Mechanism of cardiac preconditioning with volatile anaesthetics.
In recent years, there has been increased interest in the mechanisms involved in anaesthetic-induced cardioprotection. It is not thoroughly understood how volatile anaesthetics protect the myocardium from ischaemia or reperfusion injury, but the overall mechanism is likely to be multifactorial. This review examines the recent experimental and clinical research underlying the cellular and molecular mechanisms involved in anaesthetic-induced preconditioning. A variety of intracellular signalling pathways have been implicated in the protective phenomenon. Ischaemic preconditioning and anaesthetic-induced preconditioning share similar molecular mechanisms, including activation of guanine nucleotide-binding proteins, triggering of second messenger pathways, activation of multiple kinases, mediation of nitric oxide formation and reactive oxygen species release, maintenance of intracellular and/or mitochondrial Ca2+ homeostasis and moderation of the opening of adenosine-triphosphate-sensitive potassium channels. A more thorough understanding of the multiple signalling steps and the ultimate cytoprotective mechanisms underlying anaesthetic-induced preconditioning may lead to improvements in the management of ischaemia and/or reperfusion injury.
Hu
Z-Y
ZY
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, PR China.
Liu
J
J
D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D000818:Animals; D002118:Calcium / Q000378:metabolism; D019204:GTP-Binding Proteins / Q000502:physiology; D006321:Heart / Q000187:drug effects*; D006706:Homeostasis; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial; D054086:KATP Channels / Q000187:drug effects / Q000502:physiology; D009569:Nitric Oxide / Q000502:physiology; D011493:Protein Kinase C / Q000502:physiology; D011505:Protein-Tyrosine Kinases / Q000502:physiology; D017382:Reactive Oxygen Species / Q000378:metabolism
D018685:Anesthetics, Inhalation; D054086:KATP Channels; D017382:Reactive Oxygen Species; D009569:Nitric Oxide; D011505:Protein-Tyrosine Kinases; D011493:Protein Kinase C; D019204:GTP-Binding Proteins; D002118:Calcium