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Preconditioning strategies for kidney ischemia reperfusion injury: implications of the "time-window" in remote ischemic preconditioning.

Yoon YE, Lee KS, Choi KH, Kim KH, Yang SC, Han WK - PLoS ONE (2015)

Bottom Line: However, there has been no demonstrated result in large animals and the role of time window in remote IP remains to be defined.The IP-L group had lower urinary neutrophil gelatinase-associated lipocalin than control and IP-E at 72 hours post-ischemia.Taken together, remote IP showed a significant reduction in renal injury biomarkers from ischemia reperfusion injury.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
Remote ischemic preconditioning (IP) is a potential renoprotective strategy. However, there has been no demonstrated result in large animals and the role of time window in remote IP remains to be defined. Using a single-kidney porcine model, we evaluated organ protective function of remote IP in renal ischemia reperfusion injury. Fifteen Yorkshire pigs, 20 weeks old and weighing 35-38 kg were used. One week after left nephrectomy, we performed remote IP (clamping right external iliac artery, 2 cycles of 10 minutes) and right renal artery clamping (warm ischemia; 90 minutes). The animals were randomly divided into three groups: control group, warm ischemia without IP; group 1 (remote IP with early window [IP-E]), IP followed by warm ischemia with a 10-minute time window; and group 2 (remote IP with late window [IP-L]), IP followed by warm ischemia after a 24-hour time window. There were no differences in serum creatinine changes between groups. The IP-L group had lower urinary neutrophil gelatinase-associated lipocalin than control and IP-E at 72 hours post-ischemia. At 72 hours post-ischemia, the urinary kidney injury molecule-1 (KIM-1) was lower in the IP-L group than in the control and IP-E groups, and the IP-L group KIM-1 was near pre-ischemic levels, whereas the control and IP-E group KIM-1 levels were rising. Microalbumin also tended to be lower in the IP-L group. Taken together, remote IP showed a significant reduction in renal injury biomarkers from ischemia reperfusion injury. To effectively provide kidney protection, remote IP might require a considerable, rather than short, time window of ischemia.

No MeSH data available.


Related in: MedlinePlus

Protocol for the experiments used in ischemic preconditioning (40 minutes) and index ischemia (90 minutes).Black rectangles are the time zone of “clamping”, clear rectangles represent the “declamping”. See the Materials and Methods section for details. IP-E, remote ischemic preconditioning with early window; IP-L, remote ischemic preconditioning with late window.
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pone.0124130.g001: Protocol for the experiments used in ischemic preconditioning (40 minutes) and index ischemia (90 minutes).Black rectangles are the time zone of “clamping”, clear rectangles represent the “declamping”. See the Materials and Methods section for details. IP-E, remote ischemic preconditioning with early window; IP-L, remote ischemic preconditioning with late window.

Mentions: To construct a single-kidney porcine model, we performed a laparoscopic left nephrectomy. After an adaption period of 1 week, IP and right renal artery clamping (warm ischemia) were performed as follows: IP was conducted by clamping the right external iliac artery for 2 cycles of 10 minutes ischemia followed by 10 minutes reperfusion, and warm ischemia was performed by clamping the remnant right renal artery for 90 minutes. The animals were randomly allocated into three experimental groups: control group (n = 5), 90 minutes of warm ischemia without IP; group 1 (n = 5, remote IP with early window [IP-E]) 20 minutes IP followed by 90 minutes warm ischemia after a 10-minute time window; and group 2 (n = 5, remote IP with late window [IP-L]), 20 minutes IP, followed by 24 hours as a time window of ischemia, which was subsequently followed by 90 minutes warm ischemia (Fig 1). These procedures were performed by two surgeons (W.K.H. and Y.E.Y.). All surgeries were performed laparoscopically, with the pneumoperitoneum maintained at 12 mmHg and three 5-mm ports used for instrumentation. Once the experiment was completed, the animals were euthanized with an intravenous injection of potassium chloride solution.


