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Zhang W, Wu Y, Zeng M, Yang C, Qiu Z, Liu R, Wang L, Zhong M, Chen Q, Liang W. Protective role of remote ischemic conditioning in renal transplantation and partial nephrectomy: A systematic review and meta-analysis of randomized controlled trials. Front Surg 2023; 10:1024650. [PMID: 37091267 PMCID: PMC10113469 DOI: 10.3389/fsurg.2023.1024650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/24/2023] [Indexed: 04/08/2023] Open
Abstract
ObjectiveStudies have shown that remote ischemic conditioning (RIC) can effectively attenuate ischemic-reperfusion injury in the heart and brain, but the effect on ischemic-reperfusion injury in patients with kidney transplantation or partial nephrectomy remains controversial. The main objective of this systematic review and meta-analysis was to investigate whether RIC provides renal protection after renal ischemia-reperfusion injury in patients undergoing kidney transplantation or partial nephrectomy.MethodsA computer-based search was conducted to retrieve relevant publications from the PubMed database, Embase database, Cochrane Library and Web of Science database. We then conducted a systematic review and meta-analysis of randomized controlled trials that met our study inclusion criteria.ResultsEleven eligible studies included a total of 1,145 patients with kidney transplantation or partial nephrectomy for systematic review and meta-analysis, among whom 576 patients were randomly assigned to the RIC group and the remaining 569 to the control group. The 3-month estimated glomerular filtration rate (eGFR) was improved in the RIC group, which was statistically significant between the two groups on kidney transplantation [P < 0.001; mean difference (MD) = 2.74, confidence interval (CI): 1.41 to 4.06; I2 = 14%], and the 1- and 2-day postoperative Scr levels in the RIC group decreased, which was statistically significant between the two groups on kidney transplantation (1-day postoperative: P < 0.001; MD = 0.10, CI: 0.05 to 0.15, I2 = 0; 2-day postoperative: P = 0.006; MD = 0.41, CI: 0.12 to 0.70, I2 = 0), but at other times, there was no significant difference between the two groups in Scr levels. The incidence of delayed graft function (DGF) decreased, but there was no significant difference (P = 0.60; 95% CI: 0.67 to 1.26). There was no significant difference between the two groups in terms of cross-clamp time, cold ischemia time, warm ischemic time, acute rejection (AR), graft loss or length of hospital stay.ConclusionOur meta-analysis showed that the effect of remote ischemia conditioning on reducing serum creatinine (Scr) and improving estimate glomerular filtration rate (eGFR) seemed to be very weak, and we did not observe a significant protective effect of RIC on renal ischemic-reperfusion. Due to small sample sizes, more studies using stricter inclusion criteria are needed to elucidate the nephroprotective effect of RIC in renal surgery in the future.
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Affiliation(s)
- Wenfu Zhang
- The First Clinical Medical College of Gannan Medical University, Ganzhou, China
- Department of Anesthesia, hospital of Traditional Chinese Medicine of Zhongshan, Zhongshan, China
| | - Yingting Wu
- Department of Critical Care Medicine Nursing, the First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Mingwang Zeng
- The First Clinical Medical College of Gannan Medical University, Ganzhou, China
| | - Chao Yang
- The First Clinical Medical College of Gannan Medical University, Ganzhou, China
| | - Zhengang Qiu
- Department of Oncology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Rongrong Liu
- Department of Neurology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Lifeng Wang
- Anesthesia Surgery Center of the First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Maolin Zhong
- Anesthesia Surgery Center of the First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Qiaoling Chen
- Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
- Correspondence: Qiaoling Chen Weidong Liang
| | - Weidong Liang
- The First Clinical Medical College of Gannan Medical University, Ganzhou, China
- Anesthesia Surgery Center of the First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- Correspondence: Qiaoling Chen Weidong Liang
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Mao XL, Cai Y, Chen YH, Wang Y, Jiang XX, Ye LP, Li SW. Novel Targets and Therapeutic Strategies to Protect Against Hepatic Ischemia Reperfusion Injury. Front Med (Lausanne) 2022; 8:757336. [PMID: 35059411 PMCID: PMC8764312 DOI: 10.3389/fmed.2021.757336] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/08/2021] [Indexed: 12/16/2022] Open
Abstract
Hepatic ischemia reperfusion injury (IRI), a fascinating topic that has drawn a lot of interest in the last few years, is a major complication caused by a variety of clinical situations, such as liver transplantation, severe trauma, vascular surgery, and hemorrhagic shock. The IRI process involves a series of complex events, including mitochondrial deenergization, metabolic acidosis, adenosine-5'-triphosphate depletion, Kupffer cell activation, calcium overload, oxidative stress, and the upregulation of pro-inflammatory cytokine signal transduction. A number of protective strategies have been reported to ameliorate IRI, including pharmacological therapy, ischemic pre-conditioning, ischemic post-conditioning, and machine reperfusion. However, most of these strategies are only at the stage of animal model research at present, and the potential mechanisms and exact therapeutic targets have yet to be clarified. IRI remains a main cause of postoperative liver dysfunction, often leading to postoperative morbidity or even mortality. Very recently, it was reported that the activation of peroxisome proliferator-activated receptor γ (PPARγ), a member of a superfamily of nuclear transcription factors activated by agonists, can attenuate IRI in the liver, and FAM3A has been confirmed to mediate the protective effect of PPARγ in hepatic IRI. In addition, non-coding RNAs, like LncRNAs and miRNAs, have also been reported to play a pivotal role in the liver IRI process. In this review, we presented an overview of the latest advances of treatment strategies and proposed potential mechanisms behind liver IRI. We also highlighted the role of several important molecules (PPARγ, FAM3A, and non-coding RNAs) in protecting against hepatic IRI. Only after achieving a comprehensive understanding of potential mechanisms and targets behind IRI can we effectively ameliorate IRI in the liver and achieve better therapeutic effects.
