Ischaemic preconditioning – Current knowledge and potential future applications after 30 years of experience

Stokfisz, Karolina; Ledakowicz-Polak, Anna; Zagórski, Maciej; Zielińska, Marzenna

doi:10.1016/j.advms.2016.11.006

Cited by 75 publications

(61 citation statements)

References 137 publications

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“…This was first described for myocardial ischemia in dogs by Murry et al and refers to a tissue adaptation in stressful situations, brought about by preapplied short ischemic periods with subsequent reperfusions, which protects the organ from subsequent ischemic reperfusion injury (RI). This effect has been seen in a number of organs and has been detected up to 72 h poststimulation . Several animal models have already indicated that such preconditioning is also possible in interventions involving the pancreas, and has a protective effect against postoperative complications .…”

Section: Discussionmentioning

confidence: 93%

Impact of donor cardiopulmonary resuscitation on the outcome of simultaneous pancreas–kidney transplantation—a retrospective study

et al. 2020

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Previous cardiac arrest in brain-dead donors has been discussed as a potential risk factor in pancreas transplantation (PT), leading to a higher rate of organ refusal. This study aimed to assess the impact of cardiopulmonary resuscitation (CPR) in brain-dead donors on pancreas transplant outcome. A total of 518 type 1 diabetics underwent primary simultaneous pancreas-kidney (SPK) transplantation at our center between 1994 and 2018. Patients were divided into groups, depending on whether their donor had been resuscitated or not. A total of 91 (17.6%) post-CPR donors had been accepted for transplantation (mean duration of cardiac arrest, 19.4 AE 15.6 min). Those donors were younger (P < 0.001), had lower pancreas donor risk index (PDRI, P = 0.003), and had higher serum creatinine levels (P = 0.021). With a median follow-up of 167 months (IQR 82-229), both groups demonstrated comparable short-and long-term patient and graft survival. The resuscitation time (<20 min vs. ≥20 min) also showed no impact, with similar survival rates for both groups. A multivariable Cox regression analysis suggested no statistically significant association between donor CPR and patient or graft survival. Our results indicate that post-CPR brain-dead donors are suitable for PT without increasing the risk of complications.

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Section: Discussionmentioning

confidence: 93%

Impact of donor cardiopulmonary resuscitation on the outcome of simultaneous pancreas–kidney transplantation—a retrospective study

et al. 2020

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“…In the controls, the infarcted area consisted 30% of the area at risk, whereas that of the preconditioned animals was only 7.5% of the area at risk (25% of the infarct size in the controls). This landmark study has paved the way to subsequent studies demonstrating the protective effects of IPC in the kidney, brain, liver, and intestine [11,12]. Moreover, in various studies, the paradigms of IPC varied considerably ranging from intervals of minutes to seconds.…”

Section: Protective Mechanisms Associated With Ischemia and Reperfusionmentioning

confidence: 99%

“…The severity of the IH and the hypoxemia in OSA are determined by the number of the hypoxic events per hour of sleep, termed Apnea-Hypopnea Index (AHI). It mostly ranges from a cutoff point of 10 events per hour of sleep for normal breathing to mild (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), moderate (21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and severe OSA (>30 events per hour of sleep). In severe patients, blood oxygenation levels can intermittently drop to as low as 60%.…”

Section: Introductionmentioning

confidence: 99%

Intermittent Hypoxia and Obstructive Sleep Apnea: Mechanisms, Interindividual Responses and Clinical Insights

