Local preconditioning by thermal stress accelerates microvascular thrombus formation

Heme oxygenase 1 (HO-1) has been shown to suppress microvascular thrombus formation. Because stress conditioning induces HO-1 and, in addition, the anticoagulant thrombomodulin and thrombospondin 1, we studied the effect of hyperthermic and hypothermic local stress conditioning on microvascular thrombus formation. For local stress conditioning, the hindlimb of Sprague-Dawley rats was subjected to local heating (42.5 degrees C) or cooling (4 degrees C) for 30 min at 24 h before induction of thrombosis. Sham-exposed hindlimbs served as controls. Thrombosis was induced photochemically in arterioles and venules of the preconditioned tissue (muscle, subcutis, and periosteum) by continuous light exposure after injection of a fluorescent dye. Immunohistochemistry revealed that stress conditioning distinctly induced HO-1, thrombomodulin, and thrombospondin 1 but also von Willebrand factor in endothelial cells. Of interest, intravital fluorescence microscopic analysis of the kinetics of thrombus formation could not confirm an antithrombotic effect of stress conditioning but showed, in contrast, a significant acceleration of thrombosis (P < 0.05) in both arterioles and venules of either of the tissues studied. Although hypothermic and hyperthermic stress conditioning induces antithrombotic HO-1, thrombomodulin, and thrombospondin 1, it enhances endogenous thrombogenicity, most probably due to upregulation of the prothrombotic von Willebrand factor. Thus, preconditioning with local stress cannot be considered as a strategy to prevent thrombus formation.