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Affiliation(s)
- Xin-Li Mao
- Key Laboratory of Minimally Invasive Techniques and Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.,Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.,Institute of Digestive Disease, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Yue Cai
- Key Laboratory of Minimally Invasive Techniques and Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.,Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.,Institute of Digestive Disease, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Ya-Hong Chen
- Health Management Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Yi Wang
- Key Laboratory of Minimally Invasive Techniques and Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.,Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.,Institute of Digestive Disease, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Xiu-Xiu Jiang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Li-Ping Ye
- Key Laboratory of Minimally Invasive Techniques and Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.,Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.,Institute of Digestive Disease, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Shao-Wei Li
- Key Laboratory of Minimally Invasive Techniques and Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.,Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.,Institute of Digestive Disease, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
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Cavalcante LCDC, Rodrigues GM, Ribeiro Júnior RFG, Monteiro AM, Damasceno AVBS, Couteiro RP, Yasojima EY, Brito MVH, Percário S. Ischemic perconditioning on mesenteric ischemia/reperfusion injury in rats. Acta Cir Bras 2021; 36:e360903. [PMID: 34755763 PMCID: PMC8580514 DOI: 10.1590/acb360903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/09/2021] [Indexed: 11/22/2022] Open
Abstract
Purpose: To evaluate if the perconditioning affects the antioxidant capacity in
mesenteric ischemia and reperfusion injury. Methods: Twenty-one Wistar rats were assigned into three groups, as follows: Sham, IR
and rPER. The animals were subjected to mesenteric ischemia for 30 min. rPER
consisted of three cycles of 5-min hindlimb ischemia followed by 5 min
hindlimb perfusion at the same time to mesenteric ischemic period. After 5
minutes, blood and 5 cm of terminal ileum were harvested for thiobarbituric
acid reactive substances (TBARS) and Trolox equivalent antioxidant capacity
(TEAC) measurement. Results: rPER technique was able to reduce intestinal tissue TBARS levels
(p<0.0001), but no statistic difference was observed in blood levels
between groups, although it was verified similar results in rPER and Sham
group. rPER technique also enhanced TEAC levels in both blood (p = 0.0314)
and intestinal tissue (p = 0.0139), compared to IR group. Conclusions: rPER appears as the most promising technique to avoid IR injury. This
technique reduced TBARS levels in blood and intestinal tissue and promoted
the maintenance of antioxidant defense in mesenteric acute injury.
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Monteiro AM, Couteiro RP, Silva DFD, Trindade Júnior SC, Silva RC, Sousa LFFD, Santos DRD, Freitas JJDS, Brito MVH. Remote ischemic conditioning improves rat brain antioxidant defense in a time-dependent mechanism. Acta Cir Bras 2021; 36:e360707. [PMID: 34495142 PMCID: PMC8428670 DOI: 10.1590/acb360707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/22/2021] [Indexed: 08/30/2023] Open
Abstract
Purpose To clarify the best protocol for performing remote ischemic conditioning and
to minimize the consequences of ischemia and reperfusion syndrome in brain,
the present study aimed to evaluate different time protocols and the
relation of the organs and the antioxidant effects of this technique. Methods The rat’s left femoral artery was clamped with a microvascular clamp in times
that ranged from 1 to 5 minutes, according to the corresponding group. After
the cycles of remote ischemic conditioning and a reperfusion of 20 minutes,
the brain and the left gastrocnemius were collected. The samples were used
to measure glutathione peroxidase, glutathione reductase and catalase
levels. Results In the gastrocnemius, the 4-minute protocol increased the catalase
concentration compared to the 1-minute protocol, but the latter increased
both glutathione peroxidase and glutathione reductase compared to the
former. On the other hand, the brain demonstrated higher catalase and
glutathione peroxidase in 5-minute group, and the 3-minute group reached
higher values of glutathione reductase. Conclusions Remote ischemic conditioning increases brain antioxidant capacity in a
time-dependent way, while muscle presents higher protection on 1-minute
cycles and tends to decrease its defence with longer cycles of intermittent
occlusions of the femoral artery.
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Yasojima EY, Domingues RJDS, Silva RC, Sousa LFFD, Trindade Júnior SC. Comparison of remote and local postconditioning against hepatic ischemic-reperfusion injury in rats. Acta Cir Bras 2021; 36:e360101. [PMID: 33533826 PMCID: PMC7853697 DOI: 10.1590/acb360101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 12/11/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose: The aim of this study is to compare the hepatic protective effect of both
remote and local postconditioning (POS). Methods: Twenty-eight Wistar rats were assigned into four groups: sham group(SHAM),
ischemia-reperfusion group (IR), local ischemic POS group (lPOS) and remote
ischemic POS group (rPOS). Animals were subjected to liver ischemia for 30
min. Local ischemic POS group consisted of four cycles of 5 min liver
ischemia, followed by 5 min reperfusion (40 min). Remote ischemic POS group
consisted of four cycles of 5 min hind limb ischemia, followed by 5 min hind
limb perfusion after the main liver ischemia period. After 190 minutes
median and left liver lobes were harvested for biochemical and
histopathology analysis. Results: All the conditioning techniques were able to increase the level of
bothglutathione reductase and peroxidase, showing higher values in the rPOS
group when compared to the lPOS. Also, thiobarbituric acid reactive
substances were higher in all intervention groups when compared to SHAM, but
rPOS had the lower rates of increase, showing the best result. The
histopathology analysis showed that all groups had worst injury levels than
SHAM, but rPOS had lower degrees of damage when compared to the lPOS,
although it was not statistically significant. Conclusion: Remote postconditioning is a promising technique to reduce liver
ischemia-reperfusion injury, once it increased antioxidants substances and
reduced the damage.
