Evaluation of Nephroprotective Efficacy of Hypoxic Preconditioning in Patients Undergoing Coronary Artery Bypass Surgery

Vesnina, Zh. V.; Lishmanov, Yu. B.; Alexandrova, Ekaterina A.; Нестеров, Е. А.

doi:10.1159/000446571

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…1 Despite extensive research, therapies for AKI are still lacking in clinical practice. In contrast, preventive strategies using various so-called preconditioning protocols, including caloric restriction (CR) and interventions activating hypoxia signaling (ischemic preconditioning [IP] and hypoxic preconditioning [HP]), [2][3][4] have been found to be extraordinarily effective in animal models. Although it has long been known that CR 5 and activation of hypoxia signaling 6,7 lead to an extension of healthy lifespan, more recent experiments demonstrated that a short-term application of CR or IP/HP induces robust protection of various organs, including heart, 8 kidney, 9,10 brain, and liver.…”

Section: Resultsmentioning

confidence: 99%

The Integrated RNA Landscape of Renal Preconditioning against Ischemia-Reperfusion Injury

Johnsen¹,

Kubacki²,

Yeroslaviz³

et al. 2020

JASN

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BackgroundAlthough AKI lacks effective therapeutic approaches, preventive strategies using preconditioning protocols, including caloric restriction and hypoxic preconditioning, have been shown to prevent injury in animal models. A better understanding of the molecular mechanisms that underlie the enhanced resistance to AKI conferred by such approaches is needed to facilitate clinical use. We hypothesized that these preconditioning strategies use similar pathways to augment cellular stress resistance.MethodsTo identify genes and pathways shared by caloric restriction and hypoxic preconditioning, we used RNA-sequencing transcriptome profiling to compare the transcriptional response with both modes of preconditioning in mice before and after renal ischemia-reperfusion injury.ResultsThe gene expression signatures induced by both preconditioning strategies involve distinct common genes and pathways that overlap significantly with the transcriptional changes observed after ischemia-reperfusion injury. These changes primarily affect oxidation-reduction processes and have a major effect on mitochondrial processes. We found that 16 of the genes differentially regulated by both modes of preconditioning were strongly correlated with clinical outcome; most of these genes had not previously been directly linked to AKI.ConclusionsThis comparative analysis of the gene expression signatures in preconditioning strategies shows overlapping patterns in caloric restriction and hypoxic preconditioning, pointing toward common molecular mechanisms. Our analysis identified a limited set of target genes not previously known to be associated with AKI; further study of their potential to provide the basis for novel preventive strategies is warranted. To allow for optimal interactive usability of the data by the kidney research community, we provide an online interface for user-defined interrogation of the gene expression datasets (http://shiny.cecad.uni-koeln.de:3838/IRaP/).

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Section: Resultsmentioning

confidence: 99%

The Integrated RNA Landscape of Renal Preconditioning against Ischemia-Reperfusion Injury

Johnsen¹,

Kubacki²,

Yeroslaviz³

et al. 2020

JASN

View full text Add to dashboard Cite

show abstract

“…For example, HPC induced neuroprotection against transient global cerebral ischemia in adult rats [10]. Furthermore, a recent clinical trial found that a 10-min HPC could protect the kidneys from ischemic injury and postsurgical dysfunction in patients undergoing coronary artery bypass surgery [14].…”

Section: Introductionmentioning

confidence: 99%

Hypoxia preconditioning attenuates lung injury after thoracoscopic lobectomy in patients with lung cancer: a prospective randomized controlled trial

Zhang

Chen

et al. 2019

BMC Anesthesiol

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BackgroundHypoxic preconditioning (HPC) may protect multiple organs from various injuries. We hypothesized that HPC would reduce lung injury in patients undergoing thoracoscopic lobectomy.MethodsIn a prospective randomized controlled trial, 70 patients undergoing elective thoracoscopic lobectomy were randomly allocated to the HPC group or the control group. Three cycles of 5-min hypoxia and 3-min ventilation applied to the nondependent lung served as the HPC intervention. The primary outcome was the PaO2/FiO2 ratio. Secondary outcomes included postoperative pulmonary complications, pulmonary function, and duration of hospital stay.ResultsHPC significantly increased the PaO2/FiO2 ratio compared with the control at 30 min after one-lung ventilation and 7 days after operation. Compared with the control, it also significantly improved postoperative pulmonary function and markedly reduced the postoperative hospital stay duration. No significant differences between groups were observed in the incidence of pulmonary complications or overall postoperative morbidity.ConclusionsHPC improves postoperative oxygenation, enhances the recovery of pulmonary function, and reduces the duration of hospital stay in patients undergoing thoracoscopic lobectomy.Trial registrationThis study was registered in the Chinese Clinical Trial Registry (ChiCTR-IPR-17011249) on April 27, 2017.

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Activation of hypoxia-sensing pathways promotes renal ischemic preconditioning following myocardial infarction

Terker

Sasaki

Arroyo

et al. 2021

American Journal of Physiology-Renal Physiology

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Ischemic heart disease is the leading cause of death worldwide and is frequently comorbid with chronic kidney disease. Physiological communication is known to occur between the heart and the kidney and primary dysfunction in either organ can induce dysfunction in the other, a clinical entity known as cardiorenal syndrome, but mechanistic details are lacking. Here, we used a model of experimental myocardial infarction (MI) to test effects of chronic cardiac ischemia on acute and chronic kidney injury. Surprisingly, chronic cardiac damage protected animals from subsequent acute ischemic renal injury, an effect that was accompanied by evidence of chronic kidney hypoxia. The protection observed post-MI was similar to protection observed in a separate group of healthy animals housed in ambient hypoxic conditions prior to kidney injury, suggesting a common mechanism. There was evidence that chronic cardiac injury activates renal hypoxia-sensing pathways. Increased renal abundance of several glycolytic enzymes following MI suggested a shift towards anaerobic glycolysis may confer renal ischemic preconditioning. In contrast, effects on chronic renal injury followed a different pattern with post-MI animals displaying worsened chronic renal injury and fibrosis. These data show that while chronic cardiac injury following MI protected against acute kidney injury via activation of hypoxia-sensing pathways, it worsened chronic kidney injury. The results further our understanding of cardiorenal signaling mechanisms and have implications for the treatment of heart failure patients with associated renal disease.

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Evaluation of Nephroprotective Efficacy of Hypoxic Preconditioning in Patients Undergoing Coronary Artery Bypass Surgery

Cited by 3 publications

References 25 publications

The Integrated RNA Landscape of Renal Preconditioning against Ischemia-Reperfusion Injury

The Integrated RNA Landscape of Renal Preconditioning against Ischemia-Reperfusion Injury

Hypoxia preconditioning attenuates lung injury after thoracoscopic lobectomy in patients with lung cancer: a prospective randomized controlled trial

Activation of hypoxia-sensing pathways promotes renal ischemic preconditioning following myocardial infarction

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