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16.05.2024 | Original Articles

Spermidine Exerts Protective Effects in Random-Pattern Skin Flap Survival in Rats: Possible Involvement of Inflammatory Cytokines, Nitric Oxide, and VEGF

verfasst von: Kimiya Jouyban, Razieh Mohammad Jafari, Mohammad Charkhpour, Hadis Rezaei, Behrouz Seyfinejad, Mohammad Amin Manavi, Seyed Mohammad Tavangar, Ahmad Reza Dehpour

Erschienen in: Aesthetic Plastic Surgery

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Abstract

Background

Distal necrosis and inflammation are two of the most common health consequences of random-pattern skin flaps survival (SFS). Anti-inflammatory effects of spermidine have been identified in various studies. On the other hand, considering the involvement of the nitric oxide molecule in the spermidine mode of action and also its role in skin tissue function, we analyzed the possible effects of spermidine on the SFS and also, potential involvement of nitrergic pathway and inflammatory cytokine in these phenomena.

Methods

Each rat was pretreated with either a vehicle (control) or various doses of spermidine (0.5, 1, 3, 5, 10 and 30 mg/kg) and then was executed a random-pattern skin flap paradigm. Also, spermidine at the dose of 5 mg/kg was selected and one group rats received spermidine 20 min prior to surgery and one additional dose 1 day after operation. Then, 7 days after operations, interleukin (IL)-6, tumor necrosis factor (TNF)-α, interferon-gamma (IFN-γ), and nitrite levels were inquired in the tissue samples by ELIZA kit. Vascular endothelial growth factor expression was assessed by DAPI staining and fluorescent microscopes. The concentrations of three polyamines, including spermidine, spermine, and cadaverine, were analyzed using HPLC.

Results

Pretreatment with spermidine 5 mg/kg improved SFS considerably in microscopic skin H&E staining analysis and decreased the percentage of necrotic area. Moreover, spermidine exerted promising anti-inflammatory effects via the modulation of nitric oxide and reducing inflammatory cytokines.