Preconditioning strategies for kidney ischemia reperfusion injury: implications of the "time-window" in remote ischemic preconditioning.

Yoon YE, Lee KS, Choi KH, Kim KH, Yang SC, Han WK - PLoS ONE (2015)

Protocol for the experiments used in ischemic preconditioning (40 minutes) and index ischemia (90 minutes).Black rectangles are the time zone of “clamping”, clear rectangles represent the “declamping”. See the Materials and Methods section for details. IP-E, remote ischemic preconditioning with early window; IP-L, remote ischemic preconditioning with late window.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400007&req=5

pone.0124130.g001: Protocol for the experiments used in ischemic preconditioning (40 minutes) and index ischemia (90 minutes).Black rectangles are the time zone of “clamping”, clear rectangles represent the “declamping”. See the Materials and Methods section for details. IP-E, remote ischemic preconditioning with early window; IP-L, remote ischemic preconditioning with late window.
Mentions: To construct a single-kidney porcine model, we performed a laparoscopic left nephrectomy. After an adaption period of 1 week, IP and right renal artery clamping (warm ischemia) were performed as follows: IP was conducted by clamping the right external iliac artery for 2 cycles of 10 minutes ischemia followed by 10 minutes reperfusion, and warm ischemia was performed by clamping the remnant right renal artery for 90 minutes. The animals were randomly allocated into three experimental groups: control group (n = 5), 90 minutes of warm ischemia without IP; group 1 (n = 5, remote IP with early window [IP-E]) 20 minutes IP followed by 90 minutes warm ischemia after a 10-minute time window; and group 2 (n = 5, remote IP with late window [IP-L]), 20 minutes IP, followed by 24 hours as a time window of ischemia, which was subsequently followed by 90 minutes warm ischemia (Fig 1). These procedures were performed by two surgeons (W.K.H. and Y.E.Y.). All surgeries were performed laparoscopically, with the pneumoperitoneum maintained at 12 mmHg and three 5-mm ports used for instrumentation. Once the experiment was completed, the animals were euthanized with an intravenous injection of potassium chloride solution.

Bottom Line: However, there has been no demonstrated result in large animals and the role of time window in remote IP remains to be defined.The IP-L group had lower urinary neutrophil gelatinase-associated lipocalin than control and IP-E at 72 hours post-ischemia.Taken together, remote IP showed a significant reduction in renal injury biomarkers from ischemia reperfusion injury.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
Remote ischemic preconditioning (IP) is a potential renoprotective strategy. However, there has been no demonstrated result in large animals and the role of time window in remote IP remains to be defined. Using a single-kidney porcine model, we evaluated organ protective function of remote IP in renal ischemia reperfusion injury. Fifteen Yorkshire pigs, 20 weeks old and weighing 35-38 kg were used. One week after left nephrectomy, we performed remote IP (clamping right external iliac artery, 2 cycles of 10 minutes) and right renal artery clamping (warm ischemia; 90 minutes). The animals were randomly divided into three groups: control group, warm ischemia without IP; group 1 (remote IP with early window [IP-E]), IP followed by warm ischemia with a 10-minute time window; and group 2 (remote IP with late window [IP-L]), IP followed by warm ischemia after a 24-hour time window. There were no differences in serum creatinine changes between groups. The IP-L group had lower urinary neutrophil gelatinase-associated lipocalin than control and IP-E at 72 hours post-ischemia. At 72 hours post-ischemia, the urinary kidney injury molecule-1 (KIM-1) was lower in the IP-L group than in the control and IP-E groups, and the IP-L group KIM-1 was near pre-ischemic levels, whereas the control and IP-E group KIM-1 levels were rising. Microalbumin also tended to be lower in the IP-L group. Taken together, remote IP showed a significant reduction in renal injury biomarkers from ischemia reperfusion injury. To effectively provide kidney protection, remote IP might require a considerable, rather than short, time window of ischemia.

No MeSH data available.


Related in: MedlinePlus