The effect of pre- and post-remote ischemic conditioning reduces the injury associated with intestinal ischemia/reperfusion

• Published in: Pediatric surgery international Vol. 36; no. 12; pp. 1437 - 1442
• Main Authors: Miyake, Hiromu, Koike, Yuhki, Seo, Shogo, Lee, Carol, Li, Bo, Ganji, Niloofar, Pierro, Agostino
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2020; Springer Nature B.V
• Subjects: Animals; Cytokines; Digestive System Abnormalities - complications; Digestive System Abnormalities - physiopathology; Disease Models, Animal; Gene expression; Histology; Intestinal Volvulus - complications; Intestinal Volvulus - physiopathology; Intestines - physiopathology; Ischemia; Laboratories; Laparotomy; Male; Medicine; Medicine & Public Health; Original Article; Oxidative Stress; Pediatric Surgery; Pediatrics; Proteins; Rats; Rats, Sprague-Dawley; Reperfusion Injury - etiology; Reperfusion Injury - physiopathology; Reperfusion Injury - prevention & control; Surgery; Thoracic surgery; Remote ischemic conditioning; Oxidative stress; Inflammation; Ischemia reperfusion injury
• ISSN: 0179-0358; 1437-9813
• DOI: 10.1007/s00383-020-04762-5

Purpose Midgut volvulus is associated with intestinal ischemia/reperfusion (IR) injury and can progress to severe intestinal damage. Remote ischemic conditioning (RIC) reduces IR-induced injury in distant organs. The aim of this study was to investigate whether RIC protects the intestine from IR injury. Methods We investigated intestinal IR injury in 3 weeks old SD rats. Animals underwent: (i) sham laparotomy, (ii) intestinal IR injury, (iii) intestinal IR + RIC during ischemia, or (iv) intestinal IR + RIC after reperfusion. Intestinal IR injury was achieved by 45 min occlusion of superior mesenteric artery followed by de-occlusion. RIC was administered via four cycles of 5 min of hind limb ischemia followed by 5 min reperfusion. Animals were sacrificed 24 h after surgery and the ileum was harvested for evaluation. Results Intestinal injury was present after IR. However, this injury was reduced in both IR + RIC groups. Expression of inflammatory cytokine IL6 was lower in IR + RIC groups compared to IR alone. Carbonyl protein was also significantly lower in IR + RIC compared to IR, indicating lower oxidative stress in both IR + RIC groups. Conclusion Remote ischemic conditioning attenuated intestinal injury, inflammation, and oxidative stress in experimental intestinal ischemia/reperfusion injury. Remote ischemic conditioning may be useful in children with midgut volvulus to reduce the intestinal injury. Level of evidence Experimental study. Type of study Animal experiment.