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Miyake H, Koike Y, Seo S, Lee C, Li B, Ganji N, Pierro A. The effect of pre- and post-remote ischemic conditioning reduces the injury associated with intestinal ischemia/reperfusion. Pediatr Surg Int 2020; 36:1437-1442. [PMID: 33068141 DOI: 10.1007/s00383-020-04762-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/08/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Midgut volvulus is associated with intestinal ischemia/reperfusion (IR) injury and can progress to severe intestinal damage. Remote ischemic conditioning (RIC) reduces IR-induced injury in distant organs. The aim of this study was to investigate whether RIC protects the intestine from IR injury. METHODS We investigated intestinal IR injury in 3 weeks old SD rats. Animals underwent: (i) sham laparotomy, (ii) intestinal IR injury, (iii) intestinal IR + RIC during ischemia, or (iv) intestinal IR + RIC after reperfusion. Intestinal IR injury was achieved by 45 min occlusion of superior mesenteric artery followed by de-occlusion. RIC was administered via four cycles of 5 min of hind limb ischemia followed by 5 min reperfusion. Animals were sacrificed 24 h after surgery and the ileum was harvested for evaluation. RESULTS Intestinal injury was present after IR. However, this injury was reduced in both IR + RIC groups. Expression of inflammatory cytokine IL6 was lower in IR + RIC groups compared to IR alone. Carbonyl protein was also significantly lower in IR + RIC compared to IR, indicating lower oxidative stress in both IR + RIC groups. CONCLUSION Remote ischemic conditioning attenuated intestinal injury, inflammation, and oxidative stress in experimental intestinal ischemia/reperfusion injury. Remote ischemic conditioning may be useful in children with midgut volvulus to reduce the intestinal injury. LEVEL OF EVIDENCE Experimental study. TYPE OF STUDY Animal experiment.
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Affiliation(s)
- Hiromu Miyake
- Division of General and Thoracic Surgery, The Hospital for Sick Children, 1526-555 University Ave, Toronto, ON, M5G1X8, Canada.,Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 4208660, Japan
| | - Yuhki Koike
- Division of General and Thoracic Surgery, The Hospital for Sick Children, 1526-555 University Ave, Toronto, ON, M5G1X8, Canada
| | - Shogo Seo
- Division of General and Thoracic Surgery, The Hospital for Sick Children, 1526-555 University Ave, Toronto, ON, M5G1X8, Canada
| | - Carol Lee
- Division of General and Thoracic Surgery, The Hospital for Sick Children, 1526-555 University Ave, Toronto, ON, M5G1X8, Canada
| | - Bo Li
- Division of General and Thoracic Surgery, The Hospital for Sick Children, 1526-555 University Ave, Toronto, ON, M5G1X8, Canada
| | - Niloofar Ganji
- Division of General and Thoracic Surgery, The Hospital for Sick Children, 1526-555 University Ave, Toronto, ON, M5G1X8, Canada
| | - Agostino Pierro
- Division of General and Thoracic Surgery, The Hospital for Sick Children, 1526-555 University Ave, Toronto, ON, M5G1X8, Canada. .,University of Toronto, Toronto, Canada.
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Costa FLDS, Teixeira RKC, Yamaki VN, Valente AL, Percário S, Brito MVH. Remote ischemic conditioning enhances heart and brain antioxidant defense. J Vasc Bras 2020; 19:e20190129. [PMID: 34178069 PMCID: PMC8202165 DOI: 10.1590/1677-5449.190129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Ischemia-reperfusion injury contributes to morbidity after revascularization
procedures. Along with early reperfusion, tissue conditioning by alternating
intervals of brief ischemia-reperfusion episodes is considered the best approach
to limit tissue damage. Remote ischemic conditioning is conducted remotely, in
tissues other than those under ischemia. Despite this, remote ischemic
conditioning protection mechanisms are poorly understood, which can lead to
misapplication. Objectives To assess whether remote ischemic conditioning works in the heart and brain
through enhancement of cells’ antioxidant defenses and whether the response is
sustained or temporary. Methods Twenty-one male Wistar rats were assigned to three groups (n = 7): SHAM: same
procedure as the other groups, but no remote ischemic conditioning was carried
out. RIC 10: heart and brain were harvested 10 minutes after the remote ischemic
conditioning protocol. RIC 60: heart and brain were harvested 60 minutes after the
remote ischemic conditioning protocol. The remote ischemic conditioning protocol
consisted of 3 cycles of 5 min left hindlimb ischemia followed by 5 min left
hindlimb perfusion, lasting 30 min in total. Heart and brain samples were used to
measure the tissue antioxidant capacity. Results Remote ischemic conditioning increased heart and brain antioxidant capacity after
10 minutes (0.746 ± 0.160/0.801 ± 0.227 mM/L) when compared to SHAM (0.523 ±
0.078/0.404 ± 0.124 mM/L). No enhancement of heart or brain antioxidant capacity
was detected 60 minutes after remote ischemic conditioning (0.551 ± 0.073/0.455 ±
0.107 mM/L). Conclusions Remote ischemic conditioning temporarily enhances heart and brain antioxidant
defenses in male Wistar rats.
