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The process of ischemia/reperfusion (I/R) triggers molecular mechanisms leading to changes in cellular structures which may be alleviated by surgical maneuvers or by use of drugs. During the period of ischemia, cellular structures are progressively damaged, however, the restoration of blood flow, paradoxically, can further exacerbate the ischemic cell damage. The molecular mechanisms by which these injuries occur in ischemia/reperfusion injury are still not fully understood and many studies have been conducted in an attempt to minimize the deleterious effects. Changes arising from the lack of oxygen, due to changes in cellular metabolism, cytokine release, interaction between leukocytes and endothelial cells and the production of free radicals, and nitric oxide are discussed. Some clinical investigations, the preponderance of evidence to date suggests that administration of NO-donor agents, drugs or surgical maneuvers may be an effective treatment for I/R injury in human subjects.

Moreira JR Editora