Protective effect of NAC preconditioning against ischemia-reperfusion injury in piglet small bowel transplantation: effects on plasma TNF, IL-8, hyaluronic acid, and NO.

Background: Ischemia-reperfusion (I/R) injury is one of the main factors affecting the function and structure of small bowel transplantation (SBT), by generation of proinflammatory mediators such as reactive oxygen species, reactive nitrogen species, cytokines, and endotoxin. Experimental data have demonstrated that N-acetylcysteine (NAC) attenuates intestinal I/R injury. The objective of this study was to determine the effect of NAC preconditioning on the SBT-I/R induced inflammatory cascade, with particular focus on TNF, IL-8, hyaluronic acid, and NO.

Methods: Fifteen domestic pigs were used as donors. Fifteen recipient animals were randomly assigned into two groups. Group 1: SBTx (n=7) served as controls and Group 2: SBTx (n=8) served as the experimental group (NAC administration).

Results: NAC administration at a continuous 4 h intravenous bolus dose of 200 mg/kg of body weight, starting before initiation of bowel transplantation, resulted in statistically significant (P<0.05) higher plasma levels of NO, and lower plasma levels of hyaluronic acid, TNF-α, IL-8, and LDH compared with those of the control group, at the 360 min time point.

Conclusions: NAC confers a protective role in small bowel transplantation associated, partly, with NO generation and hyaluronic acid, TNF-α and IL-8 amelioration.