Remote Ischemic Preconditioning Does Not Affect the Release of Humoral Factors in Propofol-Anesthetized Cardiac Surgery Patients: A Secondary Analysis of the RIPHeart Study

Ney, Julia; Hoffmann, Katleen; Meybohm, Patrick; Goetzenich, Andreas; Kraemer, Sandra; Benstöm, Carina; Weber, Nina C.; Bickenbach, Johannes; Rossaint, Rolf; Marx, Gernot; Zacharowski, Kai; Stoppe, Christian

doi:10.3390/ijms19041094

Cited by 22 publications

(14 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For example, a study found that the serum level of macrophage migration inhibitory factor was increased, whereas no difference was found in IL-6, IL-8, and IL-10 serum levels between the RIPC group and a control group in patients undergoing cardiac surgery. 31 Another study reported increased blood levels of TNF-α, IL-6, IL-8, and IL-10 in 5 healthy volunteers after RIPC. 32 TNF-α and IL-6 play major roles in initiating and amplifying the postischemic inflammatory response, whereas IL-10 is mainly an anti-inflammatory factor.…”

Section: Discussionmentioning

confidence: 99%

Changes in cerebral autoregulation and blood biomarkers after remote ischemic preconditioning

Guo

Liu

et al. 2019

Neurology

View full text Add to dashboard Cite

ObjectiveTo determine the effect of remote ischemic preconditioning (RIPC) on dynamic cerebral autoregulation (dCA) and various blood biomarkers in healthy adults.MethodsA self-controlled interventional study was conducted. Serial measurements of dCA were performed at 7 time points (7, 9, and 11 am; 2, 5, and 8 pm, and 8 am on the next day) without or with RIPC, carried out at 7:20 to 8 am. Venous blood samples were collected at baseline (7 am) and 1 hour after RIPC, and blood biomarkers, including 5 neuroprotective factors and 25 inflammation-related biomarkers, were measured with a quantitative protein chip.ResultsFifty participants were enrolled (age 34.54 ± 12.01 years, 22 men). Compared with the results on the day without RIPC, dCA was significantly increased at 6 hours after RIPC, and the increase was sustained for at least 24 hours. After RIPC, 2 neuroprotective factors (glial cell-derived neurotrophic factor and vascular endothelial growth factor-A) and 4 inflammation-related biomarkers (transforming growth factor-β1, leukemia inhibitory factor, matrix metallopeptidase-9, and tissue inhibitor of metalloproteinase-1) were significantly elevated compared with their baseline levels. Conversely, monocyte chemoattractant protein-1 was significantly lower compared with its baseline level.ConclusionsRIPC induces a sustained increase of dCA from 6 to at least 24 hours after treatment in healthy adults. In addition, several neuroprotective and inflammation-related blood biomarkers were differentially regulated shortly after RIPC. The increased dCA and altered blood biomarkers may collectively contribute to the beneficial effects of RIPC on cerebrovascular function.ClinicalTrials.gov identifier:NCT02965547.

show abstract

Section: Discussionmentioning

confidence: 99%

Changes in cerebral autoregulation and blood biomarkers after remote ischemic preconditioning

Guo

Liu

et al. 2019

Neurology

View full text Add to dashboard Cite

show abstract

“…Contrary to the findings in animal models, the majority of recent randomised control clinical trials have been unable to demonstrate a clear effect of RIC on pro-inflammatory cytokine release (Table .2 ) [ 37 , 39 , 105 , 106 , 108 , 149 , 158 ]. However, to date, cytokines have predominantly been measured in small studies only (less than 100 participants).…”

Section: Cytokines In Myocardial Infarction and Infectionmentioning

confidence: 86%

Does remote ischaemic conditioning reduce inflammation? A focus on innate immunity and cytokine response

