Intestinal preconditioning prevents systemic inflammatory response in hemorrhagic shock. Role of HO-1.
Intestinal ischemia-reperfusion has been implicated in the systemic inflammatory response and organ injury in hemorrhagic shock, but the exact role of the intestine has never been directly demonstrated. Preconditioning (PC) with brief periods of intermittent ischemia is a known potent anti-ischemic intervention and thus can be used as a tool to assess the role of local intestinal ischemia-reperfusion injury in systemic inflammatory response. Thus rats were first subjected to sham surgery or intestinal preconditioning with four cycles of 1-min ischemia and 10 min of reperfusion 24 h before hemorrhagic shock followed by resuscitation. PC reduced fluid requirements, lung edema, and lactate and tumor necrosis factor-alpha production. These effects were abolished by the heme-oxygenase-1 (HO-1) inhibitor tin protoporphyrin (Sn-PP). PC induced more than fivefold in intestinal HO-1 expression. These results suggest that intestinal ischemia-reperfusion is a major trigger for inflammatory response and organ injury in nonseptic shock. HO-1 appears to play an important role in the protective effect of intestinal preconditioning.
Institut National de la Santé et de la Recherche Médicale, Rouen University Medical School and Rouen University Hospital, France 76183.
Fabienne
F
Tamion
Vincent
V
Richard
Yann
Y
Lacoume
Christian
C
Thuillez
D000818:Animals; D005440:Fluid Therapy; D006419:Heme Oxygenase (Decyclizing) / Q000378:metabolism*; D051547:Heme Oxygenase-1; D007249:Inflammation / Q000517:prevention & control*; D007422:Intestines / Q000502:physiology*; D019194:Ischemic Preconditioning; D019344:Lactic Acid / Q000378:metabolism; D008297:Male; D011654:Pulmonary Edema / Q000209:etiology; D051381:Rats; D017208:Rats, Wistar; D012771:Shock, Hemorrhagic / Q000503:physiopathology*; D013152:Splanchnic Circulation; D016019:Survival Analysis; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D014409:Tumor Necrosis Factor-alpha; D019344:Lactic Acid; D006419:Heme Oxygenase (Decyclizing); D051547:Heme Oxygenase-1