人参皂苷Rb1与皮瓣缺血再灌注损伤的研究与进展
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摘要
背景:在整形外科中,缺血再灌注损伤是常见的病理生理过程,在随意皮瓣、游离皮瓣及复合组织瓣移植手术中都时有发生,严重者将导致皮瓣部分甚至全部坏死。近年来大量研究报道了人参皂苷Rb1在多种组织器官缺血再灌注损伤中均有良好的保护作用。目的:就皮瓣缺血再灌注损伤机制与人参皂苷Rb1的作用机制研究进展综述。18方法:检索中国期刊全文数据库(CNKI)和PubM ed数据库1996年1月至20年6月相关文献;检索词为"皮瓣,缺血再灌注损伤,人参皂苷Rb1;Ginsenosides,Reperfusion Injury,Flaps"。纳入有关人参皂苷Rb1药理作用、人参皂苷Rb1减轻组织器官缺血再灌注损伤及皮瓣缺血再灌注损伤研究的文献进行分析探讨。结果与结论:皮瓣缺血再灌注损伤是缺血组织器官恢复血供后出现的一种复杂的非特异性损伤级联反应,涉及过量的氧自由基生成、炎症细胞激活浸润及其与内皮相互作用、能量衰竭、细胞内钙超载、一氧化氮生成等方面。人参皂苷Rb1可通过其抗氧化、抑制炎症反应、增加一氧化氮合成、抗凋亡、抑制钙超载等机制在皮瓣缺血再灌注损伤中发挥保护作用。
BACKGROUND: Ischemia/reperfusion injury is a common pathophysiological process in plastic surgery, which happens in random flap, free flap and composite tissue flap transplantation, even will lead to partial or whole flap necrosis. Ginsenosides Rb1 has been shown to exert protection in ischemia/reperfusion injuries of various tissues and organs. OBJECTIVE: To review the mechanism of ischemia/reperfusion injury of flap and action mechanism of ginsenosides Rb1. METHODS: CNKI and PubMed databases were searched for the articles published between January 1996 and June 2018 with the keywords of "ginsenosides, reperfusion injury, flaps" in English and Chinese, respectively. The articles addressing the pharmacological effects of ginsenosides Rb1, ginsenosides Rb1 alleviating tissue ischemia/reperfusion injury and flap ischemia/reperfusion injury were included.RESULTS AND CONCLUSION: Flap ischemia/reperfusion injury is complex non-specific cascade damage after ischemic tissues restoring blood supply, which Involves in excessive production of oxygen free radicals, inflammation infiltration and its interaction with endothelial cells, energy failure, intracellular calcium overload, and nitric oxide production. Ginsenosides Rb1 has the effects of anti-oxidation, anti-inflammation and antiapoptosis. Ginsenosides Rb1 exerts good protection in ischemia/reperfusion injuries of various tissues and organs through anti-oxidation, anti-inflammation, increasing nitric oxide production, antiapoptosis, inhibiting calcium overload.
BACKGROUND: Ischemia/reperfusion injury is a common pathophysiological process in plastic surgery, which happens in random flap, free flap and composite tissue flap transplantation, even will lead to partial or whole flap necrosis. Ginsenosides Rb1 has been shown to exert protection in ischemia/reperfusion injuries of various tissues and organs. OBJECTIVE: To review the mechanism of ischemia/reperfusion injury of flap and action mechanism of ginsenosides Rb1. METHODS: CNKI and PubMed databases were searched for the articles published between January 1996 and June 2018 with the keywords of "ginsenosides, reperfusion injury, flaps" in English and Chinese, respectively. The articles addressing the pharmacological effects of ginsenosides Rb1, ginsenosides Rb1 alleviating tissue ischemia/reperfusion injury and flap ischemia/reperfusion injury were included.RESULTS AND CONCLUSION: Flap ischemia/reperfusion injury is complex non-specific cascade damage after ischemic tissues restoring blood supply, which Involves in excessive production of oxygen free radicals, inflammation infiltration and its interaction with endothelial cells, energy failure, intracellular calcium overload, and nitric oxide production. Ginsenosides Rb1 has the effects of anti-oxidation, anti-inflammation and antiapoptosis. Ginsenosides Rb1 exerts good protection in ischemia/reperfusion injuries of various tissues and organs through anti-oxidation, anti-inflammation, increasing nitric oxide production, antiapoptosis, inhibiting calcium overload.
