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Journal of Bone and Joint Surgery - British Volume, Vol 83-B, Issue 8, 1202-1206.
doi: 10.1302/0301-620X.83B8.11754  
Copyright © 2001 by British Editorial Society of Bone and Joint Surgery
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Oral vitamin C attenuates acute ischaemia-reperfusion injury in skeletal muscle

S. R. Kearns, AFRCS I, Specialist Registrar in Orthopaedics

James Connolly Memorial Hospital, Blanchardstown, Dublin 15, Ireland.

D. Moneley, AFRCS I, Registrar in General Surgery; P. Murray, FRCS Orth, Consultant Orthopaedic Surgeon; and C. Kelly, MCh, Professor of Vascular General Surgery

Beaumont Hospital, PO Box 1297, Beaumont Road, Dublin 9, Ireland.

A. F. Daly, MRCP I

Faculty of Health Sciences, Trinity College, Dublin 2, Ireland.

Correspondence should be sent to Mr S. R. Kearns.

Ischaemia-reperfusion injury (IRI) is caused by endothelial and subendothelial damage by neutrophil-derived oxidants. Vitamin C is an antioxidant which attenuates endothelial injury after IRI. Our aim was to evaluate the effect of oral vitamin C in the prevention of IRI in skeletal muscle. We used a model of cross-clamping (3 hours) and reperfusion (1 hour) of the cremaster muscle in rats. Muscle function was assessed electrophysiologically by electrical field stimulation. Infiltration by neutrophils was determined by the activity of tissue myeloperoxidase (MPO) and tissue oedema by the wet-to-dry ratio. Neutrophil respiratory burst activity was measured in control animals and groups pretreated with vitamin C.

IRI significantly decreased muscle function and increased muscle neutrophil MPO activity and muscle oedema. Pretreatment with vitamin C preserved muscle function and reduced tissue oedema and neutrophil infiltration. Neutrophil respiratory burst activity was reduced in the group treated with vitamin C compared with the control group.

We conclude that pretreatment with oral vitamin C protects against acute muscle IRI, possibly by attenuating neutrophil respiratory burst activity.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General