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Open Access Research

Effect of remote ischemic post-conditioning on systemic inflammatory response and survival rate in lipopolysaccharide-induced systemic inflammation model

Yun-Hee Kim1, Dae-Wui Yoon2, Je-Hyeong Kim2, Jeoung-Hyuk Lee3 and Choon-Hak Lim4*

Author Affiliations

1 Department of Anaesthesiology and Pain Medicine, Korea University College of Medicine, Ansan, Republic of Korea

2 Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine, Ansan, Republic of Korea

3 Department of Anaesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Ilsan, Republic of Korea

4 Department of Anaesthesiology and Pain Medicine, Korea University College of Medicine, Seoul, Republic of Korea

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Journal of Inflammation 2014, 11:16  doi:10.1186/1476-9255-11-16

Published: 21 May 2014

Abstract

Background

Remote ischemic preconditioning (RIPC) and postconditioning (RpostC) have protective effects on ischemia and reperfusion injury. The effects have been reported to activate heme oxygenase-1 (HO-1) and attenuate nuclear factor kappa B (NF-κB) and subsequently reduce systemic inflammation. Ischemic preconditioning prevented inflammatory responses by modulating HO-1 expression in endotoxic shock model. Therefore, we investigated whether RpostC could have protective effects on lipopolysaccharide (LPS)-induced systemic inflammation.

Methods

The LPS-induced sepsis mice received LPS (20 mg/kg) intraperitoneally. Remote ischemic conditioning was induced with three 10-min ischemia/10-min reperfusion cycles of the right hind limbs using tourniquet before LPS injection (RIPC) or after LPS injection (RpostC). The effects of RIPC and RpostC were examined for the survival rate, serum cytokines, NF-κB, HO-1 and liver pathology in the LPS injected mice.

Results

Survival rate within 120 hours significantly increased in the LPS injected and remote ischemic conditioned mice than in LPS only injected mice (60-65% vs 5%, respectively, p < 0.01). Tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and interleukin-6 (IL-6) increased markedly in the LPS only injected mice, however, remote ischemic conditioning suppressed the changes (p < 0.05). Interleukin-10 (IL-10) level was significantly higher in the LPS injected and RpostC treated mice than in the LPS only injected mice (p = 0.014). NF-κB activation was significantly attenuated (p < 0.05) and HO-1 levels were substantially higher in the LPS injected and remote ischemic conditioned mice than in the LPS only injected mice. Neutrophil infiltration was significantly attenuated in the LPS injected and remote ischemic conditioned mice than in the only LPS injected mice (p < 0.05).

Conclusions

RpostC attenuated inflammatory responses and improved survival outcomes of mice with LPS-induced systemic inflammation. The mechanism may be caused by modifying NF-κB mediated expression of cytokines.

Keywords:
Remote ischemic preconditioning; Remote ischemic postconditioning; Systemic inflammation