A rabbit hindlimb model of I/R (2.5/2 h) was used (IR group). Phlogenzym®, containing rutin, trypsin, and bromelain, was applied enterally (60 mg/kg body weight) as a bolus 30 min prior to ischemia (Ph group). Sham-operated animals served as controls (CO group). Plasma malondialdehyde, potassium, and microvascular perfusion (monitored by laser flowmetry) were assessed. Histomorphometry and electron microscopy were performed from major adductor muscles.
Two hours after reperfusion, potassium levels were significantly elevated in IR compared to Ph group (6.7 ± 1.2 versus 4.9 ± 0.9 mmol/l, P < 0.006). Enhanced lipid peroxidation, apparent by increased plasma malondialdehyde levels, was ameliorated in the Ph group (1.0 ± 0.1 versus 0.7 ± 0.1 nmol/ml, P < 0.0001). No-reflow (reduction of blood flow by 62 % in IR group) was not observed in the Ph group (P < 0.004). Phlogenzym® treatment prevented microvascular constriction (17.6 ± 2.3 versus 12.6 ± 1.1 μm2, P < 0.0001) and mollified interstitial edema (21.5 ± 2.0 versus 26.0 ± 3.7 % , P < 0.017), resulting in mild ultrastructural alterations in contrast to pronounced sarcolemmal and mitochondrial damage in untreated rabbits.
Phlogenzym® had a protective effect on skeletal muscle during I/R injury expressed by prevention of no-reflow and preservation of muscle tissue.