The effects of MESNA (2-merkapto-ethane-sulfonate) on the rat lower extremity ichemia reprusion model

In plastic surgery, flap surgery, replantations after partial or complete ruptures in the extremities, and transplantations are areas of intense concern in current practice. The success rate of such surgeries is closely related to ischemia/reperfusion (I/R) injury. Many endogenous and exogenous substances have been investigated and continue to be investigated to reduce ischemia-reperfusion injury in different tissues. However, there is still no pharmacological agent that completely prevents I/R damage. 2-mercaptoethane sodium sulfonate (MESNA) is a drug used in the treatment of hemorrhagic cystitis due to chemotherapeutic agents such as iophosphamide and cyclophosphamide. In different experimental studies, its protective effects against I/R damage in the lung, kidney, ovary, and intestine have been experimentally demonstrated. However, there are no studies on ischemia-reperfusion injury in lower extremity and skeletal muscle. This study was planned with the hypothesis that Mesna, which has shown positive effects on I/R damage in many organs, may have positive effects on lower extremity I/R damage. Materials and Methods: In our study, 24 male Sprague Dawley rats, each group consisting of 8 rats, were used. The groups were divided into three groups as control group, I/R group and I/R + Mesna group. No procedure was applied to the control group. In the other two groups, 4 hours of ischemia and 4 hours of reperfusion was applied with a tourniquet from the proximal of the right extremity trochanter majus. In the I/R group, physiological saline was administered for 15 minutes after ischemia and at the time of reperfusion, and 150mg/kg/dose Mesna was administered intraperitoneally to the I/R+Mesna group at the same time. After I/R was completed, the subjects were sacrificed by taking intracardiac blood under deep anesthesia. Tissue samples were then taken from the right gastrocnemius muscles of all rats for histopathological and biochemical examination. Results: Presence of extravasated erythrocytes, loss of transverse striation, migration of nuclei to the center, separation of muscle fibers, increase in connective tissue, intercellular/interfascicular edema and pnml number in the control group and I/R and I/R+Mesna groups were statistically significant(p<0.001) Although the IR and IR+Mesna groups are statistically the same. As a result, it was found that although the group in which Mesna was applied histologically and numerically, decreased degenerative values, this was not at a statistically significant level. There was no significant difference between the control and experimental groups in terms of MDA (p=0.860), which is an indicator of lipid peroxidation, and MPO, which was included in the evaluation in terms of antioxidant activity (p=0.539). Conclusion: The findings we obtained as a result of our study are that Mesna did not statistically significantly reduce ischemia-reperfusion injury in the lower extremity muscle tissue. Keywords: Muscle tissue, Mesna, ischemia reperfusion