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Affiliation(s)
| | | | - Vitor Nagai Yamaki
- Universidade do Estado do Pará - UEPA, Laboratório de Cirurgia Experimental, Belém, PA, Brasil
| | - André Lopes Valente
- Universidade do Estado do Pará - UEPA, Laboratório de Cirurgia Experimental, Belém, PA, Brasil
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Damasceno AVBS, Barros CAVD, Percario S, Ribeiro Junior RFG, Monteiro AM, Gouveia EHH, Henriques HYB. Remote ischemic conditioning protects against testicular ischemia∕reperfusion injury in rats. Acta Cir Bras 2020; 35:e202000203. [PMID: 32348402 PMCID: PMC7184938 DOI: 10.1590/s0102-865020200020000003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/03/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the effect of remote ischemic conditioning associated to N-acetylcysteine (NAC) on testicular ischemia∕reperfusion (I∕R) injury in rats. Methods Twenty-five adult male Wistar rats were randomly distributed into five experimental groups (n=5), as follows: Sham, I∕R, Perconditioning (PER), NAC and PER+NAC. Two-hour ischemia was induced by rotating the left testis 720° to clockwise direction, followed by 4 hours of reperfusion. Perconditioning was performed by three I/R cycles of 10 min each on the left limb, 30 min before reperfusion. N-acetylcysteine (150 mg∕kg) was administered 30 min before reperfusion. Results Statistical differences were observed in MDA levels between I/R group with all groups (p<0.01), in addition there was statistical difference between PER and Sham, and PER+ NAC groups (p<0.05) in plasma. Conclusions The protective effect of perconditioning isolated in the reduction of lipid peroxidation related to oxidative stress was demonstrated. However, when Perconditioning was associated with NAC, there was no protective effect against testicular injury of ischemia and reperfusion.
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Gong R, Wu YQ. Remote ischemic conditioning during primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis. J Cardiothorac Surg 2019; 14:14. [PMID: 30696461 PMCID: PMC6352430 DOI: 10.1186/s13019-019-0834-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 01/08/2019] [Indexed: 01/23/2023] Open
Abstract
Objective This systematic review was designed to evaluate the efficacy of remote ischemic conditioning (RIC) with primary percutaneous coronary intervention (PCI) versus primary PCI alone for ST-segment elevation myocardial infarction (STEMI). Search strategy Computerized search for trials from PubMed, EMBASE, CENTRAL and Cochrane Database of Systematic Reviews databases. Selection criteria Trials investigating RIC plus primary PCI (group A) versus primary PCI alone (group B). Outcome measures Myocardial enzyme levels; left ventricular ejection fraction (LVEF); major adverse cardiac and cerebrovascular events (MACCEs); TIMI flow grade III; myocardial salvage index or infarct size per patients. Results In all, 14 studies involving 3165 subjects were included. There was a significant association of myocardial edema levels, myocardial salvage index and incidence of MACCEs in group A compared with group B (myocardial edema levels: SMD = − 0.36, 95% CI (− 0.59, − 0.13); myocardial salvage index: MD = 0.06, 95% CI (0.02, 0.10); MACCE: OR = 0.70, 95% CI (0.57, 0.85)). With regard to infarct size, TIMI flow grade III and LVEF, group A appeared to be equivalent with group B (infarct size: MD = − 1.67, 95% CI (− 3.46, 0.11); TIMI flow grade III: OR = 1.04, 95% CI (0.71, 1.52); LVEF: MD = 0.74, 95% CI (− 0.80, 2.28)). Conclusion RIC was associated with lower myocardial edema levels, myocardial salvage index and incidence of MACCE, while non-significant beneficial effect on infarct size, TIMI flow grade III or LVEF. These findings suggest that RIC is a promising adjunctive treatment to PCI for the prevention of reperfusion injury in STEMI patients.
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Affiliation(s)
- Ren Gong
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Yan-Qing Wu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.
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Li DY, Liu WT, Wang GY, Shi XJ. Impact of combined ischemic preconditioning and remote ischemic perconditioning on ischemia-reperfusion injury after liver transplantation. Sci Rep 2018; 8:17979. [PMID: 30568237 PMCID: PMC6299280 DOI: 10.1038/s41598-018-36365-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/19/2018] [Indexed: 12/15/2022] Open
Abstract
Ischemic preconditioning (IPC) and remote ischemic perconditioning (RIPer) confer protective effects against liver ischemia-reperfusion injury (IRI), but data about RIPer applying in liver transplantation is lacking. The study aimed to evaluate whether the combination of IPC and RIPer provides reinforced protective effects. C57BL/6 mice (160 pairs) were allocated into four groups: control, subjected to liver transplantation only; IPC, donor hilar was clamped for 10 min followed by 15 min of reperfusion; RIPer, three cycles of occlusion (5 min) and opening (5 min) of femoral vascular bundle were performed before reperfusion; IPC + RIPer, donors and recipients were subjected to IPC and RIPer respectively. Liver tissues were obtained for histological evaluation, TUNEL staining, malondialdehyde assays, GSH-Px assays, and NF-κB p65 protein and Bcl-2/Bax mRNA analyses. Blood samples were used to evaluate ALT, AST, TNF-α, NOx levels and flow cytometry. We found that protective efficacy of RIPer is less than IPC in terms of ALT, TNF-α, GSH-Px and NOx at 2 h postoperation, but almost equivalent at 24 h and 72 h postoperation. Except for Suzuki scores, ALT, Bcl-2/Bax mRNA ratio, other indices showed that combined treatment brought enhanced attenuation in IRI, compared with single treatment, through additive effects on antioxidation, anti-apoptosis, modulation of microcirculation disturbance, and inhibition of innate immune response. This study suggested a combined strategy that could enhance protection against IRI in clinical liver transplantation, otherwise, provided a hint that RIPer's mechanism might be partly or totally different from IPC in humoral pathway.
