title: Remote or conventional ischemic preconditioning--local liver metabolism in rats studied with microdialysis.
abstract: BACKGROUND
  Ischemic preconditioning (IPC) of the liver decreases liver injury secondary to ischemia and reperfusion. An attractive alternative to IPC is remote ischemic preconditioning (R-IPC), but these two methods have not previously been compared.
  
  
  METHODS
  Eighty-seven rats were randomized into four groups: sham operated (n = 15), 1 h segmental ischemia (IRI, n = 24), preceded by IPC (n = 24), or R-IPC (n = 24) (to the left hindleg). IPC and R-IPC were performed with 10 min ischemia and 10 min of reperfusion. Analyses of liver microdialysate (MD), serum transaminase levels, and liver histology were made.
  
  
  RESULTS
  Rats treated with IPC and R-IPC had significantly lower AST, 71.5 (19.6) IU/L respective 96.6 (12.4) at 4 h reperfusion than those subjected to IRI alone, 155 (20.9), P = 0.0004 and P = 0.04 respectively. IPC also had lower ALT levels, 41.6 (11.3) IU/L than had IRI 107.4 (15.5), P = 0.003. The MD glycerol was significantly higher during ischemia in the R-IPC [759 (84) μM] and the IRI [732 (67)] groups than in the IPC 514 (70) group, P = 0.022 and P = 0.046 respectively. The MD glucose after ischemia was lower in the IPC group 7.1 (1.2) than in the IRI group 12.7 (1.6), P = 0.005. Preconditioning to the liver caused an direct increase in lactate, glucose and glycerol in the ischemic segment compared with the control segment an effect not seen in the R-IPC and IRI groups.
  
  
  CONCLUSIONS
  IPC affects glucose metabolism in the rat liver, observed with MD. IPC reduces liver cell injury during ischemic and reperfusion in rats. R-IPC performed over the same length of time as IPC does not have the same effect as the latter on ALT levels and MD glycerol; this may suggest that R-IPC does not offer the same protection as IPC in this setting of rat liver IRI.
authors.affiliation: Department of Surgery, Faculty of Health Sciences, Linköping University, Surgical Clinic, County Council of Östergötland, Linköping, Sweden. bergthor.bjornsson@lio.se
authors.forename: Bergthor
authors.initials: B
authors.lastname: Björnsson
authors.forename: Anders
authors.initials: A
authors.lastname: Winbladh
authors.forename: Linda
authors.initials: L
authors.lastname: Bojmar
authors.forename: Lena M
authors.initials: LM
authors.lastname: Trulsson
authors.forename: Hans
authors.initials: H
authors.lastname: Olsson
authors.forename: Tommy
authors.initials: T
authors.lastname: Sundqvist
authors.forename: Per
authors.initials: P
authors.lastname: Gullstrand
authors.forename: Per
authors.initials: P
authors.lastname: Sandström
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D005990:Glycerol / Q000378:metabolism; D019194:Ischemic Preconditioning / Q000379:methods*; D007773:Lactates / Q000378:metabolism; D008099:Liver / Q000098:blood supply* / Q000378:metabolism* / Q000473:pathology; D008297:Male; D017551:Microdialysis / Q000379:methods*; D023421:Models, Animal; D011773:Pyruvates / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D000637:Transaminases / Q000097:blood
chemical_list: D001786:Blood Glucose; D007773:Lactates; D011773:Pyruvates; D000637:Transaminases; D005990:Glycerol