Conclusions

Spermidine could improve skin flaps survival, probably through the nitrergic system and inflammation pathways. This preclinical study provides level III evidence for the potential therapeutic effects of spermidine on SFS in rats, based on the analysis of animal models. Further studies are needed to confirm these findings in clinical settings.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literatur
1.
Zurück zum Zitat Gdalevitch P et al (2015) Effects of nitroglycerin ointment on mastectomy flap necrosis in immediate breast reconstruction: a randomized controlled trial. Plast Reconstr Surg 135(6):1530–1539PubMedCrossRef Gdalevitch P et al (2015) Effects of nitroglycerin ointment on mastectomy flap necrosis in immediate breast reconstruction: a randomized controlled trial. Plast Reconstr Surg 135(6):1530–1539PubMedCrossRef
2.
Zurück zum Zitat Wang X et al (2022) Dynamically responsive scaffolds from microfluidic 3D printing for skin flap regeneration. Adv Sci 9(22):e2201155CrossRef Wang X et al (2022) Dynamically responsive scaffolds from microfluidic 3D printing for skin flap regeneration. Adv Sci 9(22):e2201155CrossRef
3.
Zurück zum Zitat Lee JH et al (2022) Current status of experimental animal skin flap models: ischemic preconditioning and molecular factors. Int J Mol Sci 23(9):5234PubMedPubMedCentralCrossRef Lee JH et al (2022) Current status of experimental animal skin flap models: ischemic preconditioning and molecular factors. Int J Mol Sci 23(9):5234PubMedPubMedCentralCrossRef
4.
Zurück zum Zitat Ellabban MA et al (2022) Experimental study of the effects of nitroglycerin, botulinum toxin A, and clopidogrel on bipedicled superficial inferior epigastric artery flap survival. Sci Rep 12(1):20891PubMedPubMedCentralCrossRef Ellabban MA et al (2022) Experimental study of the effects of nitroglycerin, botulinum toxin A, and clopidogrel on bipedicled superficial inferior epigastric artery flap survival. Sci Rep 12(1):20891PubMedPubMedCentralCrossRef
6.
Zurück zum Zitat Chen J et al (2023) Protein kinase D1 promotes the survival of random-pattern skin flaps in rats. Biochem Biophys Res Commun 641:67–76PubMedCrossRef Chen J et al (2023) Protein kinase D1 promotes the survival of random-pattern skin flaps in rats. Biochem Biophys Res Commun 641:67–76PubMedCrossRef
7.
Zurück zum Zitat Lou J et al (2022) Cyclic helix B peptide promotes random-pattern skin flap survival via TFE3-mediated enhancement of autophagy and reduction of ROS levels. Br J Pharmacol 179(2):301–321PubMedCrossRef Lou J et al (2022) Cyclic helix B peptide promotes random-pattern skin flap survival via TFE3-mediated enhancement of autophagy and reduction of ROS levels. Br J Pharmacol 179(2):301–321PubMedCrossRef
8.
Zurück zum Zitat Aryannejad A et al (2021) Protective effect of modafinil on skin flap survival in the experimental random-pattern skin flap model in rats: the role of ATP-sensitive potassium channels and nitric oxide pathway. J Plast Reconstr Aesthet Surg 74(6):1346–1354PubMedCrossRef Aryannejad A et al (2021) Protective effect of modafinil on skin flap survival in the experimental random-pattern skin flap model in rats: the role of ATP-sensitive potassium channels and nitric oxide pathway. J Plast Reconstr Aesthet Surg 74(6):1346–1354PubMedCrossRef
9.
Zurück zum Zitat Roh TS et al (2017) Effect of botulinum toxin A on vasoconstriction and sympathetic neurotransmitters in a murine random pattern skin flap model. Wound Repair Regen 25(1):75–85PubMedCrossRef Roh TS et al (2017) Effect of botulinum toxin A on vasoconstriction and sympathetic neurotransmitters in a murine random pattern skin flap model. Wound Repair Regen 25(1):75–85PubMedCrossRef