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Affiliation(s)
- Ding-Yang Li
- Department of Hepatobiliary & Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China
| | - Wen-Tao Liu
- Department of Hepatobiliary & Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, China
| | - Guang-Yi Wang
- Department of Hepatobiliary & Pancreatic Surgery, The First Norman Bethune Hospital Affiliated to Jilin University, Changchun, 130021, Jilin Province, China
| | - Xiao-Ju Shi
- Department of Hepatobiliary & Pancreatic Surgery, The First Norman Bethune Hospital Affiliated to Jilin University, Changchun, 130021, Jilin Province, China.
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Wang Y, Zhang Z, Zhang L, Yang H, Shen Z. RLIPostC protects against cerebral ischemia through improved synaptogenesis in rats. Brain Inj 2018; 32:1429-1436. [PMID: 30036110 DOI: 10.1080/02699052.2018.1483029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Remote limb ischemic post-conditioning (RLIPostC) has been shown to be neuroprotective in cerebral ischemia, whereas the effect of RLIPostC on synaptogenesis remains elusive. In the present study, we investigated the effects of RLIPostC on synaptogenesis in an experimental stroke rat model. METHODS Sprague-Dawley rats were subjected to left middle cerebral artery occlusion (MCAO) and were randomly divided into a control group, an RLIPostC group and a sham group. The RLIPostC group received three cycles of RLIPostC treatment immediately after reperfusion (ten minutes ischemia and ten minutes reperfusion in bilateral femoral artery). The neurological function was assessed by neurological deficit scores and the foot fault test at days 7 and 14 after MCAO. At day 14 after MCAO, the infarct volume and oedema were determined by cresyl violet (CV) staining and by measuring brain water content, respectively. Synaptogenesis was evaluated by western blotting and immunofluorescence staining. RESULTS Our results showed that RLIPostC treatment significantly promoted the recovery of behavioural function, reduced infarct volume and brain oedema, and increased the expressions of SYN1, PSD95 and GAP43. CONCLUSIONS These results confirmed that RLIPostC treatment for cerebral ischemia was safe and effective. A possible molecular mechanism of the beneficial effects of RLIPostC treatment may be the promotion of synaptogenesis.
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Affiliation(s)
- Yingli Wang
- a School of Pharmacentical Sciences & Yunnan Provincal Key Laboratory of Pharmacology for Natural Products , Kunming Medical University , Kunming , China.,b Department of Emergency and Critical Medicine , Yichang Central People's Hospital , Yichang , China
| | - Zhaohui Zhang
- b Department of Emergency and Critical Medicine , Yichang Central People's Hospital , Yichang , China
| | - Lei Zhang
- a School of Pharmacentical Sciences & Yunnan Provincal Key Laboratory of Pharmacology for Natural Products , Kunming Medical University , Kunming , China.,b Department of Emergency and Critical Medicine , Yichang Central People's Hospital , Yichang , China
| | - Haoran Yang
- a School of Pharmacentical Sciences & Yunnan Provincal Key Laboratory of Pharmacology for Natural Products , Kunming Medical University , Kunming , China
| | - Zhiqiang Shen
- a School of Pharmacentical Sciences & Yunnan Provincal Key Laboratory of Pharmacology for Natural Products , Kunming Medical University , Kunming , China
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Santos CHMD, Dourado DM, Silva BAKD, Pontes HBD, Azevedo-Neto ED, Vendas GSDC, Chaves IDO, Miranda JVC. ATORVASTATIN CAN PREVENT HEPATIC REMOTE REPERFUSION INJURY. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2018; 30:197-200. [PMID: 29019561 PMCID: PMC5630213 DOI: 10.1590/0102-6720201700030008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/25/2017] [Indexed: 12/18/2022]
Abstract
Background: Some studies have shown that statins have a promising effect on protection against reperfusion injury. Aim: To evaluate the ability of ischemic postconditioning, statins and both associated to prevent or minimize reperfusion injury in the liver of rats subjected to ischemia and reperfusion by abdominal aorta clamping. Method: Were used 41 Wistar rats, which were distributed into five groups: ischemia and reperfusion (I/R), ischemic postcondictioning (IPC), postconditioning + statin (IPC+S), statin (S) and Sham. It was performed a medium laparotomy, dissection and isolation of the infra-renal abdominal aorta; excepting Sham group, all the others were submitted to the aorta clamping for 70 min (ischemia) and posterior clamping removing (reperfusion, 70 min). In the IPC and IPC+S groups, postconditioning was performed between the ischemia and reperfusion phases by four cycles of reperfusion and ischemia lasting 30 s each. In IPC+S and S groups, preceding the surgical procedure, administration of 3.4 mg/day of atorvastatin was performed for seven days by gavage. The left hepatic lobe was removed for histological study and euthanasia was performed. Results: The mean hepatic injury was 3 in the I/R group, 1.5 in the IPC group, 1.2 in the IPC+S group, 1.2 in the S group, and 0 in the SHAM group. The I/R group had a higher degree of tissue injury compared to the others in the statistical analysis and there was no difference between the others (p<0.01). Conclusion: Ischemic postconditioning and atorvastatin were able to minimize hepatic reperfusion injury, either alone or in combination.
