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Remote Limb Ischemic Preconditioning: A Neuroprotective Technique in Rodents
Published on: June 2, 2015
Transient limb ischemia induces remote ischemic preconditioning in vivo
R K Kharbanda1, U M Mortensen, P A White
1University College, London, UK. rk285@cam.ac.uk
Circulation
|December 4, 2002
Summary
Remote ischemic preconditioning using limb ischemia protects against endothelial dysfunction in humans and reduces heart attack size in pigs. This simple method has potential clinical applications for reducing tissue damage from ischemia-reperfusion injury.
Area of Science:
- Cardiovascular Physiology
- Ischemia-Reperfusion Biology
Background:
- Ischemic preconditioning (IP) mitigates local tissue damage from ischemia-reperfusion (IR).
- Evidence suggests IP may also protect remote tissues from IR injury.
- This study investigated if limb ischemia induces remote preconditioning, affecting human endothelial function and experimental myocardial infarction.
Purpose of the Study:
- To determine if limb ischemia can induce remote preconditioning in humans.
- To assess the effect of remote preconditioning on endothelial IR injury in humans.
- To evaluate the impact of remote preconditioning on experimental myocardial infarct size in pigs.
Main Methods:
- Human forearm endothelial function was assessed via acetylcholine response after limb ischemia-reperfusion.
- Remote preconditioning in humans involved brief cycles of ischemia in the contralateral limb.
- Myocardial infarction size in pigs was measured after LAD artery occlusion, with and without remote limb preconditioning.
Main Results:
- Remote preconditioning prevented the reduction in forearm blood flow response to acetylcholine observed in controls after IR.
- In pigs, remote limb ischemia significantly reduced myocardial infarct size (26% vs. 53% of area at risk).
Conclusions:
- Remote ischemic preconditioning effectively prevents IR-induced endothelial dysfunction in humans.
- Limb ischemia as a remote preconditioning stimulus reduces myocardial infarct size in experimental models.
- Transient limb ischemia is a promising, simple preconditioning strategy with potential clinical utility.
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