Ischemic preconditioning protects cardiomyocyte mitochondria through mechanisms independent of cytosol
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Updated: May 3, 2026

In vitro Assessment of Myocardial Protection following Hypothermia-Preconditioning in a Human Cardiac Myocytes Model
Published on: October 27, 2020
Marisol Ruiz-Meana1, Estefanía Núñez2, Elisabet Miro-Casas1
1Vall d'Hebron University Hospital and Reseach Institute, Universitat Autònoma de Barcelona, Spain.
Abstract:
Mitochondria play a central role in the protection conferred by ischemic preconditioning (IP) by not fully elucidated mechanisms. We investigated whether IP protects mitochondria against ischemia-reperfusion (IR) injury through mechanisms independent of cytosolic signaling. In isolated rat hearts, sublethal IR increased superoxide production and reduced complex-I- and II-mediated respiration in subsarcolemmal (SS), but not interfibrillar (IF) mitochondria. This effect of IR on mitochondrial respiration was significantly attenuated by IP. Similar results were obtained in isolated cardiac mitochondria subjected to in vitro IR. The reduction in SS mitochondrial respiration in the heart and in vitro model was paralleled by an increase in oxidized cysteine residues, which was also prevented by IP. IP was also protective in mitochondria submitted to lethal IR. The protective effect of IP against respiratory failure was unaffected by inhibition of mitochondrial KATP channels or mitochondrial permeability transition. However, IP protection was lost in mitochondria from genetically-modified animals in which connexin-43, a protein present in SS but not IF mitochondria, was replaced by connexin-32. Our results demonstrate the existence of a protective mitochondrial mechanism or "mitochondrial preconditioning" independent of cytosol that confers protection against IR-induced respiratory failure and oxidative damage, and requires connexin-43.
Insights
Ischemic preconditioning (IP) protects mitochondria from injury via a novel, cytosol-independent mechanism. This "mitochondrial preconditioning" involves connexin-43 and prevents respiratory failure and oxidative damage during ischemia-reperfusion (IR).
Area of Science:
- Mitochondrial biology
- Cardiovascular research
- Cellular physiology
Background:
- Mitochondria are crucial for ischemic preconditioning (IP) protection, but mechanisms remain unclear.
- Investigating IP's direct effects on mitochondria against ischemia-reperfusion (IR) injury, independent of cytosolic factors.
Purpose of the Study:
- To determine if IP protects mitochondria from IR injury through intrinsic mitochondrial pathways.
- To elucidate the role of specific mitochondrial proteins in IP-mediated protection.
Main Methods:
- Isolated rat hearts and cardiac mitochondria subjected to sublethal and lethal IR.
- Assessed mitochondrial respiration (Complex I and II), superoxide production, and cysteine oxidation.
- Utilized genetically modified animals with altered connexin expression.
Main Results:
- IR reduced subsarcolemmal (SS) mitochondrial respiration and increased oxidative damage, effects attenuated by IP.
- IP protection was independent of mitochondrial KATP channels and permeability transition.
- Loss of IP protection occurred when connexin-43 was replaced by connexin-32, indicating its critical role.
Conclusions:
- A "mitochondrial preconditioning" mechanism exists, independent of cytosolic signaling.
- This intrinsic mitochondrial protection requires connexin-43 and safeguards against IR-induced respiratory failure and oxidative stress.

