The impact of Cordycepin on the survival of perforator flap and its mechanism
RAN Xinyu1, YAN Yao2,QIU Chuanqi1, SUN Yinuo1, CAI Yunhao1, ZHOU Zihan1, XU Ke2, WANG Jian1.
1.Department of Wound Repair, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China; 2.Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo 315302, China
RAN Xinyu,YAN Yao,QIU Chuanqi, et al. The impact of Cordycepin on the survival of perforator flap and its mechanism[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(7): 547-553.
Abstract：Objective: To explore whether Cordycepin promotes the survival of perforator flap and its possible mechanisms. Methods: Before modeling, 20 male SD rats (6-8 weeks) were randomly divided as the control group and Cordycepin group, with 10 in each. A model of the back perforator flap was established, with the Cordycepin group receiving Cordycepin at 20 mg/kg, while the control group receiving 0.9% sodium chloride solution. The necrosis of the distal end of the flap and the blood perfusion were observed in each group 7 days after surgery, and the subcutaneous edema rate was measured by taking flap tissue from each group. The effect of cordycepin on the survival of perforator flaps and the changes in relevant tissue indicators, such as oxidative stress, cell apoptosis, and autophagy, were investigated through pathological staining, oxidative stress-related kit detection, and Western blot. Results: Each group showed necrosis of varying degrees in the distal end of the pedicle flap 7 days postoperatively. Compared with the control group, the Cordyceps group had lower rate of distal flap necrosis and subcutaneous edema, and better blood perfusion (P<0.05). HE staining and Masson results showed that the Cordyceps group had more micro-vessels in the flap, with more orderly subcutaneous structures and collagen arrangement. The results of MDA, SOD, GSH, and other assay kits showed that the Cordyceps group had decreased MDA levels (P<0.05) and increased SOD and GSH levels (P<0.05). Tunel fluorescence staining results showed fewer apoptotic cells in the Cordyceps group (P<0.05). Protein immunoblotting results showed that cordycepin could regulate the increase of oxidative stress-related protein Nrf2, the increase of HO-1 (P<0.05), the increase of the level of apoptosis-related protein Bcl-2, the decrease of the level of cleavedcaspase3 and Baxs (P<0.05), the increase of the level of autophagy-related proteins p-AMPK and LC3II, and the decrease of the level of p62 in the flap tissue. Conclusion: Cordycepin treatment promotes distal survival of perforator flaps, which may be attributed to its inhibition of oxidative stress, suppression of cell apoptosis and regulation of autophagy levels. Cordycepin is a potential therapeutic approach for preventing distal necrosis of flaps.