Lavie¹

2020

Atherosclerosis, Arteriosclerosis and Arteriolosclerosis

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Obstructive sleep apnea (OSA), a nightly respiratory condition, is characterized by recurrent upper airway collapse causing intermittent hypoxia (IH) resembling ischemia and reperfusion (I/R). Consequently, blood oxygenation levels are cyclically reduced; sleep fragmentation and sympathetic activation develop, thus invoking oxidative stress and inflammation. OSA is a major risk factor for cardio-/ cerebrovascular morbidity and mortality. However, not all OSA patients develop cardio-/cerebrovascular disease, even if suffering from similar OSA severity. Possibly, this results from interindividual differences in responses to a given hypoxic stimulus involving gene polymorphism in oxygen-regulated transcription factors and downstream genes. The current review is aimed at highlighting potentially protective mechanisms induced by IH and OSA, rather than its well-established deleterious effects, while focusing on acute coronary syndromes. Therefore, protective mechanisms revealed in I/R biology and exhibited in vitro and in animal models utilizing IH followed by a severe ischemia are discussed and linked to acute myocardial infarction patients with concomitant OSA. The roles of endothelial progenitor cells, their proliferative and angiogenic properties, and collateral formation are emphasized in the clinical setting, as well as heterogenic interindividual responses to identical hypoxic stimuli. These findings might represent potential predictors to cardio-/cerebrovascular health, by identifying patients at higher or lower cardiovascular risk.

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“…Reduced glutathione (GSH) was evaluated fluorometrically according to Galván-Arzate et al (24) Mitochondrial protein (15 µg) was derivatized with 100 μl of o-phthalaldehyde ([OPA] 1 mg/mL) in 2-mL final volume and incubated for 20 minutes at room temperature. Fluorescent signal was measured at λ ex = 350 and λ em = 420 in a LS50B Luminescence Spectrophotometer (Perkin-Elmer, Waltham, MA).…”

Section: Reduced Glutathione and Oxidized Glutathione Determinationmentioning

confidence: 99%

Cytidine‐5'‐Diphosphocholine Protects the Liver From Ischemia/Reperfusion Injury Preserving Mitochondrial Function and Reducing Oxidative Stress

Zazueta¹,

Buelna‐Chontal²,

Macías-López³

et al. 2018

Liver Transpl

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Cytidine-5'-diphosphocholine (CDP-choline) participates as an intermediary in the synthesis of phosphatidylcholine, an essential component of cellular membranes. Citicoline treatment has shown beneficial effects in cerebral ischemia, but its potential to diminish reperfusion damage in liver has not been explored. In this work, we evaluated the hepatoprotective effect of citicoline and its possible association with inflammatory/oxidative stress and mitochondrial function because they are the main cellular features of reperfusion damage. Ischemia/reperfusion (I/R) in rat livers was performed with the Pringle's maneuver, clamping the 3 elements of the pedicle (hepatic artery, portal vein, and biliary tract) for 30 minutes and then removing the clamp to allow hepatic reperfusion for 60 minutes. The I/R + citicoline group received the compound before I/R. Liver injury was evaluated by measuring aspartate aminotransferase and alanine aminotransferase as well as lactic acid levels in serum; proinflammatory cytokines, proresolving lipid mediators, and nuclear factor kappa B content were determined as indicators of the inflammatory response. Antioxidant effects were evaluated by measuring markers of oxidative stress and antioxidant molecules. Oxygen consumption and the activities of the respiratory chain were used to monitor mitochondrial function. CDP-choline reduced aspartate aminotransferase (AST), alanine aminotransferase (ALT), as well as lactic acid levels in blood samples from reperfused rats. Diminution in tumor necrosis factor alpha (TNF-α) and increase in the proresolving lipid mediator resolvin D1 were also observed in the I/R+citicoline group, in comparison with the I/R group. Oxidative/nitroxidative stress in hepatic mitochondria concurred with deregulation of oxidative phosphorylation, which was associated with the loss of complex III and complex IV activities. In conclusion, CDP-choline attenuates liver damage caused by ischemia and reperfusion by reducing oxidative stress and maintaining mitochondrial function. Liver Transplantation XX XX-XX 2018 AASLD.

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Ischaemic preconditioning – Current knowledge and potential future applications after 30 years of experience

Cited by 75 publications

References 137 publications

Impact of donor cardiopulmonary resuscitation on the outcome of simultaneous pancreas–kidney transplantation—a retrospective study

Impact of donor cardiopulmonary resuscitation on the outcome of simultaneous pancreas–kidney transplantation—a retrospective study

Intermittent Hypoxia and Obstructive Sleep Apnea: Mechanisms, Interindividual Responses and Clinical Insights

Cytidine‐5'‐Diphosphocholine Protects the Liver From Ischemia/Reperfusion Injury Preserving Mitochondrial Function and Reducing Oxidative Stress

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