El flujo como indicador del efecto terapéutico del ácido folínico en la isquemia-reperfusión

Objective: an intestinal reperfusion study with two aims: a) to assess the usefulness of intestinal capillary blood flow measure- ment by laser-Doppler for intestinal reperfusion studies; and b) to compare the effects of racemic and levo forms of folinic acid in treating the syndrome. Experimental design: a murine model of intestinal ischemia by completely clamping the superior mesenteric artery for 90 minutes. A comparison was made of three treatment groups: saline, folinic acid, and levo-folinic acid. The following factors were analyzed: changes in biochemical parameters (levels of crea- tine kinase, lactic dehydrogenase, and alkaline phosphatase at 60 minutes, and at two and seven days after restoring blood flow), capillary flow in the jejunum and ileum by laser-Doppler (during is- chemia and after the first hour of reperfusion), intestinal mucosa injury, and survival curve. Results: laser-Doppler provided reliable data on how the dif- ferent treatments affected capillary flow during intestinal reperfu- sion. Levo-folinic acid improved capillary flow in the ileum after 25 minutes of reperfusion, and also reduced mucosal injury in the same stretch of intestine by the seventh day post-reperfusion (p < 0.05). On the other hand, it produced an initial increase in serum enzymes during reperfusion, and did not modify survival. Conclusions: the changes observed in intestinal capillary blood flow measurement by laser-Doppler have similarities with the effects of drugs on pathological mucosal changes. We could not prove that the levo form of folinic acid has a stronger protec- tive effect versus racemic folinic acid in intestinal ischemia-reper- fusion syndrome.