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Liang D, He X, Wang Z, Li C, Gao B, Wu J, Bai Y. Remote limb ischemic postconditioning promotes motor function recovery in a rat model of ischemic stroke via the up-regulation of endogenous tissue kallikrein. CNS Neurosci Ther 2018; 24:519-527. [PMID: 29399973 PMCID: PMC6489769 DOI: 10.1111/cns.12813] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 12/27/2017] [Accepted: 12/29/2017] [Indexed: 01/16/2023] Open
Abstract
AIMS Remote ischemic conditionings, such as pre- and per-conditioning, are known to provide cardioprotection in animal models of ischemia. However, little is known about the neuroprotection effect of postconditioning after cerebral ischemia. In this study, we aim to evaluate the motor function rescuing effect of remote limb ischemic postconditioning (RIPostC) in a rat model of acute cerebral stroke. METHODS Left middle cerebral artery occlusion (MCAO) was performed to generate the rat model of ischemic stroke, followed by daily RIPostC treatment for maximum 21 days. The motor function after RIPostC was assessed with foot fault test and balance beam test. Local infarct volume was measured through MRI scanning. Neuronal status was evaluated with Nissl's, HE, and MAP2 immunostaining. Lectin immunostaining was performed to evaluate the microvessel density and area. RESULTS Daily RIPostC for more than 21 days promoted motor function recovery and provided long-lasting neuroprotection after MCAO. Reduced infarct volume, rescued neuronal loss, and enhanced microvessel density and size in the injured areas were observed. In addition, the RIPostC effect was associated with the up-regulation of endogenous tissue kallikrein (TK) level in circulating blood and local ischemic brain regions. A TK receptor antagonist HOE-140 partially reversed RIPostC-induced improvements, indicating the specificity of endogenous TK mediating the neuroprotection effect of RIPostC. CONCLUSION Our study demonstrates RIPostC treatment as an effective rehabilitation therapy to provide motor function recovery and alleviate brain impairment in a rat model of acute cerebral ischemia. We also for the first time provide evidence showing that the up-regulation of endogenous TK from remote conditioning regions underlies the observed effects of RIPostC.
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Affiliation(s)
- Dan Liang
- Department of Rehabilitation MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Xi‐Biao He
- Shanghai University of Medicine & Health SciencesShanghaiChina
| | - Zheng Wang
- Department of NeurologyHuashan HospitalState Key Laboratory of Medical NeurobiologyFudan UniversityShanghaiChina
| | - Ce Li
- Department of Rehabilitation MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Bei‐Yao Gao
- Department of Rehabilitation MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Jun‐Fa Wu
- Department of Rehabilitation MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Yu‐Long Bai
- Department of Rehabilitation MedicineHuashan HospitalFudan UniversityShanghaiChina
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Chen G, Thakkar M, Robinson C, Doré S. Limb Remote Ischemic Conditioning: Mechanisms, Anesthetics, and the Potential for Expanding Therapeutic Options. Front Neurol 2018; 9:40. [PMID: 29467715 PMCID: PMC5808199 DOI: 10.3389/fneur.2018.00040] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/17/2018] [Indexed: 12/23/2022] Open
Abstract
Novel and innovative approaches are essential in developing new treatments and improving clinical outcomes in patients with ischemic stroke. Remote ischemic conditioning (RIC) is a series of mechanical interruptions in blood flow of a distal organ, following end organ reperfusion, shown to significantly reduce infarct size through inhibition of oxidation and inflammation. Ischemia/reperfusion (I/R) is what ultimately leads to the irreversible brain damage and clinical picture seen in stroke patients. There have been several reports and reviews about the potential of RIC in acute ischemic stroke; however, the focus here is a comprehensive look at the differences in the three types of RIC (remote pre-, per-, and postconditioning). There are some limited uses of preconditioning in acute ischemic stroke due to the unpredictability of the ischemic event; however, it does provide the identification of biomarkers for clinical studies. Remote limb per- and postconditioning offer a more promising treatment during patient care as they can be harnessed during or after the initial ischemic insult. Though further research is needed, it is imperative to discuss the importance of preclinical data in understanding the methods and mechanisms involved in RIC. This understanding will facilitate translation to a clinically feasible paradigm for use in the hospital setting.
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Affiliation(s)
- Gangling Chen
- Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL, United States.,Department of Pharmacology of Chinese Materia Medica, China Pharmaceutical University, Nanjing, China
| | - Mrugesh Thakkar
- Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL, United States
| | - Christopher Robinson
- McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Sylvain Doré
- Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL, United States.,McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Neurology, University of Florida, Gainesville, FL, United States.,Department of Psychiatry, University of Florida, Gainesville, FL, United States.,Department of Pharmaceutics, University of Florida, Gainesville, FL, United States.,Department of Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
