Protection against acute porcine lung ischemia/reperfusion injury by systemic preconditioning via hind limb ischemia

Abstract

Summary Previous work on various organs and tissues has shown that ischemic preconditioning protects against reperfusion injury in these organs and also against secondary effects in the lung. In contrast, the purpose of this study was to investigate the effects of preconditioning in a remote organ (hind limb ischemia) on an ischemia/reperfusion (I/R) treatment of the lung itself. A porcine model of in situ left lung ischemia (90 min) and reperfusion (5 h) was used. Systemic preconditioning was induced by clamping the left common femoral artery (3 × 5 min). Lung injury was assessed in terms of pulmonary vascular resistance, pulmonary artery pressure, pulmonary venous and arterial pO2, and tissue macrophage counts. The zymosan‐stimulated release of reactive oxygen species (ROS) in whole blood was determined by a chemiluminometric procedure. Inflammatory cytokines (interleukin‐1β and interleukin‐6) were measured in arterial plasma as indicators of a systemic inflammatory reaction. Preconditioning by hind limb ischemia completely prevented the I/R‐induced functional impairment of the lung, the pulmonary hypertension and the reduced oxygenation capacity. The plasma levels of interleukin‐1β and the macrophage counts in preconditioned animals were reduced to control values, whereas the levels of interleukin‐6 and the release of ROS were not affected by preconditioning. In conclusion, systemic preconditioning by repeated hind limb ischemia protects against acute I/R injury of the lung but not against all indices of reperfusion‐associated systemic inflammation.

Decreased Capacity of Immune Cells to Cause Tissue Injury Mediates Kidney Ischemic Preconditioning

“…Attenuation of lung IRI damage in a porcine model of lung IRI could be achieved by brief, repeated phases of sublethal ischemia to the hind limb skeletal muscle (19). The results showed that functional characteristics of lung IRI were completely reversed; however, the brief ischemia to the hind limb was not sufficient to completely ameliorate the systemic inflammation.…”

Remote Ischemic Preconditioning: A Novel Protective Method From Ischemia Reperfusion Injury—A Review

“…During surgery of the lower limbs, there is release of cytokines after prolonged limb ischemia leading to acute respiratory distress syndrome and limb preconditioning could protect against lung dysfunction found with acute respiratory distress syndrome. (2) RIPC by left femoral artery occlusion (3 ϫ 5 min) prior to lung IRI (90 min ischemia, 5 h reperfusion) [59] in a porcine model reversed the detrimental effects of lung IRI on lung function and attenuated pulmonary hypertension and impaired gas exchange. Thus, both models of RIPC [58].…”

Remote ischemic preconditioning in cardiac surgery: caught between clinical relevance and statistical significance?

“…RIPC also protects other organs such as brain, lung, liver, and kidney [1,2,4,11,19,24,25]. Recently, RIPC has been brought from the bench to the operating theater.…”