Vitamin E protects human skeletal muscle from damage during surgical ischemia-reperfusion

Purpose The biochemical and morphological alterations induced in lower limb skeletal muscle by ischemia-reperfusion (I–R) during aortic surgery and the effect of vitamin E pretreatment were investigated. Methods Two groups of patients undergoing aortic aneurysm resection, one untreated and one treated with vitamin E, were examined. Quadricep muscle biopsies were taken after induction of anesthesia, at the end of ischemia, and after reperfusion. The malondialdehyde (MDA) content and morphology of biopsies were examined to assess peroxidative processes. Results Ischemia did not induce an increase in MDA content but did increase neutrophil infiltration in muscle fibers of untreated patients. Reperfusion led to a significant increase in MDA content and to intermyofibrillar edema and mitochondrial swelling. The MDA content was not increased during ischemia and neutrophil infiltration was minimal in vitamin E treated patients. At reperfusion, the MDA content, the ultrastructural injuries and neutrophil infiltration were significantly reduced by the treatment. Conclusions Vitamin E is effective in reducing the oxidative muscle damage occurring after a period of I–R.