South Clin Ist Euras. 2022; 33(3): 320-325 | DOI: 10.14744/scie.2022.57873

Protective Role of Progesterone on Lung Injury Induced by Ischemia Reperfusion of the Lower Limbs

Esin Ak¹, Þehkar Oktay¹, Dilek Özbeyli², Aleyna Muhan³, Koray Ak^4
1Department Of Basic Medical Sciences, Faculty Of Dentistry,Marmara University, Ýstanbuli Turkey
²Department Of Pathology, Laboratory Techniques, Vocational School Of Health Services, Marmara University, Ýstanbul, Turkey
³Department Of Basic Medical Sciences, Institute Of Health Sciences, Marmara University, Istanbul, Turkey
⁴Department Of Cardiovascular Surgery, Faculty Of Medicine, Marmara University, Istanbul, Turkey.

INTRODUCTION: Remote lung injury is one of the most challenging issues in patients undergoing ischemia reperfusion (IR) injury of the lower limbs. We examined the role of progesterone (PG) on the remote injury of the lungs seen after IR of the lower limbs.
METHODS: Eighteen male Sprague Dawley rats were divided into three groups. (1) Control: rats had only two physiological saline injections intraperitoneally (i.p.) 2 h apart under general anesthesia. (2) IR: underwent 2 h tourniquet induced ischemia for both lower limbs followed by 2 h of reperfusion. Animals were injected with physiological saline (i.p.) before both ischemia and reperfusion. (3) IR + PG: rats underwent the same IR protocol as the IR group and were injected with PG (16 mg/kg, i.p.) before both ischemia and reperfusion. After reperfusion, rats were sacrificed, and lung tissues were taken out for histopathologic and biochemical analyses.
RESULTS: In IR + PG group, tissue levels of malondialdehyde and nitric oxide decreased significantly compared with the IR group (p<0.01). Similarly, glutathione level and superoxide dismutase and glutathione S-transferase activities significantly increased in the IR + PG group than in the IR group (p<0.05, p<0.01, and p<0.05, respectively). In light microscopy, reduced inflammatory cell infiltration, amelioration in alveolar structure, and mild vascular congestion in the parenchyma were seen in the IR + PG group. A significant improvement in histopathologic score was seen in the IR + PG group compared with the IR group (p<0.001).
DISCUSSION AND CONCLUSION: PG might be effective in attenuating remote injury of the lung in lower body IR via its antioxidant function.

Keywords: Ischemia, lower limb; lung; remote organ injury; reperfusion.

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Alt Ekstremite Ýskemi Reperfüzyon Sonrasý Görülen Akciðer Hasarýnda Progesteronun Koruyucu Rolü

Esin Ak¹, Þehkar Oktay¹, Dilek Özbeyli², Aleyna Muhan³, Koray Ak^4
1Marmara Üniiversitesi Diþhekimliði Fakültesi, Temel Týp Bilimleri Bölümü, Ýstanbul, Türkiye
²Marmara Üniversitesi Saðlýk Hizmetleri Meslek Yüksekokulu, Patoloji Anabilim Dalý, Laboratuvar Teknikleri, Ýstanbul, Türkiye
³Marmara Üniversitesi Saðlýk Bilimleri Enstitüsü, Temel Týp Bilimleri Bölümü, Ýstanbul, Türkiye.
⁴Marmara Üniversitesi Týp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalý, Ýstanbul, Türkiye.

GÝRÝÞ ve AMAÇ: Alt ekstremitede iskemi reperfüzyon (IR) hasarýna maruz kalan hastalarda görülen en önemli problemlerden birisi akciðer hasarýdýr. Bu çalýþmamýzda alt ekstremite IR sonrasý ortaya çýkan akciðer hasarýnda progesteronun (PG) rolü araþtýrýlmýþtýr.
YÖNTEM ve GEREÇLER: On sekiz adet erkek Sprague-Dawley sýçan üç gruba ayrýldý: (1) kontrol: sýçanlara genel anestezi sonrasý iki saat aralýkla iki kez serum fizyolojik (SF) enjeksiyonu yapýldý (intraperitoneal (i.p.)), (2) IR: sýçanlara turnike kullanýlarak iki saat iskemi sonrasýnda iki saat reperfüzyon uygulandý. Hem iskemi hem de reperfüzyon öncesi ayný dozda SF enjeksiyonu yapýldý, (3) IR+PG: sýçanlara IR grubuyla ayný deney protokolü uygulanmýþ olup hem iskemi hem de reperfüzyon öncesi PG enjeksiyonu yapýlmýþtýr (16 mg/kg, i.p.). Reperfüzyon sonrasý sýçanlar sakrifiye edilerek akciðer dokusu çýkartýlmýþ ve biyokimyasal ve histolojik analizler yapýlmýþtýr.
BULGULAR: IR+PG grubunda doku malondialdehit ve nitrik oksit seviyeleri IR grubuna kýyasla anlamlý düzeyde azalmýþtýr (p<0.01). Benzer þekilde IR+PG grubunda glutatyon seviyesi ve süperoksit dismutaz ve glutatyon S-transferaz aktiviteleri IR grubuna kýyasla anlamlý derecede artmýþtýr (p<0.05, p<0.01 ve p<0.05). Iþýk mikroskopik incelemede IR+PG grubunda akciðer parankiminde azalmýþ enflamatuvar hücre infiltrasyonu, alveol yapýlarda düzelme ve hafif vasküler konjesyon görülmüþtür. IR+PG grubunda IR grubuna kýyasla histopatolojik skorda anlamlý düzeyde iyileþme tespit edilmiþtir (p<0.001).
TARTIÞMA ve SONUÇ: Progesteron antioksidan fonksiyonundan dolayý alt ekstremite IR sonrasý görülen akciðer hasarýnýn azaltýlmasýnda etkili olabilir.

Anahtar Kelimeler: Akciðer, alt ekstremite; iskemi; reperfüzyon; uzak organ hasarý.

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