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15
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Yamaki IN, Pontes RVS, Costa FLDAS, Yamaki VN, Teixeira RKC, Yasojima EY, Brito MVH. Kidney ischemia and reperfunsion syndrome: effect of lidocaine and local postconditioning. Rev Col Bras Cir 2017; 43:348-353. [PMID: 27982328 DOI: 10.1590/0100-69912016005012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 09/01/2016] [Indexed: 11/21/2022] Open
Abstract
Objective: to evaluate the effects of blocking the regulation of vascular tone on the ischemia and reperfusion syndrome in rats through the use of lidocaine in the postconditioning technique. Methods: we randomized 35 rats into seven groups of five animals: Group 1- Control; Group 2- Ischemia and Reperfusion; Group 3- Ischemia, Reperfusion and Saline; Group 4- Ischemic Postconditioning; Group 5- Ischemic Postconditioning and Saline; Group 6- Lidocaine; Group 7- Ischemic Postconditioning and Lidocaine. Except for the control group, all the others were submitted to renal ischemia for 30 minutes. In postconditioning groups, we performed ischemia and reperfusion cycles of five minutes each, applied right after the main ischemia. In saline and lidocaine groups, we instilled the substances at a rate of two drops per minute. To compare the groups, we measured serum levels of urea and creatinine and also held renal histopathology. Results: The postconditioning and postconditioning + lidocaine groups showed a decrease in urea and creatinine values. The lidocaine group showed only a reduction in creatinine values. In histopathology, only the groups submitted to ischemic postconditioning had decreased degree of tubular necrosis. Conclusion: Lidocaine did not block the effects of postconditioning on renal ischemia reperfusion syndrome, and conferred better glomerular protection when applied in conjunction with ischemic postconditioning. Objetivo: avaliar os efeitos do bloqueio da regulação do tônus vascular por meio do uso da lidocaína na técnica de pós-condicionamento isquêmico na síndrome de isquemia e reperfusão renal em ratos. Métodos: trinta e cinco ratos foram randomizados em sete grupos de cinco animais: Grupo 1- Controle; Grupo 2- Isquemia e Reperfusão; Grupo 3- Isquemia, Reperfusão e Solução Salina; Grupo 4- Pós-condicionamento Isquêmico; Grupo 5- Pós-condicionamento Isquêmico e Solução Salina; Grupo 6- Lidocaína; Grupo 7- Pós-condicionamento Isquêmico e lidocaína. Com exceção do grupo controle, todos os demais foram submetidos à isquemia renal de 30 minutos. Nos grupos de pós-condicionamento, foi realizado o ciclo de isquemia e reperfusão de cinco minutos cada, aplicado logo após a isquemia principal. Nos grupos salina e lidocaína foram instiladas as substâncias numa taxa de duas gotas por minuto. Para comparar os grupos, foram dosados os níveis séricos de ureia e creatinina e análise histopatológica renal. Resultados: os grupos pós-condicionamento e pós-condicionamento + lidocaína apresentaram uma redução nos valores de ureia e creatinina. O grupo lidocaína apresentou apenas uma redução nos valores de creatinina. Na análise histopatológica, apenas os grupos submetidos ao pós-condicionamento isquêmico apresentaram redução do grau de necrose tubular. Conclusão: a lidocaína não bloqueou os efeitos do pós-condicionamento na síndrome de isquemia e reperfusão renal, mas conferiu melhor na proteção glomerular quando aplicada em conjunto com o pós-condicionamento isquêmico.
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Affiliation(s)
- Igor Nagai Yamaki
- Faculty of Medicine, Pará University Center (CESUPA), Belém, PA, Brazil
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Costa FLDS, Yamaki VN, Teixeira RKC, Feijó DH, Valente AL, Carvalho LTFD, Yasojima EY, Brito MVH. Perconditioning combined with postconditioning on kidney ischemia and reperfusion. Acta Cir Bras 2017; 32:599-606. [PMID: 28902935 DOI: 10.1590/s0102-865020170080000001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 07/17/2017] [Indexed: 11/22/2022] Open
Abstract
Purpose: To evaluate if combination of perconditioning and postconditioning provides improved renal protection compared to perconditioning alone in a model of renal reperfusion injury. Methods: Thirty rats were assigned into 6 groups: normality; sham; ischemia and reperfusion; postconditioning; perconditioning; perconditioning + postconditioning. Animals were subjected to right nephrectomy and left renal ischemia for 30 minutes. Postconditioning consisted of 3 cycles of 5 min renal perfusion followed by 5 min of renal ischemia after major ischemic period. Perconditioning consisted of 3 cycles of 5 min hindlimb ischemia followed by 5 min of hindlimb perfusion contemporaneously to renal major ischemic period. After 24 hours, kidney was harvested and blood collected to measure urea and creatinine. Results: Perconditioning obtained better values for creatinine and urea level than only postconditioning (p<0.01); performing both techniques contemporaneously had no increased results (p>0.05). Regarding tissue structure, perconditioning was the only technique to protect the glomerulus and tubules (p<0.05), while postconditioning protected only the glomerulus (p<0.05). Combination of both techniques shows no effect on glomerulus or tubules (p>0.05). Conclusions: Perconditioning had promising results on ischemia and reperfusion induced kidney injury, enhanced kidney function and protected glomerulus and tubules. There was no additive protection when postconditioning and perconditioning were combined.
