1. Protective effect of modafinil on skin flap survival in the experimental random-pattern skin flap model in rats: The role of ATP-sensitive potassium channels and nitric oxide pathway.
- Author
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Aryannejad A, Gandominejad A, Tabary M, Noroozi N, Abbasi A, Araghi F, Mohammad Jafari R, and Dehpour AR
- Subjects
- Animals, Central Nervous System Stimulants pharmacology, Dose-Response Relationship, Drug, Injections, Intraperitoneal, Male, Metabolic Networks and Pathways drug effects, Necrosis prevention & control, Protective Agents pharmacology, Rats, Rats, Wistar, Treatment Outcome, Graft Survival drug effects, Graft Survival physiology, Modafinil pharmacology, Nitric Oxide metabolism, Potassium Channels metabolism, Skin Transplantation methods, Surgical Flaps pathology
- Abstract
Background: The brain-stimulating agent modafinil acts through nitric oxide (NO) and adenosine triphosphate (ATP)-sensitive potassium (K
ATP ) channels, involved in the skin flap survival (SFS). The main aim of this study was to investigate the efficacy of modafinil on SFS in rats through the involvement of NO pathway and KATP channels., Methods: Using controlled experiment study design, we enrolled a sample of Wistar male rats. Different doses of modafinil (10, 25, 50, and 100 mg/kg) were injected intraperitoneally (i.p.) before the surgery. L-NAME (non-selective nitric oxide synthase [NOS] inhibitor), aminoguanidine (inducible NOS inhibitor), and 7-nitroindazole (neuronal NOS inhibitor) were administered prior to modafinil. The role of KATP channels was determined by coadministering glibenclamide (KATP channel blocker) or cromakalim (KATP channel opener) with modafinil. The predictor variables were administration of different doses of modafinil, and the coadministration of modafinil with L-NAME, aminoguanidine, 7-nitroindazole, glibenclamide, and cromakalim. The main outcome variables included the percentage of necrotic area (PNA) in flap tissues, histopathological results, vascular endothelial growth factor (VEGF) immunohistochemical (IHC) staining, and nitrite concentrations. Appropriate statistics were computed considering p-value ≤ 0.05 significant., Results: Modafinil 25 mg/kg was the most effective dose (PNA: 26 [95% CI: 19-33]) vs. control (PNA: 81 [95% CI: 71-92]) (p< 0.001). All NOS inhibitors significantly reversed the protective effect of modafinil (p< 0.001). Non-effective dose of cromakalim had a synergistic effect with the sub-effective dose of modafinil (10 mg/kg), while glibenclamide reversed the effect of modafinil 25 mg/kg (p< 0.001)., Conclusions: Modafinil increases SFS mediated by NO pathway and KATP channels, which could therefore be a target to improve SFS., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interests., (Copyright © 2020 Elsevier Ltd. All rights reserved.)- Published
- 2021
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