Effect of spinal cord preconditioning on paraplegia during cross-clamping of the thoracic aorta.
BACKGROUND
Paraplegia is a devastating complication of operations for thoracic or thoracoabdominal aneurysms. Preconditioning the brain with sublethal ischemia induces resistance to subsequent ordinarily lethal ischemia (ischemic tolerance). We investigated whether ischemic tolerance could be induced by preconditioning canine spinal cord. The role of heat-shock proteins (HSP) in this process was investigated.


METHODS
In experiment 1, the preconditioning group (n = 6) had aortic cross-clamping for 20 minutes, whereas controls (n = 6) had no cross-clamping. After 48 hours the aorta was cross-clamped for 60 minutes in both groups. Neurologic examination was performed 24 hours later and the spinal cord was studied for immunohistochemically. In experiment 2, either 48 hours after 20 minutes of clamping or after sham operation (n = 4), HSP were investigated immunohistochemically.


RESULTS
In experiment 1, 3 of 6 controls became paraplegic but none of the 6 preconditioning group dogs became paraplegic. The HSP appeared on sections from all 6 PC dogs and 3 control dogs that did not exhibit paraplegia. In experiment 2, HSP were present in clamped animals but could not be detected after sham operation.


CONCLUSIONS
Ischemic tolerance was induced by preconditioning the canine spinal cord, in which HSP are believed to be involved.
Matsuyama
K
K
Second Department of Surgery, Fukui Medical School, Japan.
Chiba
Y
Y
Ihaya
A
A
Kimura
T
T
Tanigawa
N
N
Muraoka
R
R
D000818:Animals; D001013:Aorta, Thoracic / Q000601:surgery; D001794:Blood Pressure; D003250:Constriction; D004195:Disease Models, Animal; D004285:Dogs; D018840:HSP70 Heat-Shock Proteins / Q000378:metabolism; D006439:Hemodynamics; D019194:Ischemic Preconditioning; D010264:Paraplegia / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D013116:Spinal Cord / Q000098:blood supply*
D018840:HSP70 Heat-Shock Proteins