2004
- Anaesthetics and cardiac preconditioning. Part I. Signalling and cytoprotective mechanismsBritish Journal of Anaesthesia, 2003
- Sevoflurane Provides Greater Protection of the Myocardium than Propofol in Patients Undergoing Off-pump Coronary Artery Bypass SurgeryAnesthesiology, 2003
- Preconditioning by Sevoflurane Decreases Biochemical Markers for Myocardial and Renal Dysfunction in Coronary Artery Bypass Graft Surgery: A Double-blinded, Placebo-controlled, Multicenter StudyAnesthesiology, 2003
- Sevoflurane and Isoflurane Protect the Reperfused Guinea Pig Heart by Reducing Postischemic Adhesion of Polymorphonuclear NeutrophilsAnesthesiology, 1999
- Anesthetic-induced PreconditioningAnesthesiology, 1997
- Isoflurane Mimics Ischemic Preconditioning via Activation of KATPChannelsAnesthesiology, 1997
- Halothane, Isoflurane, and Sevoflurane Reduce Postischemic Adhesion of Neutrophils in the Coronary SystemAnesthesiology, 1997