Publication: Modulación mediante precondicionamiento isquémico de la expresión de MCP1 y citoquinas proinflamatorias en un modelo exprimental de isquemia-reperfusión pulmonar
Loading...
Files
Official URL
Full text at PDC
Publication Date
2017-09-12
Authors
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad Complutense de Madrid
Citations
Exportar
Abstract
Privar de flujo sanguíneo a un órgano (isquemia) y luego restablecerlo (reperfusión) causa un daño que se denomina lesión por isquemia reperfusión (LIR). Las lesiones producidas durante la fase de isquemia se relacionan sobretodo con la privación de oxígeno que reduce los fenómenos respiratorios celulares y puede llegar a causar, en pocos minutos, lesiones irreversibles en órganos vitales tales como el corazón, cerebro, pulmón o hígado. La reperfusión supone después el paso al torrente sanguíneo de productos tóxicos desde el tejido isquémico y la multiplicación de mediadores inflamatorios. Todo ello genera una respuesta inflamatoria que no solo daña el órgano sometido a isquemia(respuesta local), sino también órganos distantes(respuesta sistémica). En el caso de la cirugía pulmonar, cada vez son más y de mayor complejidad los procedimientos quirúrgicos, que a menudo producirán fenómenos de isquemia por un determinado periodo de tiempo. En este caso, la isquemia se caracteriza por ausencia de flujo sanguíneo en el pulmón, formandose así, radicales libres de oxígeno, citoquinas y proteasas que supondrán un reclutamiento de neutrófilos y linfocitos manifestándose finalmente en daño alveolar difuso, edema intersticial, aumento de las resistencias vasculares, disminución de la complianza e hipoxia. A pesar de que se conoce la existencia de la lesión por isquemia reperfusión desde hace más de cuarenta años, su fisiopatología es compleja, y a pesar de los esfuerzos para reducir su impacto, los logros obtenidos han sido más bien escasos...
To deprive blood flow to an organ (ischemia) and then reset (reperfusion) causes damage called ischemia reperfusion (LIR). The injuries during the ischemia are related mainly to oxygen deprivation that reduces cellular respiratory phenomena and may even cause, in minutes, irreversible damage to vital organs such as the heart, brain, lung or liver. Reperfusion following step involves the bloodstream of toxic products from the ischemic tissue and multiplication of inflammatory mediators. All this generates an inflammatory response that not only damages the organ subjected to ischemia (local response), but also distant organs (systemic response). In the case of lung surgery, they are becoming more and more complex surgical procedures, where often occur phenomena of ischemia for a specified period of time. In this case, ischemia is characterized by the absence of blood flow in the lung, thus forming, free oxygen radicals, cytokines and proteases which will involve recruitment of neutrophils and lymphocytes eventually manifesting in diffuse alveolar damage, interstitial edema, increased resistance vascular, decreased compliance and hypoxia. Although it is known the existence of ischemia reperfusion for over forty years ago, its physiology is complex, and despite efforts to reduce its impact, the achievements have been rather limited. Have been applied several therapeutic strategies based on the administration of drugs (steroids, antioxidants, cytokine antibodies ...), others in applying gene therapy, perfusion preservation solutions, various ventilation and surgical techniques, and finally, others based the so-called thermal shock...
To deprive blood flow to an organ (ischemia) and then reset (reperfusion) causes damage called ischemia reperfusion (LIR). The injuries during the ischemia are related mainly to oxygen deprivation that reduces cellular respiratory phenomena and may even cause, in minutes, irreversible damage to vital organs such as the heart, brain, lung or liver. Reperfusion following step involves the bloodstream of toxic products from the ischemic tissue and multiplication of inflammatory mediators. All this generates an inflammatory response that not only damages the organ subjected to ischemia (local response), but also distant organs (systemic response). In the case of lung surgery, they are becoming more and more complex surgical procedures, where often occur phenomena of ischemia for a specified period of time. In this case, ischemia is characterized by the absence of blood flow in the lung, thus forming, free oxygen radicals, cytokines and proteases which will involve recruitment of neutrophils and lymphocytes eventually manifesting in diffuse alveolar damage, interstitial edema, increased resistance vascular, decreased compliance and hypoxia. Although it is known the existence of ischemia reperfusion for over forty years ago, its physiology is complex, and despite efforts to reduce its impact, the achievements have been rather limited. Have been applied several therapeutic strategies based on the administration of drugs (steroids, antioxidants, cytokine antibodies ...), others in applying gene therapy, perfusion preservation solutions, various ventilation and surgical techniques, and finally, others based the so-called thermal shock...
Description
Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 03-02-2016