11.
Zurück zum Zitat Zou D et al (2022) A comprehensive review of spermidine: safety, health effects, absorption and metabolism, food materials evaluation, physical and chemical processing, and bioprocessing. Compr Rev Food Sci Food Saf 21(3):2820–2842PubMedCrossRef Zou D et al (2022) A comprehensive review of spermidine: safety, health effects, absorption and metabolism, food materials evaluation, physical and chemical processing, and bioprocessing. Compr Rev Food Sci Food Saf 21(3):2820–2842PubMedCrossRef
12.
Zurück zum Zitat Shi YJ et al (2022) The untapped potential of spermidine alkaloids: sources, structures, bioactivities and syntheses. Eur J Med Chem 240:114600PubMedCrossRef Shi YJ et al (2022) The untapped potential of spermidine alkaloids: sources, structures, bioactivities and syntheses. Eur J Med Chem 240:114600PubMedCrossRef
14.
15.
Zurück zum Zitat Freitag K et al (2022) Spermidine reduces neuroinflammation and soluble amyloid beta in an Alzheimer’s disease mouse model. J Neuroinflammation 19(1):172PubMedPubMedCentralCrossRef Freitag K et al (2022) Spermidine reduces neuroinflammation and soluble amyloid beta in an Alzheimer’s disease mouse model. J Neuroinflammation 19(1):172PubMedPubMedCentralCrossRef
16.
Zurück zum Zitat Ni Y et al (2022) Spermidine ameliorates nonalcoholic steatohepatitis through thyroid hormone-responsive protein signaling and the gut microbiota-mediated metabolism of bile acids. J Agric Food Chem 70(21):6478–6492PubMedCrossRef Ni Y et al (2022) Spermidine ameliorates nonalcoholic steatohepatitis through thyroid hormone-responsive protein signaling and the gut microbiota-mediated metabolism of bile acids. J Agric Food Chem 70(21):6478–6492PubMedCrossRef
17.
Zurück zum Zitat Yuan H et al (2021) Spermidine inhibits joints inflammation and macrophage activation in mice with collagen-induced arthritis. J Inflamm Res 14:2713–2721PubMedPubMedCentralCrossRef Yuan H et al (2021) Spermidine inhibits joints inflammation and macrophage activation in mice with collagen-induced arthritis. J Inflamm Res 14:2713–2721PubMedPubMedCentralCrossRef
18.
Zurück zum Zitat Ma L et al (2021) Preventive and therapeutic spermidine treatment attenuates acute colitis in mice. J Agric Food Chem 69(6):1864–1876PubMedCrossRef Ma L et al (2021) Preventive and therapeutic spermidine treatment attenuates acute colitis in mice. J Agric Food Chem 69(6):1864–1876PubMedCrossRef
19.
Zurück zum Zitat Baek AR et al (2020) Spermidine attenuates bleomycin-induced lung fibrosis by inducing autophagy and inhibiting endoplasmic reticulum stress (ERS)-induced cell death in mice. Exp Mol Med 52(12):2034–2045PubMedPubMedCentralCrossRef Baek AR et al (2020) Spermidine attenuates bleomycin-induced lung fibrosis by inducing autophagy and inhibiting endoplasmic reticulum stress (ERS)-induced cell death in mice. Exp Mol Med 52(12):2034–2045PubMedPubMedCentralCrossRef
20.
Zurück zum Zitat Szeliga M, Albrecht J (2021) Roles of nitric oxide and polyamines in brain tumor growth. Adv Med Sci 66(1):199–205PubMedCrossRef Szeliga M, Albrecht J (2021) Roles of nitric oxide and polyamines in brain tumor growth. Adv Med Sci 66(1):199–205PubMedCrossRef
21.
Zurück zum Zitat Kapoor RT, Hefft DI, Ahmad A, Allakhverdiev S (2021) Nitric oxide and spermidine alleviate arsenic-incited oxidative damage in Cicer arietinum by modulating glyoxalase and antioxidant defense system. Funct Plant Biol 50:108–120CrossRef Kapoor RT, Hefft DI, Ahmad A, Allakhverdiev S (2021) Nitric oxide and spermidine alleviate arsenic-incited oxidative damage in Cicer arietinum by modulating glyoxalase and antioxidant defense system. Funct Plant Biol 50:108–120CrossRef
22.
