| Abstract [eng] |
Aim of the study: To analyse and summarise the existing scientific data on the relationship between time to restoration of blood flow and histological changes in striated muscles in neglected acute limb ischaemia. Methods. A literature review was performed using the Pubmed database. 39 articles were included based on inclusion and exclusion criteria. Discussion: Over the past decade, significant progress has been made in understanding the mechanisms and interventions associated with ischaemia-reperfusion (I/R) injury in skeletal muscle. In vivo studies show time-dependent changes during the ischaemia-reperfusion phase, such as an increase in inflammatory markers, a decrease in microcirculation, rhabdomyolysis, and nerve fibre damage and others In vivo and in vitro studies have investigated a wide range of pharmacological interventions to mitigate the I/R injury. Some promising strategies include mitochondrial transplantation, naftidrofuryl and cilostazol administration, dual-sensitivity injectable hydrogel, dexamethasone treatment, chronic intermittent hypobaric hypoxia, oxytocin administration, lycopene supplementation, extracellular vesicles, N-methyl-4-isoleucine-cycloporin, nitrate and citrulline supplementation, high mobility box group 1 protein modulation, fresh-frozen plasma administration, curcumin analogues, T-cell sequestrator FTY720, glutathione-S-transferase inhibitor ethacrynic acid, picroside II administration, SA-10 charged nanoparticles, water-soluble carbon monoxide releasing molecules (CORM-3), treatment with iloprost, etc. These interventions have shown beneficial effects in reducing lesions, improving mitochondrial function, reducing oxidative stress and inflammation, promoting angiogenesis, and preserving muscle contractility. In addition, instrumental studies such as dynamic contrast-enhanced magnetic resonance imaging, 3-carbamoyl PROXYL-enhanced magnetic resonance imaging, colour digital subtraction angiography, computed tomography perfusion imaging (CTPI), photoacoustic imaging, MRI, 3-charge coupled device, and infrared imaging have shown positive results for ischaemia-reperfusion lesion volume monitoring. Conclusions: In conclusion, despite the limitations of the studies and the difficulties in summarising the results, the studies showed time-dependent histobiological changes and potential pharmacological treatments for ischaemia-reperfusion injury. Further studies are needed to establish the relationship between time intervals, histobiological changes and the applicability of animal studies to humans. |