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Affiliation(s)
- Felipe Lobato da Silva Costa
- MD, Department of Experimental Surgery, School of Medicine, Universidade do Estado do Pará (UEPA), Belem-PA, Brazil. Conception, design, intellectual and scientific content of the study; interpretation of data; manuscript writing
| | - Vitor Nagai Yamaki
- MD, School of Medicine, UEPA, Belem-PA, Brazil. Acquisition and interpretation of data, statistical analysis
| | - Renan Kleber Costa Teixeira
- Fellow Master degree, Department of Experimental Surgery, UEPA, Belem-PA, Brazil. Interpretation of data, manuscript writing, critical revision
| | - Daniel Haber Feijó
- Graduate student, School of Medicine, UEPA, Belem-PA, Brazil. Interpretation of data, manuscript preparation
| | - André Lopes Valente
- Graduate student, School of Medicine, UEPA, Belem-PA, Brazil. Acquisition and interpretation of data, manuscript preparation
| | - Luan Teles Ferreira de Carvalho
- Graduate student, School of Medicine, UEPA, Belem-PA, Brazil. Acquisition and interpretation of data, manuscript preparation
| | - Edson Yuzur Yasojima
- PhD, Associate Professor, Department of Experimental Surgery, School of Medicine, UEPA, Belem-PA, Brazil. Conception, design, intellectual and scientific content of the study; critical revision
| | - Marcus Vinicius Henriques Brito
- PhD, Full Professor, Department of Experimental Surgery, School of Medicine, UEPA, Belem-PA, Brazil. Conception, design, intellectual and scientific content of the study; critical revision
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Oliveira RDCSD, Brito MVH, Ribeiro Júnior RFG, Oliveira LOD, Monteiro AM, Brandão FMV, Cavalcante LCDC, Gouveia EHH, Henriques HYB. Influence of remote ischemic conditioning and tramadol hydrochloride on oxidative stress in kidney ischemia/reperfusion injury in rats. Acta Cir Bras 2017; 32:229-235. [DOI: 10.1590/s0102-865020170030000007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/15/2017] [Indexed: 11/21/2022] Open
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18
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Brito MVH, Yasojima EY, Percário S, Ribeiro Júnior RFG, Cavalcante LCDC, Monteiro AM, Couteiro RP, Rodrigues IADS, Santos HAGD. Effects of hypertonic saline solution associated to remote ischemic perconditioning in kidney ischemia/reperfusion injury in rats. Acta Cir Bras 2017; 32:211-218. [DOI: 10.1590/s0102-865020170030000005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/22/2017] [Indexed: 11/22/2022] Open
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Limb Remote Ischemic Postconditioning Reduces Ischemia-Reperfusion Injury by Inhibiting NADPH Oxidase Activation and MyD88-TRAF6-P38MAP-Kinase Pathway of Neutrophils. Int J Mol Sci 2016; 17:ijms17121971. [PMID: 27898007 PMCID: PMC5187771 DOI: 10.3390/ijms17121971] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 10/30/2016] [Accepted: 11/17/2016] [Indexed: 12/11/2022] Open
Abstract
Limb remote ischemic postconditioning (LRIP) has been confirmed to reduce the ischemia-reperfusion injury but its mechanisms are still not clear. This study clarified the mechanism of LRIP based on the nicotinamide-adenine dinucleotide phosphate (NADPH) oxidase and Myeloid differentiation factor 88 (MyD88)-Tumor necrosis factor (TNF) receptor-associated factor 6 (TRAF6)-P38 pathway of neutrophils. Rat middle cerebral artery occlusion (MCAO) model was used in this study. Ischemia-reperfusion injury was carried out by MCAO 1.5 h followed by 24 h reperfusion. LRIP operation was performed to the left femoral artery at 0, 1 or 3 h after reperfusion. Behavioral testing, including postural reflex test, vibrissae-elicited forelimb placing test and tail hang test, showed that LRIP operated at 0 h of reperfusion could significantly ameliorate these behavioral scores. Pathological examinations, infarct size, Myeloperoxidase (MPO) activity showed that LRIP operated at 0 h of reperfusion could significantly ameliorate the pathological scores, reduce the infarct size and MPO activity in the brain and increase the MPO activity in the left leg. By using Neutrophil counting, immunofluorescence and real-time PCR techniques, we found that LRIP operated at 0 h of reperfusion could reduce neutrophil counts in the peripheral blood and downregulate the activation of neutrophil in the peripheral blood and rat brain. Western blots revealed that MyD88, TRAF6, p38 mitogen-activated protein kinase (p38-MAPK) in neutrophils and the phosphorylation of p47phox (Ser 304 and Ser 345) in neutrophil could be downregulated by LRIP. Our study suggests that LRIP inhibits the number and activation of neutrophils in the rat brain and peripheral blood linked to down-regulating the activation of NADPH oxidase in neutrophils by MyD88/TRAF6/p38-MAPK pathway.
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Zhang Y, Xu H, Wang T, He J, Wei J, Wang T, Dong J. Remote limb ischemic post-conditioning attenuates ischemia-reperfusion injury in rat skin flapby limiting oxidative stress. Acta Cir Bras 2016; 31:15-21. [PMID: 26840351 DOI: 10.1590/s0102-865020160010000003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 12/19/2015] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To investigate the effect of remote ischemic post-conditioning (RIPoC) against ischemia-reperfusion (I/R) injury on flaps of rats. METHODS Sprague-Dawley rats were randomized into the Sham, Control, RIPoC1 and RIPoC2 groups. All the animals were submitted to a 5×4 cm superficial inferior epigastric artery flap. Eight hours of flap ischemia was induced and two protocols of limb RIPoC were applied. Tissue MDA level and SOD activity in 24-h reperfusion were assessed. Flap survival was assessed 7 days postoperatively. RESULTS Compared to the Control group, the RIPoC1 group showed statistically decreased MDA level at 6-, 12-, and 24-h reperfusion (P = 0.01, P < 0.01 and P < 0.01, respectively), and statistically increased SOD activity at 12- and 24-h reperfusion (P < 0.05 and P < 0.01, respectively). Flap survival rate on the 7th day was significantly higher in the RIPoC1 group than the control group (47.9 ± 6.4 vs . 29.4 ± 7.1 %, P < 0.01). CONCLUSION Three cycles of 5-min Limb remote ischemic post-conditioning rather than a single cycle of 15-min limb RIPoC has protective effect on flaps against ischemia-reperfusion injury by attenuating oxidative stress.
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Affiliation(s)
- Yi Zhang
- School of Medicine, Shanghai Jiao Tong University, China
| | - Hua Xu
- School of Medicine, Shanghai Jiao Tong University, China
| | - Tao Wang
- School of Medicine, Shanghai Jiao Tong University, China
| | - Jinguang He
- School of Medicine, Shanghai Jiao Tong University, China
| | - Jiao Wei
- School of Medicine, Shanghai Jiao Tong University, China
| | - Tingliang Wang
- School of Medicine, Shanghai Jiao Tong University, China
| | - Jiasheng Dong
- School of Medicine, Shanghai Jiao Tong University, China
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