Zurück zum Zitat Jiang MZ et al (2004) Effects of antioxidants and nitric oxide on TNF-alpha-induced adhesion molecule expression and NF-kappaB activation in human dermal microvascular endothelial cells. Life Sci 75(10):1159–1170PubMedCrossRef Jiang MZ et al (2004) Effects of antioxidants and nitric oxide on TNF-alpha-induced adhesion molecule expression and NF-kappaB activation in human dermal microvascular endothelial cells. Life Sci 75(10):1159–1170PubMedCrossRef
23.
Zurück zum Zitat Ramot Y et al (2015) N(1)-methylspermidine, a stable spermidine analog, prolongs anagen and regulates epithelial stem cell functions in human hair follicles. Arch Dermatol Res 307(9):841–847PubMedCrossRef Ramot Y et al (2015) N(1)-methylspermidine, a stable spermidine analog, prolongs anagen and regulates epithelial stem cell functions in human hair follicles. Arch Dermatol Res 307(9):841–847PubMedCrossRef
24.
Zurück zum Zitat Takuathung MN et al (2021) Anti-psoriatic and anti-inflammatory effects of Kaempferia parviflora in keratinocytes and macrophage cells. Biomed Pharmacother 143:112229PubMedCrossRef Takuathung MN et al (2021) Anti-psoriatic and anti-inflammatory effects of Kaempferia parviflora in keratinocytes and macrophage cells. Biomed Pharmacother 143:112229PubMedCrossRef
25.
Zurück zum Zitat McFarlane RM, Deyoung G, Henry RA (1965) The design of a pedicle flap in the rat to study necrosis and its prevention. Plast Reconstr Surg 35:177–182PubMedCrossRef McFarlane RM, Deyoung G, Henry RA (1965) The design of a pedicle flap in the rat to study necrosis and its prevention. Plast Reconstr Surg 35:177–182PubMedCrossRef
26.
Zurück zum Zitat Seyfinejad B et al (2022) Ion-pair hollow fiber liquid-phase microextraction combined with capillary electrophoresis for the determination of biogenic amines in rat tissues. J Pharm Biomed Anal 219:114909PubMedCrossRef Seyfinejad B et al (2022) Ion-pair hollow fiber liquid-phase microextraction combined with capillary electrophoresis for the determination of biogenic amines in rat tissues. J Pharm Biomed Anal 219:114909PubMedCrossRef
27.
Zurück zum Zitat Abbaszadeh-Kasbi A et al (2019) Acute activation of α7-nicotinic receptors by nicotine improves rodent skin flap survival through nitrergic system. Ann Plast Surg 83(2):211–216PubMedCrossRef Abbaszadeh-Kasbi A et al (2019) Acute activation of α7-nicotinic receptors by nicotine improves rodent skin flap survival through nitrergic system. Ann Plast Surg 83(2):211–216PubMedCrossRef
28.
Zurück zum Zitat Taleb S et al (2014) Metformin improves skin flap survival through nitric oxide system. J Surg Res 192(2):686–691PubMedCrossRef Taleb S et al (2014) Metformin improves skin flap survival through nitric oxide system. J Surg Res 192(2):686–691PubMedCrossRef
29.
Zurück zum Zitat Ala M et al (2020) Sodium valproate improves skin flap survival via gamma-aminobutyric acid and histone deacetylase inhibitory system. J Surg Res 246:519–526PubMedCrossRef Ala M et al (2020) Sodium valproate improves skin flap survival via gamma-aminobutyric acid and histone deacetylase inhibitory system. J Surg Res 246:519–526PubMedCrossRef
30.
Zurück zum Zitat Dehdashtian A et al (2019) Sumatriptan increases skin flap survival through activation of 5-hydroxytryptamine 1b/1d receptors in rats: the mediating role of the nitric oxide pathway. Plast Reconstr Surg 144(1):70e–77ePubMedCrossRef Dehdashtian A et al (2019) Sumatriptan increases skin flap survival through activation of 5-hydroxytryptamine 1b/1d receptors in rats: the mediating role of the nitric oxide pathway. Plast Reconstr Surg 144(1):70e–77ePubMedCrossRef
34.
