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{{Reperfusion injury}}


{{SI}}
{{CMG}} {{AE}} {{AC}} {{Shivam Singla}}


{{EJ}}
{{SK}} Reperfusion Damage; Damage, Reperfusion; Damages, Reperfusion; Reperfusion Damages; Ischemia-Reperfusion Injury; Ischemia-Reperfusion Injury; Injury, Ischemia-Reperfusion; Injuries, Ischemia-Reperfusion; Injury, Ischemia-Reperfusion; Ischemia-Reperfusion Injuries; Injury, Reperfusion; Injuries, Reperfusion; Reperfusion Injuries


{{CMG}}
==[[Reperfusion injury overview|Overview]]==


==Overview==
==[[Reperfusion injury pathophysiology|Pathophysiology]]==
'''Reperfusion injury''' refers to damage to [[tissue (biology)|tissue]] caused when [[blood]] supply returns to the tissue after a period of [[ischemia]].  The absence of [[oxygen]] and [[nutrient]]s from blood creates a condition in which the restoration of [[circulatory system|circulation]] results in [[inflammation]] and [[oxidation|oxidative]] damage through the induction of [[oxidative stress]] rather than restoration of normal function.


==Mechanisms of reperfusion injury==
==[[Reperfusion injury risk factors|Risk Factors]]==
The damage of reperfusion injury is due in part to the [[inflammatory response]] of damaged tissues.  [[White blood cell]]s carried to the area by the newly returning blood release a host of [[cytokine|inflammatory factors]] such as [[interleukin]]s as well as [[reactive oxygen species|free radicals]] in response to tissue damage
<ref name="WMClark">{{cite web | last = Clark | first = Wayne M. | title = Reperfusion Injury in Stroke | work = eMedicine | publisher = WebMD  | date = January 5, 2005 | url = http://www.emedicine.com/neuro/topic602.htm | accessdate = 2006-08-09 }}</ref>.The restored blood flow reintroduces oxygen within [[cell (biology)|cell]]s that damages cellular [[protein]]s, [[DNA]], and the [[plasma membrane]].  Damage to the cell's membrane may in turn cause the release of more free radicals. Such reactive species may also act indirectly in [[redox signaling]] to turn on [[apoptosis]].  Leukocytes may also build up in small [[capillary|capillaries]], obstructing them and leading to more ischemia<ref name="WMClark" />.


Reperfusion injury plays a part in the [[brain]]'s [[ischemic cascade]], which is involved in [[stroke]] and [[brain trauma]].  Repeated bouts of ischemia and reperfusion injury also are thought to be a factor leading to the formation and failure to [[wound healing|heal]] of [[chronic wound]]s such as [[pressure sore]]s and [[diabetic foot]] [[ulcer]]s<ref name="TMustoe">{{cite journal | author=Mustoe T. | title=Understanding chronic wounds: a unifying hypothesis on their pathogenesis and implications for therapy | journal=AMERICAN JOURNAL OF SURGERY | volume=187 | issue=5A | year=2004 | pages=65S-70S | id=PMID 15147994}}</ref>.  Continuous pressure limits blood supply and causes ischemia, and the inflammation occurs during reperfusion.  As this process is repeated, it eventually damages tissue enough to cause a [[wound]]<ref name="TMustoe" />.
==[[Reperfusion injury natural history|Natural History, Complications & Prognosis]]==


In prolonged ischemia (60 minutes or more), [[hypoxanthine]] is formed as breakdown product of [[Adenosine triphosphate|ATP]] metabolism. The enzyme ''[[xanthine dehydrogenase]]'' is converted to ''[[xanthine oxidase]]'' as a result of the higher availability of oxygen. This oxidation results in molecular oxygen being converted into highly reactive [[superoxide]] and [[hydroxyl]] [[Radical (chemistry)|radicals]].  Xanthine oxidase also produces [[uric acid]],  which may act as both a prooxidant and as a scavenger of reactive species such as peroxinitrite.  Excessive [[nitric oxide]] produced during reperfusion reacts with [[superoxide]] to produce the potent reactive species [[peroxynitrite]].  Such radicals and reactive oxygen species attack cell membrane lipids, proteins, and glycosaminoglycans, causing further damage.  They may also initiate specific biological processes by [[redox signaling]].
==Treatment==
'''[[Reperfusion injury medical therapy|Medical Therapy]]'''


==Treatment==
'''[[Reperfusion injury future or investigational therapies|Future or Investigational Therapies]]'''
[[Glisodin]], a [[dietary supplement]] derived from [[superoxide dismutase]] (SOD) and wheat [[gliadin]], has been studied for its ability to mitigate [[ischemia]]-reperfusion injury. A study of [[aortic cross-clamping]] (a common procedure in [[cardiac surgery]]), demonstrated a strong potential benefit with further research ongoing.


==See also==
==Related Chapters==
* [[Ischemia]]
* [[Ischemia]]
* [[Myocardial_infarction#Reperfusion|Myocardial infarction -- Reperfusion]]
* [[Myocardial_infarction#Reperfusion|Myocardial infarction -- Reperfusion]]


==References==
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==External links==
* [http://www.benbest.com/cryonics/ischemia.html#reperfuse Reperfusion Injury and "No Reflow"]
* [http://www.newsweek.com/id/35045 Docs Change the Way They Think About Death]


[[Category:Physiology]]
[[Category:Physiology]]
[[Category:Neurotrauma]]
[[Category:Neurotrauma]]
[[Category:Cardiology]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date cardiology]]

Latest revision as of 19:29, 20 August 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anjan K. Chakrabarti, M.D. [2] Shivam Singla, M.D.[3]

Synonyms and keywords: Reperfusion Damage; Damage, Reperfusion; Damages, Reperfusion; Reperfusion Damages; Ischemia-Reperfusion Injury; Ischemia-Reperfusion Injury; Injury, Ischemia-Reperfusion; Injuries, Ischemia-Reperfusion; Injury, Ischemia-Reperfusion; Ischemia-Reperfusion Injuries; Injury, Reperfusion; Injuries, Reperfusion; Reperfusion Injuries

Overview

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Risk Factors

Natural History, Complications & Prognosis

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