The effects of alpha lipoic acid and l-carnitin on bacterial translocation, oxidative stress and mucosal degeneration of experimental mesenter ischemia-reperfusion

Aim: In this study, the effects of alpha lipoic acid and L-Carnitine on bacterial translocation, oxidative stress and intestinal mucosal degeneration in experimental mesenteric ischemiareperfusion injury were investigated bacterial translocation in mesenteric ischemia, oxidative stress, and intestinal mucosal degeneration. Materials and Methods: In the experiment, adult weights were about 250-300 gr. 35 male Wistar-Albino strains were used. Rats were randomly assigned to Group I (Sham), Group II (Mesenteric ischemia [Mİ]), Group III (Alpha lipoic acid + Mesenteric ischemia [ALA+Mİ]), Group IV (L-Carnitine + Mesenteric ischemia [L-K+Mİ]), Group V (Alpha lipoic acid + L-Carnitine + Mesenteric ischemia [ALA+L-K+Mİ]) including divided into 5 groups. In Group II, III, IV and V, SMA was found after laparotomy after induction of anesthesia in rats. Bulldog clamped with clamp to provide ischemia. In Group III, IV and V, In group III, rats were injected intraperitoneally with Alfa lipoic acid at a dose of 100 mg/kg 30 min before mesenteric ischemia, in group IV; L-Carnitine at a dose of 200 mg/kg was intraperitoneally administered to rats 30 minutes before mesenteric ischemia, in group V; Alpha lipoic acid at 100 mg/kg dose and L-Carnitine at 200 mg/kg dose were given intraperitoneally 30 minutes before mesenteric ischemia. In all groups, after the procedure, laparotomy was performed and MDA was taken from the intestinal tissue (ileum) and TAS, TOS and OSI (TOS / TAS) values by taking blood from portal vein for oxidative damage detection. For detection of bacterial translocation, samples taken from the mesenteric lymph node, liver, spleen and ileum were homogenized by placing them in 1 ml broth medium. These prepared homogenates were incubated at 37 °C for 24-48 hours with a Bloody agar and Eosin Methylene Blue agar. For detection of mucosal degeneration, samples taken from the intestinal tissue (ileum) were fixed in 10% neutral formalin for 24 hours and then paraffin blocks were prepared. Sections with a thickness of 5μm were prepared, scored with Chiu damage scoring by microscopic examination. Differences between the TAS, TOS, MDA and OSI (TOS/TAS) values of the groups in terms of oxidative damage and the differences between the Chiu scoring of the groups in terms of histopathologic were used by non-parametric methods, Kruskal-Wallis test for multiple group comparisons and Mann Whitney U test for dual group comparisons. In the evaluation of the microorganism reproduction, the bonds between the groups and the tissues were tested by separate Chi- Square tests. SPSS 22.0 program was used for data analysis and statistical tests were performed at a significance level of α = 0.05. Findings: For the TAS value, ALA + MI with Sham group (p-value = 0.011), ALA + MI with L-K + MI group (p-value = 0.004) and L-K + MI with ALA + L-K + MI group (pvalue = 0.002) statistically significant difference was found between. There was no statistically significant difference between the groups for TOS and MDA values at 0.05 significance level. For the OSI (TOS/TAS) value, MI with ALA + L-K + MI group (p-value = 0.026) and L-K + MI with ALA + L-K + MI group (p-value = 0.026) statistically significant difference was found between. In view of bacterial transtlation, Chi-Square tests showed that there was no link between the tissues and microorganisms (p-value = 0.680), indicating that there is a link between groups and microorganism leukemia (p-value <0.001). Also, when the groups were evaluated together, most of the microorganisms were found in the MI group. MI group followed by ALA + MI, L-K + MI, ALA + L-K + MI and Sham groups respectively. When mucosal degeneration was assessed histopathologically by Chiu scoring, the Chiu scores in the Sham group were obtained as 0 for all rats. For this reason, the binary differences between the Sham group and all other groups were statistically significant (p-value = 0.001). The highest Chiu scores were obtained in the MI group. Statistically, the binary differences between the MI group with all other groups were found to be significant according to the p-values. There was no statistically significant difference between ALA + MI group with L-K + MI and ALA + L-K + MI in terms of Chiu scores. ALA + MI and ALA + L-K + MI groups had similar scores. In addition, L-K + MI group had higher scores than ALA + MI and ALA + L-K + MI groups and the binary difference between L-K + MI with ALA + L-K + MI groups was statistically significant (p-value = 0.026). Results: This study demonstrates that ALA and L-Carnitine can be used to suppress oxidative stress in mesenteric ischemia/reperfusion injury due to its strong antioxidant properties, but the combined use of ALA and L-Carnitine will result in a stronger antioxidant effect with the resulting synergistic effect. ALA and L-Carnitine are potent antibacterial agents, but the combined use of ALA and L-Carnitine has shown that synergistic action can result in bacterial translocation in mesenteric ischemia/reperfusion injury due to its more potent antibacterial effects. It has been observed that ALA and L-Carnitine are effective agents in the prevention of intestinal mucosal degeneration after mesenteric ischemia/reperfusion injury, but it has been observed that synergy effect of ALA and LCarnitine combined with synergistic effect is more powerful. In this study, it was found that the combined use of ALA and L-Carnitine alone on their own was much more effective on bacterial translocation, oxidative stress and intestinal mucosal degeneration after mesenteric ischemia/reperfusion injury. Key Words: Alpha Lipoic Acid, Bacterial Transtition, L-Carnitine, Mesenteric Ischemia / Reperfusion Injury, Mucosal Degeneration