Zurück zum Zitat Kyriazis M, Swas L, Orlova T (2023) The impact of hormesis, neuronal stress response, and reproduction, upon clinical aging: a narrative review. J Clin Med 12(16):5433PubMedPubMedCentralCrossRef Kyriazis M, Swas L, Orlova T (2023) The impact of hormesis, neuronal stress response, and reproduction, upon clinical aging: a narrative review. J Clin Med 12(16):5433PubMedPubMedCentralCrossRef
35.
Zurück zum Zitat Calabrese E et al (2023) Polyamines and hormesis: making sense of a dose response dichotomy. Chem Biol Interact 386:110748PubMedCrossRef Calabrese E et al (2023) Polyamines and hormesis: making sense of a dose response dichotomy. Chem Biol Interact 386:110748PubMedCrossRef
36.
Zurück zum Zitat Sigrist SJ et al (2014) Spermidine-triggered autophagy ameliorates memory during aging. Autophagy 10(1):178–179PubMedCrossRef Sigrist SJ et al (2014) Spermidine-triggered autophagy ameliorates memory during aging. Autophagy 10(1):178–179PubMedCrossRef
37.
Zurück zum Zitat Yang Y et al (2017) Induction of autophagy by spermidine is neuroprotective via inhibition of caspase 3-mediated Beclin 1 cleavage. Cell Death Dis 8(4):e2738PubMedPubMedCentralCrossRef Yang Y et al (2017) Induction of autophagy by spermidine is neuroprotective via inhibition of caspase 3-mediated Beclin 1 cleavage. Cell Death Dis 8(4):e2738PubMedPubMedCentralCrossRef
38.
39.
Zurück zum Zitat Spiljar M, Kuchroo VK (2022) Metabolic regulation and function of T helper cells in neuroinflammation. Semin Immunopathol 44(5):581–598PubMedCrossRef Spiljar M, Kuchroo VK (2022) Metabolic regulation and function of T helper cells in neuroinflammation. Semin Immunopathol 44(5):581–598PubMedCrossRef
40.
Zurück zum Zitat Lu B et al (2022) Recent advances in fluorescent methods for polyamine detection and the polyamine suppressing strategy in tumor treatment. Biosensors 12(8):633PubMedPubMedCentralCrossRef Lu B et al (2022) Recent advances in fluorescent methods for polyamine detection and the polyamine suppressing strategy in tumor treatment. Biosensors 12(8):633PubMedPubMedCentralCrossRef
41.
Zurück zum Zitat Yamamoto Y et al (2018) Expression and distribution patterns of spermine, spermidine, and putrescine in rat hair follicle. Histochem Cell Biol 149(2):161–167PubMedCrossRef Yamamoto Y et al (2018) Expression and distribution patterns of spermine, spermidine, and putrescine in rat hair follicle. Histochem Cell Biol 149(2):161–167PubMedCrossRef
43.
Zurück zum Zitat Gelman J et al (1987) Reduced cell death in skin flaps in rats treated with difluoromethylornithine. Faseb j 1(6):474–477PubMedCrossRef Gelman J et al (1987) Reduced cell death in skin flaps in rats treated with difluoromethylornithine. Faseb j 1(6):474–477PubMedCrossRef
44.
Zurück zum Zitat Petereit DG et al (1994) Combining polyamine depletion with radiation therapy for rapidly dividing head and neck tumors: strategies for improved locoregional control. Int J Radiat Oncol Biol Phys 28(4):891–898PubMedCrossRef Petereit DG et al (1994) Combining polyamine depletion with radiation therapy for rapidly dividing head and neck tumors: strategies for improved locoregional control. Int J Radiat Oncol Biol Phys 28(4):891–898PubMedCrossRef
45.
46.
Zurück zum Zitat Fan W et al (2021) Effect of memantine on the survival of an ischemic random skin flap and the underlying mechanism. Biomed Pharmacother 143:112163PubMedCrossRef Fan W et al (2021) Effect of memantine on the survival of an ischemic random skin flap and the underlying mechanism. Biomed Pharmacother 143:112163PubMedCrossRef
47.
Zurück zum Zitat Paul S, Kang SC (2013) Natural polyamine inhibits mouse skin inflammation and macrophage activation. Inflamm Res 62(7):681–688PubMedCrossRef Paul S, Kang SC (2013) Natural polyamine inhibits mouse skin inflammation and macrophage activation. Inflamm Res 62(7):681–688PubMedCrossRef
