Ischemic Preconditioning Directly or Remotely Applied on the Liver to Reduce Ischemia-Reperfusion Injury in Resections and Transplantation

Cornide‐Petronio, María Eugenia; Jiménez‐Castro, Mónica B.; Gracia‐Sancho, Jordi; Peralta, Carmen A.

doi:10.5772/intechopen.86148

Cited by 5 publications

(6 citation statements)

References 74 publications

(88 reference statements)

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“…Both the anhepatic phase of LT and the vascular occlusion used in hepatic resection result in splanchnic congestion, affecting the intestine and lungs, among other organs [58,59,60,61,62]. It is, therefore, clearly of clinical and scientific importance to develop protective strategies in liver surgery [63].…”

Section: Ischemia-reperfusion Injury An Unresolved Problem In CLImentioning

confidence: 99%

Inflammasome-Mediated Inflammation in Liver Ischemia-Reperfusion Injury

Jiménez‐Castro

Cornide‐Petronio

Gracia‐Sancho

et al. 2019

Cells

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170

138

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Ischemia-reperfusion injury is an important cause of liver damage occurring during surgical procedures including hepatic resection and liver transplantation, and represents the main underlying cause of graft dysfunction and liver failure post-transplantation. To date, ischemia-reperfusion injury is an unsolved problem in clinical practice. In this context, inflammasome activation, recently described during ischemia-reperfusion injury, might be a potential therapeutic target to mitigate the clinical problems associated with liver transplantation and hepatic resections. The present review aims to summarize the current knowledge in inflammasome-mediated inflammation, describing the experimental models used to understand the molecular mechanisms of inflammasome in liver ischemia-reperfusion injury. In addition, a clear distinction between steatotic and non-steatotic livers and between warm and cold ischemia-reperfusion injury will be discussed. Finally, the most updated therapeutic strategies, as well as some of the scientific controversies in the field will be described. Such information may be useful to guide the design of better experimental models, as well as the effective therapeutic strategies in liver surgery and transplantation that can succeed in achieving its clinical application.

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Section: Ischemia-reperfusion Injury An Unresolved Problem In CLImentioning

confidence: 99%

Inflammasome-Mediated Inflammation in Liver Ischemia-Reperfusion Injury

Jiménez‐Castro

Cornide‐Petronio

Gracia‐Sancho

et al. 2019

Cells

Self Cite

170

138

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“…RIPC has been found to intensify hepatic oxygenation and hepatic microcirculation via activation of eNOS [ 19 ], as well as to increase expression of protector proteins (e.g. heme oxygenase 1) [ 20 ], which preserves mitochondrial functionality. Hence, produced SCACs can be spent more efficiently in the case of RIPC and, based on our findings we could suppose that RIPC might have a protective effect on the liver.…”

Section: Discussionmentioning

confidence: 99%

Remote ischaemic preconditioning influences the levels of acylcarnitines in vascular surgery: a randomised clinical trial

et al. 2020

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Background Vascular surgery patients have reduced tissues` blood supply, which may lead to mitochondrial dysfunction and accumulation of acylcarnitines (ACs). It has been suggested that remote ischaemic preconditioning (RIPC) has its organ protective effect via promoting mitochondrial function. The aim of this study was to evaluate the effect of RIPC on the profile of ACs in the vascular surgery patients. Methods This is a randomised, sham-controlled, double-blinded, single-centre study. Patients undergoing open surgical repair of abdominal aortic aneurysm, surgical lower limb revascularisation surgery or carotid endarterectomy were recruited non-consecutively. The RIPC protocol consisting of 4 cycles of 5 min of ischaemia, followed by 5 min of reperfusion, was applied. A blood pressure cuff was used for RIPC or a sham procedure. Blood was collected preoperatively and approximately 24 h postoperatively. The profile of ACs was analysed using the AbsoluteIDQp180 kit (Biocrates Life Sciences AG, Innsbruck, Austria). Results Ninety-eight patients were recruited and randomised into the study groups and 45 patients from the RIPC group and 47 patients from the sham group were included in final analysis. There was a statistically significant difference between the groups regarding the changes in C3-OH (p = 0.023)—there was a decrease (− 0.007 µmol/L, ± 0.020 µmol/L, p = 0.0233) in the RIPC group and increase (0.002 µmol/L, ± 0.015 µmol/L, p = 0.481) in the sham group. Additionally, a decrease from baseline to 24 h after surgery (p < 0.05) was detected both in the sham and the RIPC group in the levels of following ACs: C2, C8, C10, C10:1, C12, C12:1, C14:1, C14:2, C16, C16:1, C18, C18:1, C18:2. In the sham group, there was an increase (p < 0.05) in the levels of C0 (carnitine) and a decrease in the level of C18:1-OH. In the RIPC group, a decrease (p < 0.05) was noted in the levels of C3-OH, C3-DC (C4-OH), C6:1, C9, C10:2. Conclusions It can be concluded that RIPC may have an effect on the levels of ACs and might therefore have protective effects on mitochondria in the vascular surgery patients. Further larger studies conducted on homogenous populations are needed to make more definite conclusions about the effect of RIPC on the metabolism of ACs. Trial registration ClinicalTrials.gov database, NCT02689414. Registered 24 February 2016—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02689414.

