Butylphthalide Inhibits Autophagy and Promotes Multiterritory Perforator Flap Survival

Baolong Li; Zhengtai Chen; Xiaobin Luo; Chenxi Zhang; Hongyu Chen; Shuxuan Wang; Mengyao Zhao; Haiwei Ma; Junling Liu; Mengshi Cheng; Yanyan Yang; Hede Yan

doi:10.3389/fphar.2020.612932

Butylphthalide Inhibits Autophagy and Promotes Multiterritory Perforator Flap Survival

Front Pharmacol. 2021 Jan 29:11:612932. doi: 10.3389/fphar.2020.612932. eCollection 2020.

Authors

Baolong Li^{1

2

3}, Zhengtai Chen^{1

2

3}, Xiaobin Luo^{1

2

3}, Chenxi Zhang^{1

2

3}, Hongyu Chen^{1

2

3}, Shuxuan Wang⁴, Mengyao Zhao^{1

2

3}, Haiwei Ma^{1

2

3}, Junling Liu^{1

2

3}, Mengshi Cheng^{5

6}, Yanyan Yang^{7

6}, Hede Yan^{1

2}

Affiliations

¹ Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
² Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, China.
³ The Second School of Medicine, Wenzhou Medical University, Wenzhou, China.
⁴ Key Laboratory of Pediatric Hematology and Oncology Ministry of Health, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵ Respiratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
⁶ The First Clinical Medical College of Wenzhou Medical University, Wenzhou, China.
⁷ Infectious Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Abstract

Multiterritory perforator flap is an important plastic surgery technique, yet its efficacy can be limited by partial necrosis at the choke Ⅱ zone. Butylphthalide (NBP) has been used for many diseases but has not been studied in the multiterritory perforator flap. With the effect of NBP, we observed increasing in capillary density, inhibition of autophagy and oxidative stress, and a reduction in apoptosis of cells, all consistent with increased flap survival. However, the protective effect of NBP on multiterritory perforator flap was lost following administration of the autophagy agonist rapamycin (Rap). Through the above results, we assumed that NBP promotes flap survival by inhibiting autophagy. Thus, this study has found a new pharmacological effect of NBP on the multiterritory perforator by inhibiting autophagy to prevent distal postoperative necrosis and exert effects on angiogenesis, oxidative stress, and apoptosis within the flap.

Keywords: Angiogenesis; Autophagy; apoptosis; butylphthalide; multiterritory perforator flap.