引文
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[5]Zhang F,Hu EC,Topp S,et al.Proinflammatory cytokines gene expression in skin flaps with arterial and venous ischemia in rats.J Reconstr Microsurg.2006;22(8):641-647.
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[10]陈拓,王荣春,林仕彬,等.抑制P38MAPK对皮瓣缺血再灌注损伤过程中炎症因子、细胞凋亡的影响[J].海南医学院学报,2017,23(5):577-580.
[11]顾文奇,张巍,柴益民.利多卡因对大鼠皮瓣缺血-再灌注损伤的保护作用[J].2010,31(2):125-127.
[12]Wu X,Yu M,Li A.Protective effect of a nuclear factor-kappaBinhibitor on ischemia-reperfusion injury in a rat epigastric flap model.J Reconstr Microsurg.2008 Jul;24(5):351-359.
[13]王海南.人参皂苷药理研究进展[J].中国临床药理学与治疗学,2006,11(11):1201-1206.
[14]杨秋娅,李晓宇,刘皋林.人参皂苷Rb1的药理作用研究进展[J].中国药学杂志,2013,48(15):1233-1237.
[15]He F,Guo R,Wu SL,et al.Protective effects of ginsenoside Rb1 on human umbilical vein endothelial cells in vitro.JCardiovasc Pharmacol.2007;50(3):314-320.
[16]Wu Y,Xia ZY,Dou J,et al.Protective effect of ginsenoside Rb1 against myocardial ischemia/reperfusion injury in streptozotocin-induced diabetic rats.Molecular Biology Reports.2011;38(7):4327-4335.
[17]Sun Q,Meng QT,Jiang Y,et al.Protective Effect of Ginsenoside Rb1 against Intestinal Ischemia-Reperfusion Induced Acute Renal Injury in Mice.Plos One.2013;8(12):e80859.
[18]Lu T,Jiang Y,Zhou Z,et al.Intranasal ginsenoside Rb1targets the brain and ameliorates cerebral ischemia/reperfusion injury in rats.Biol Pharm Bull.2011;34(8):1319-1324.
[19]Wang Z,Li M,Wu WK,et al.Ginsenoside Rb1 preconditioning protects against myocardial infarction after regional ischemia and reperfusion by activation of phosphatidylinositol-3-kinase signal transduction.Cardiovasc Drugs Ther.2008;22(6):443-452.
[20]Sewerynek E,Reiter RJ,Melchiorri D,et al.Oxidative damage in the liver induced by ischemia-reperfusion:protection by melatonin.Hepatogastroenterology.1996;43(10):898-905.
[21]de Perrot M,Liu M,Waddell TK,et al.,Ischemia-reperfusion-induced lung injury.Am J Respir Crit Care Med.2003;167(4):490-511.
[22]Lee YK,Nata'atmaja BS,Kim BH,et al.Protective effect of telomerase-based 16-mer peptide vaccine(GV1001)on inferior epigastric island skin flap survivability in ischaemia-reperfusion injury rat model.J Plast Surg Hand Surg.2017;51(3):1-7.
[23]Lan L,Nakajima S,Wei L,et al.Novel method for site-specific induction of oxidative DNA damage reveals differences in recruitment of repair proteins to heterochromatin and euchromatin.Nucleic Acids Res.2014 Feb;42(4):2330-2345.
[24]Medling BD,Bueno R,Chambers C,et al.The Effect of Vitamin E Succinate on Ischemia Reperfusion Injury.Hand.2010;5(1):60-64.
[25]Chouchani ET,Pell VR,Gaude E,et al.Ischaemic accumulation of succinate controls reperfusion injury through mitochondrial ROS.Nature.2014;515(7527):431-435.
[26]顾文奇,张巍,柴益民.皮瓣缺血-再灌注损伤的治疗[J].中国修复重建外科杂志,2011,25(3):373.
[27]Mashima R,Okuyama T.Okuyama,The role of lipoxygenases in pathophysiology;new insights and future perspectives.Redox Biology.2015;6:297-310.
[28]Zhuang CL,Mao XY,Liu S,et al.Ginsenoside Rb1 improves postoperative fatigue syndrome by reducing skeletal muscle oxidative stress through activation of the PI3K/Akt/Nrf2pathway in aged rats.Eur J Pharmacol.2014;740:480-487.
[29]谢薇,夏凌辉,方峻,等.人参皂苷Rb1对人脐静脉内皮细胞一氧化氮释放和TGF-β1表达的影响及意义[J].中国医院药学杂志,2007,27(9):1225-1228.
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