48.
49.
Zurück zum Zitat Chin LC et al (2011) The influence of nitric oxide synthase 2 on cutaneous wound angiogenesis. Br J Dermatol 165(6):1223–1235PubMedCrossRef Chin LC et al (2011) The influence of nitric oxide synthase 2 on cutaneous wound angiogenesis. Br J Dermatol 165(6):1223–1235PubMedCrossRef
51.
Zurück zum Zitat Khiabani KT, Kerrigan CL (2002) The effects of the nitric oxide donor SIN-1 on ischemia-reperfused cutaneous and myocutaneous flaps. Plast Reconstr Surg 110(1):169–176PubMedCrossRef Khiabani KT, Kerrigan CL (2002) The effects of the nitric oxide donor SIN-1 on ischemia-reperfused cutaneous and myocutaneous flaps. Plast Reconstr Surg 110(1):169–176PubMedCrossRef
52.
Zurück zum Zitat Gazyakan E et al (2021) Modulation of nitric oxide bioavailability attenuates ischemia-reperfusion injury in type II diabetes. J Plast Reconstr Aesthet Surg 74(1):183–191PubMedCrossRef Gazyakan E et al (2021) Modulation of nitric oxide bioavailability attenuates ischemia-reperfusion injury in type II diabetes. J Plast Reconstr Aesthet Surg 74(1):183–191PubMedCrossRef
53.
Zurück zum Zitat Soufli I et al (2016) Overview of cytokines and nitric oxide involvement in immuno-pathogenesis of inflammatory bowel diseases. World J Gastrointest Pharmacol Ther 7(3):353–360PubMedPubMedCentralCrossRef Soufli I et al (2016) Overview of cytokines and nitric oxide involvement in immuno-pathogenesis of inflammatory bowel diseases. World J Gastrointest Pharmacol Ther 7(3):353–360PubMedPubMedCentralCrossRef
55.
Zurück zum Zitat Sheng W et al (2011) Pro-inflammatory cytokines and lipopolysaccharide induce changes in cell morphology, and upregulation of ERK1/2, iNOS and sPLA2-IIA expression in astrocytes and microglia. J Neuroinflammation 8(1):121PubMedPubMedCentralCrossRef Sheng W et al (2011) Pro-inflammatory cytokines and lipopolysaccharide induce changes in cell morphology, and upregulation of ERK1/2, iNOS and sPLA2-IIA expression in astrocytes and microglia. J Neuroinflammation 8(1):121PubMedPubMedCentralCrossRef
57.
Zurück zum Zitat Murphy MP (1999) Nitric oxide and cell death. Biochim Biophys Acta BBA Bioenerg 1411(2):401–414CrossRef Murphy MP (1999) Nitric oxide and cell death. Biochim Biophys Acta BBA Bioenerg 1411(2):401–414CrossRef
59.
Zurück zum Zitat Hwang J, Kiick KL, Sullivan MO (2023) VEGF-encoding, gene-activated collagen-based matrices promote blood vessel formation and improved wound repair. ACS Appl Mater Interfaces 15(13):16434–16447PubMedPubMedCentralCrossRef Hwang J, Kiick KL, Sullivan MO (2023) VEGF-encoding, gene-activated collagen-based matrices promote blood vessel formation and improved wound repair. ACS Appl Mater Interfaces 15(13):16434–16447PubMedPubMedCentralCrossRef
60.
Zurück zum Zitat Johnson KE, Wilgus TA (2014) Vascular endothelial growth factor and angiogenesis in the regulation of cutaneous wound repair. Adv Wound Care (New Rochelle) 3(10):647–661PubMedPubMedCentralCrossRef Johnson KE, Wilgus TA (2014) Vascular endothelial growth factor and angiogenesis in the regulation of cutaneous wound repair. Adv Wound Care (New Rochelle) 3(10):647–661PubMedPubMedCentralCrossRef
Metadaten
Titel
Spermidine Exerts Protective Effects in Random-Pattern Skin Flap Survival in Rats: Possible Involvement of Inflammatory Cytokines, Nitric Oxide, and VEGF
verfasst von
Kimiya Jouyban
Razieh Mohammad Jafari
Mohammad Charkhpour
Hadis Rezaei
Behrouz Seyfinejad
Mohammad Amin Manavi
Seyed Mohammad Tavangar
Ahmad Reza Dehpour
Publikationsdatum
16.05.2024
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-024-04119-6

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