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“…RIPC has been found to intensify hepatic oxygenation and hepatic microcirculation via activation of eNOS [19], as well as to increase expression of protector proteins (e.g. heme oxygenase 1) [20], which preserves mitochondrial functionality. Hence, produced SCACs can be spent more e ciently in the case of RIPC and, based on our ndings we could suppose that RIPC might have a protective effect on the liver.…”

Section: Discussionmentioning

confidence: 99%

Remote ischaemic preconditioning influences the levels of acylcarnitines in vascular surgery: a randomised clinical trial

Kasepalu

Kuusik

Lepner

et al. 2020

Preprint

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Background Vascular surgery affects tissues` blood supply and microcirculation and might lead to mitochondrial dysfunction, which may result in the accumulation of acylcarnitines (ACs). It has been suggested that remote ischaemic preconditioning (RIPC) has its organ protective effect via promoting mitochondrial function. The aim of this study was to evaluate the effect of RIPC on the profile of ACs in the vascular surgery patients. Methods. This is a randomised, sham-controlled, double-blinded, single-centre study. Patients undergoing open abdominal aortic aneurysm repair, surgical lower limb revascularisation surgery or carotid endarterectomy were recruited non-consecutively. The RIPC protocol consisting of 4 cycles of 5 minutes of ischaemia, followed by 5 minutes of reperfusion, was applied. A blood pressure cuff was used for RIPC or a sham procedure. Blood was collected preoperatively and approximately 24 hours postoperatively. The profile of ACs was analysed using the AbsoluteIDQp180 kit (Biocrates Life Sciences AG, Innsbruck, Austria). Results Ninety-eight patients were recruited and randomised into the study groups and 45 patients from the RIPC group and 47 patients from the sham group were included in final analysis. There was a statistically significant difference between the groups regarding the changes in C3-OH (p=0.023) - there was a decrease (-0.007 µmol/L, ± 0.020 µmol/L, p=0.0233) in the RIPC group and increase (0.002 µmol/L, ±0.015 µmol/L, p=0.481) in the sham group. Additionally, a decrease from baseline to 24 hours after surgery (p<0.05) was detected both in the sham and the RIPC group in the levels of following ACs: C2, C8, C10, C10:1, C12, C12:1, C14:1, C14:2, C16, C16:1, C18, C18:1, C18:2. In the sham group, there was an increase (p<0.05) in the levels of C0 (carnitine) and a decrease in the level of C18:1-OH. In the RIPC group, a decrease (p<0.05) was noted in the levels of C3-OH, C3-DC (C4-OH), C6:1, C9, C10:2. Conclusions It can be concluded that RIPC may have an effect on the levels of ACs and might therefore have protective effects on mitochondria in the vascular surgery patients. Further studies conducted on metabolically more homogenous populations are needed to make more definite conclusions about the effect of RIPC on the levels of ACs. Trial registration: ClinicalTrials.gov database, NCT02689414. Registered 24 February 2016 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02689414.

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Ischemic Preconditioning Directly or Remotely Applied on the Liver to Reduce Ischemia-Reperfusion Injury in Resections and Transplantation

Cited by 5 publications

References 74 publications

Inflammasome-Mediated Inflammation in Liver Ischemia-Reperfusion Injury

Inflammasome-Mediated Inflammation in Liver Ischemia-Reperfusion Injury

Remote ischaemic preconditioning influences the levels of acylcarnitines in vascular surgery: a randomised clinical trial

Remote ischaemic preconditioning influences the levels of acylcarnitines in vascular surgery: a randomised clinical trial

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