alexa Remote ischemic preconditioning provides early and late protection against endothelial ischemia-reperfusion injury in humans: role of the autonomic nervous system.


Journal of Microbial & Biochemical Technology

Author(s): Loukogeorgakis SP, Panagiotidou AT, Broadhead MW, Donald A, Deanfield JE, , Loukogeorgakis SP, Panagiotidou AT, Broadhead MW, Donald A, Deanfield JE,

Abstract Share this page

Abstract OBJECTIVES: The aim of this study was to characterize the time course and neuronal mechanism of remote ischemic preconditioning (RIPC) of the vasculature in humans. BACKGROUND: Non-lethal ischemia of internal organs induces local (ischemic preconditioning) and systemic (RIPC) resistance to lethal ischemia-reperfusion (IR) injury. Experimental RIPC has two temporal components, is neuronally mediated, is induced by limb ischemia, and reduces infarct size. In humans, RIPC prevents IR-induced vascular injury. Determining the time course and mechanism is a prelude to clinical outcome studies of RIPC. METHODS: Endothelial IR injury was induced by arm ischemia (20 min) and reperfusion, and measured by flow-mediated dilation. To establish if there are early and late phases, RIPC (three 5-min cycles of ischemia of the contralateral arm) was applied immediately, 4, 24, and 48 h before IR. To determine neuronal involvement, trimetaphan (autonomic ganglion blocker; 1 to 6 mg/min intravenous) was infused during the application of the RIPC stimulus. RESULTS: Flow-mediated dilation was reduced by IR (8.7 +/- 1.1\% before IR, 4.9 +/- 1.2\% after IR; p < 0.001), but not when preceded by RIPC (8.0 +/- 0.8\% after IR; p = NS); RIPC did not protect after 4 h (4.9 +/- 1.1\% after IR; p < 0.001), but protected at 24 (8.7 +/- 1.1\% after IR; p = NS) and 48 h (8.8 +/- 1.4\% after IR; p = NS). Trimetaphan attenuated early (8.3 +/- 1.1\% before IR, 4.2 +/- 0.9\% after IR; p < 0.05) and delayed (7.3 +/- 1.0\% before IR, 2.3 +/- 0.6\% after IR, p < 0.001) RIPC. CONCLUSIONS: Remote ischemic preconditioning in humans has two phases of protection against endothelial IR injury; an early (short) and late (prolonged) phase, both of which are neuronally mediated. The potential for late phase RIPC to provide prolonged protection during clinical IR syndromes merits investigation. This article was published in J Am Coll Cardiol and referenced in Journal of Microbial & Biochemical Technology

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version