title: Local heat shock priming promotes recanalization of thromboembolized microvasculature by upregulation of plasminogen activators.
abstract: OBJECTIVE
  Thromboembolization and subsequent microvascular perfusion failure is implicated in the pathology of a variety of diseases, including transient ischemic attack (TIA), stroke, and myocardial infarction, and also for the complications after interventional and microsurgical procedures in coronary heart disease and peripheral arterial occlusive disease. In vitro heat shock priming has been suggested to induce plasminogen activators, which are the major upregulators of the fibrinolytic system. Herein, we determined whether local heat shock priming endogenously upregulates plasminogen activators also in vivo, and whether this promotes recanalization of thromboembolized microvasculature.
  
  
  RESULTS
  To induce thromboembolization, a suspension of preformed microthrombi (maximum diameter: 40 microm) was injected via the femoral artery into the left hindlimbs of anesthetized rats. Local heat shock priming (42.5 degrees C, 30 minutes) was performed 24 hours before embolization and resulted in a significant increase of endothelium-derived plasminogen activator expression. The study of the microcirculation by intravital microscopy revealed in all tissues analyzed (muscle, periosteum, subcutis, and skin) that heat shock priming significantly (P<0.05) accelerates recanalization of the thromboembolized microvasculature when compared with nonprimed and sham-primed controls. Importantly, the addition of plasminogen activator inhibitor-1 to the microthrombi suspension completely blunted the heat shock-induced acceleration of microvascular recanalization.
  
  
  CONCLUSIONS
  Heat shock induces endogenous hyperfibrinolysis by upregulation of plasminogen activators that promote recanalization of thromboembolized microvasculature.
authors.affiliation: Institute for Clinical & Experimental Surgery, University of Saarland, D-66421 Homburg/Saar, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Rücker
authors.forename: Thilo
authors.initials: T
authors.lastname: Schäfer
authors.forename: Claudia
authors.initials: C
authors.lastname: Scheuer
authors.forename: Yves
authors.initials: Y
authors.lastname: Harder
authors.forename: Brigitte
authors.initials: B
authors.lastname: Vollmar
authors.forename: Michael D
authors.initials: MD
authors.lastname: Menger
mesh_terms: D000818:Animals; D005342:Fibrinolysis; D018869:Heat-Shock Response; D008833:Microcirculation; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D010960:Plasminogen Activators / Q000378:metabolism*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013923:Thromboembolism / Q000503:physiopathology*; D010959:Tissue Plasminogen Activator / Q000097:blood; D015854:Up-Regulation; D014568:Urokinase-Type Plasminogen Activator / Q000097:blood
chemical_list: D017395:Plasminogen Activator Inhibitor 1; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator