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Free Radicals: from Basic Science to Medicine pp 438–457Cite as

Pharmaceutical Intervention for the Prevention of Post-Ischemic Reperfusion Injury

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Part of the book series: Molecular and Cell Biology Updates ((MCBU))

Summary

In many organs a substantial proportion of the injury sustained as a consequence of ischemia is actually caused by a cascade of toxic oxygen metabolites, triggered by the generation of the superoxide by xanthine oxidase at the time of reperfusion. This mechanism, first elucidated in the feline small intestine, has also been found to be operative in the heart, lung, stomach, liver, pancreas, kidney, skin, skeletal muscle, central nervous system and other organs. Its ubiquity is based upon the ubiquity of endothelial cell xanthine oxidase in the microvasculature. Pre-clinical studies in animal models of human disease have demonstrated a variable contribution of this reperfusion injury mechanism to the total injury sustained consequent to ischemia. While ill-conceived and poorly designed clinical trials, which have failed to take this into account, and therefore have included heterogeneous and unstratifiable patient populations, have been predictably unenlightening, a few well-designed clinical trials, particularly in renal transplantation and in elective cardioplegia for cardiopulmonary bypass have confirmed the efficacy of free radical ablation for the prevention of reperfusion injury in man.

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  1. Department of Surgery The Johns Hopkins Medical Institutions, Blalock 685 The Johns Hopkins Hospital, 600 North Wolfe Street, 21205, Baltimore, MD, USA

    Toshihiko Mayumi M. D., Henry J. Schiller M. D. & Gregory B. Bulkley M. D.

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  2. Henry J. Schiller M. D.
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  3. Gregory B. Bulkley M. D.
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  1. Department of Experimental Medicine and Oncology, University of Torino, I-101 25, Torino, Italy

    G. Poli , E. Albano  & M. U. Dianzani ,  & 

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Mayumi, T., Schiller, H.J., Bulkley, G.B. (1993). Pharmaceutical Intervention for the Prevention of Post-Ischemic Reperfusion Injury. In: Poli, G., Albano, E., Dianzani, M.U. (eds) Free Radicals: from Basic Science to Medicine. Molecular and Cell Biology Updates. Birkhäuser Basel. https://doi.org/10.1007/978-3-0348-9116-5_38

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