Reperfusion injury after focal myocardial ischaemia: polymorphonuclear leukocyte activation and its clinical implications

The only way to rescue ischaemic tissue is to re-instate the oxygen supply to the tissue. However reperfusion of the ischaemic area not only oxygenate s the tissue but also initiates a cascade of processes, which may in some c ases result in temporary dysfunction of the myocardium. In order to devise protective measures, it is essential to understand the mechanisms and the t riggers of this reperfusion phenomenon. In this review we will mainly focus on the inflammatory response caused by reperfusion. We will cover the diff erent steps of polymorphonuclear leukocyte activation and will briefly disc uss the molecular biology of the receptors involved. The currently used pha rmacological medications in acute cardiology will be reviewed and in partic ular their actions on polymorphonuclear leukocyte activation, adhesion and degranulation. This review is a compilation of the current knowledge in the field and the therapeutic progress in the prevention of reperfusion injury made today. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.