Microcirculatory effects of local and remote ischemic preconditioning in supraceliac aortic clamping

Author(s)

Erling, Jr., Nilon ^[1] ; Nakagawa, Naomi Kondo ^[2] ; Miranda Costa Cruz, Jose Walber ^[2] ; Zanoni, Fernando Luiz ^[2] ; Costa Baptista-Silva, Jose Carlos ^[1] ; Sannomiya, Paulina ^[2] ; Poli-de-Figueiredo, Luiz Francisco ^[3]

Affiliation

^[1] Univ Fed Sao Paulo, Dept Surg, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Med, LIM 11, Inst Heart InCor, BR-05508 Sao Paulo - Brazil

^[3] Univ Sao Paulo, Sch Med, LIM 26, Dept Surg, BR-05508 Sao Paulo - Brazil

• Document type: Journal article
• Source: JOURNAL OF VASCULAR SURGERY; v. 52, n. 5, p. 1321-1329, NOV 2010.
• Web of Science Citations: 7

Abstract

Introduction: Supraceliac aortic clamping in major vascular procedures promotes splanchnic ischemia and reperfusion (I/R) injury that may induce endothelial dysfunction, widespread inflammation, multiorgan dysfunction, and death. We tested the hypothesis that local or remote ischemic preconditioning (IPC) may be protective against injury after supraceliac aortic clamping through the modulation of mesenteric leukocyte-endothelial interactions, as evaluated with intravital microscopy and expression of adhesion molecules. Methods: Fifty-six male Wistar rats (weight, 190 to 250 g), were divided into four groups of 14 rats each: control sham surgery without aortic occlusion; I/R through supraceliac aortic occlusion for 20 minutes, followed by 120 minutes of reperfusion; local IPC through supraceliac aortic occlusion for two cycles of 5 minutes of ischemia and 5 minutes of reperfusion, followed by the same protocol of the IR group; remote IPC through infrarenal aortic occlusion for two cycles of 10 minutes of ischemia and 10 minutes of reperfusion, followed by the same protocol of the IR group. Seven animals per group were used to evaluate in vivo leukocyte-endothelial interactions in postcapillary venules with intravital microscopy and another seven animals per group were used to collect mesentery samples for inmmnohistochemistry demonstration of adhesion molecules expression. Results: Supraceliac aortic occlusion increased the number of rolling leukocytes with slower velocities and increased the number of adherent leukocytes to the venular surface and leukocyte migration to the interstitium. The expression of P-selectin, E-selectin, and intercellular adhesion molecule-1 was also increased significantly after I/R. Local or remote IPC reduced the leukocyte recruitment in vivo and normalized the expression of adhesion molecules. Conclusions: Local or remote IPC reduces endothelial dysfunction on mesenteric microcirculation caused by I/R injury after supraceliac aortic clamping. (J Vase Surg 2010;52:1321-9.) Clinical Relevance: The present study demonstrates that ischemia and reperfusion injury induced by supraceliac aortic occlusion promotes endothelial dysfunction and leukocyte recruitment on mesenteric microcirculation. Local and remote preconditioning reduced leukocyte-endothelial interactions and normalized the expression of endothelial adhesion molecules involved in this process. Although we recognize the limitation of an experimental model, our findings suggest that local and remote ischemic preconditioning minimize the endothelial dysfunction and leukocyte recruitment events that play a central role in systemic inflammation and multiorgan dysfunction after major aortic reconstructions. (AU)

• FAPESP's process: 04/15964-6 - Mechanisms of hypertonic saline solution associated to pentoxifylline and ethy-pyruvate in the reduction of multiple organ dysfunctions after trauma, sepsis and ischemia-reperfusion
• Grantee: Maurício Rocha e Silva
• Support Opportunities: Research Projects - Thematic Grants