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Sevoflurane anesthetic preconditioning protects the lung endothelial glycocalyx from ischemia reperfusion injury in an experimental lung autotransplant model

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Abstract

Purpose

The glycocalyx is a glycoprotein-polysaccaride layer covering the endothelium luminal surface, and plays a key regulatory role in several endothelial functions. Lung ischemia reperfusion (IR) is a clinical entity that occurs in everyday thoracic surgery and causes glycocalix destruction and a florid local and systemic immune response. Moreover, sevoflurane is able to modulate the inflammatory response triggered by IR lung injury. In this study, we evaluated the protective effects of sevoflurane on the pulmonary endothelial glycocalyx in an in-vivo lung autotransplant model in pigs.

Methods

Sixteen Large White pigs underwent pneumonectomy plus lung autotransplant. They were divided into two groups depending on the hypnotic agent received (propofol or anesthetic preconditioning with sevoflurane). Glycocalyx components (syndecan-1 and heparan sulphate), cathepsin B, chemokines (MCP-1, MIP-1, and MIP-2) and adhesion molecules (VCAM and ICAM-1) were measured at four different timepoints using porcine-specific enzyme-linked immunosorbent assay (ELISA) kits.

Results

There were no differences between groups in weight or in surgical and one-lung ventilation time. Greater glycocalyx destruction and higher chemokine and adhesion molecule expression were observed in the group that did not receive sevoflurane. Heparan sulphate and serum syndecan levels were higher in the propofol group (P < 0.0001) after reperfusion, as was cathepsin B activity (P < 0.015). MCP-1, MIP-1, MIP-2, VCAM, and ICAM-1 levels were also higher in the propofol group (P < 0.006).

Conclusion

Sevoflurane preconditioning protects pulmonary glycocalyx and reduces expression of leukocyte chemokines in an in-vivo model of pulmonary IR.

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Acknowledgments

The authors are grateful to the statistical department at Gregorio Maranon Hospital. Financial support and sponsorship: the study was funded by grants from Carlos III Health Institute (Grant No. FISS PI07/00840) and the “Proyecto Investigar” by ABBOTT laboratories (Grant No. FGICBJ-2013 in Biomedic Investigation Foundation at Gregorio Marañon Hospital in Madrid).

Author information

Authors and Affiliations

  1. Anesthesiologist in cardiothoracic section, Anesthesiology Department, Gregorio Marañon Hospital, Doctor Esquerdo Street 46, 28007, Madrid, Spain

    Javier Casanova, Guillermo Sanchez, Selma Abubakra, Francisco Jose Gonzalez & Ignacio Garutti

  2. Thoracic Surgery Department, Gregorio Marañon Hospital, Madrid, Spain

    Carlos Simon

  3. Biochemistry Department, Complutense University, Madrid, Spain

    Elena Vara, Lisa Rancan & Alberto Calvo

Authors
  1. Javier Casanova
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  2. Carlos Simon
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  3. Elena Vara
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  4. Guillermo Sanchez
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  8. Francisco Jose Gonzalez
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  9. Ignacio Garutti
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Correspondence to Javier Casanova.

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Casanova, J., Simon, C., Vara, E. et al. Sevoflurane anesthetic preconditioning protects the lung endothelial glycocalyx from ischemia reperfusion injury in an experimental lung autotransplant model. J Anesth 30, 755–762 (2016). https://doi.org/10.1007/s00540-016-2195-0

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  • DOI: https://doi.org/10.1007/s00540-016-2195-0

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