Pearce¹,

Davidson²,

Yellon³

2021

Basic Res Cardiol

View full text Add to dashboard Cite

The benefits of remote ischaemic conditioning (RIC) have been difficult to translate to humans, when considering traditional outcome measures, such as mortality and heart failure. This paper reviews the recent literature of the anti-inflammatory effects of RIC, with a particular focus on the innate immune response and cytokine inhibition. Given the current COVID-19 pandemic, the inflammatory hypothesis of cardiac protection is an attractive target on which to re-purpose such novel therapies. A PubMed/MEDLINE™ search was performed on July 13th 2020, for the key terms RIC, cytokines, the innate immune system and inflammation. Data suggest that RIC attenuates inflammation in animals by immune conditioning, cytokine inhibition, cell survival and the release of anti-inflammatory exosomes. It is proposed that RIC inhibits cytokine release via a reduction in nuclear factor kappa beta (NF-κB)-mediated NLRP3 inflammasome production. In vivo, RIC attenuates pro-inflammatory cytokine release in myocardial/cerebral infarction and LPS models of endotoxaemia. In the latter group, cytokine inhibition is associated with a profound survival benefit. Further clinical trials should establish whether the benefits of RIC in inflammation can be observed in humans. Moreover, we must consider whether uncomplicated MI and elective surgery are the most suitable clinical conditions in which to test this hypothesis.

show abstract

“…27 RIPC has also been found to modulate the inflammatory response. 28 Yet there was no effect of RIPC seen on inflammatory mediators either in propofol anaesthetised 29 or sevoflurane anaesthetised cardiac surgery patients. 30 There are several limitations to the present study.…”

Section: Subgroup Analysismentioning

confidence: 96%

The Effect of Remote Ischaemic Preconditioning on Arterial Stiffness in Patients Undergoing Vascular Surgery: A Randomised Clinical Trial

Kepler

Kuusik

Lepner

et al. 2019

European Journal of Vascular and Endovascular Surgery

View full text Add to dashboard Cite

WHAT THIS PAPER ADDS The current study is the first clinical study to examine the effect of remote ischaemic preconditioning (RIPC) on arterial stiffness in patients undergoing vascular surgery. Although this study failed to demonstrate a significant effect of RIPC on the arterial stiffness parameters, there was marked improvement in arterial stiffness parameters after surgery in both the interventional and the non-interventional (sham) groups. The finding that surgery itself may have an influence on arterial stiffness has some clinical impact. Objectives: The main aim of this study was to evaluate the effect of remote ischaemic preconditioning (RIPC) on arterial stiffness in patients undergoing vascular surgery. Methods: This was a randomised, sham controlled, double blind, single centre study. Patients undergoing open abdominal aortic aneurysm repair, surgical lower limb revascularisation surgery or carotid endarterectomy were recruited. A RIPC or a sham procedure was performed, using a blood pressure cuff, along with preparation for anaesthesia. The RIPC protocol consisting of four cycles of 5 min of ischaemia, followed by 5 min of reperfusion was applied. Arterial stiffness and haemodynamic parameters were measured pre-operatively and 20e28 h after surgery. Two primary outcomes were selected: augmentation index and pulse wave velocity. Results: Ninety-eight patients were randomised. After dropouts 44 and 46 patients were included in the RIPC and sham groups, respectively. Both groups were comparable. There were no statistically significant differences in augmentation index (p ¼ .8), augmentation index corrected for heart rate of 75 beats per minute (p ¼ .8), pulse wave velocity (p ¼ .7), large artery elasticity indices (p ¼ .8), small artery elasticity indices (p ¼ .6), or mean arterial pressure (p ¼ .7) changes between the RIPC and sham groups. There occurred statistically significant (p .01) improvement in augmentation index (À5.8% vs. À5.5%), augmentation index corrected for a heart rate of 75 beats per minute (À2.5% vs. À2%), small artery elasticity indices (0.7 mL/mmHg Â 100 vs. 0.9 mL/mmHg Â 100), and mean arterial pressure post-operatively in both the RIPC and the sham groups (change median values in RIPC and sham groups, respectively). Conclusions: RIPC had no significant effect on arterial stiffness, but there was significant improvement in arterial stiffness after surgery in both groups. Arterial stiffness and haemodynamics may be influenced by surgery or anaesthesia or oxidative stress or all factors combined. Further studies are needed to clarify these findings.

show abstract

Remote Ischemic Preconditioning Does Not Affect the Release of Humoral Factors in Propofol-Anesthetized Cardiac Surgery Patients: A Secondary Analysis of the RIPHeart Study

Cited by 22 publications

References 42 publications

Changes in cerebral autoregulation and blood biomarkers after remote ischemic preconditioning

Changes in cerebral autoregulation and blood biomarkers after remote ischemic preconditioning

Does remote ischaemic conditioning reduce inflammation? A focus on innate immunity and cytokine response

The Effect of Remote Ischaemic Preconditioning on Arterial Stiffness in Patients Undergoing Vascular Surgery: A Randomised Clinical Trial

Contact Info

Product

Resources

About