title: Across-Species Transfer of Protection by Remote Ischemic Preconditioning With Species-Specific Myocardial Signal Transduction by Reperfusion Injury Salvage Kinase and Survival Activating Factor Enhancement Pathways.
abstract: BACKGROUND
  Reduction of myocardial infarct size by remote ischemic preconditioning (RIPC), that is, cycles of ischemia/reperfusion in an organ remote from the heart before sustained myocardial ischemia/reperfusion, was confirmed in all species so far, including humans.
  
  
  OBJECTIVE
  To identify myocardial signal transduction of cardioprotection by RIPC.
  
  
  RESULTS
  Anesthetized pigs were subjected to RIPC (4×5/5 minutes hindlimb ischemia/reperfusion) or placebo (PLA) before 60/180 minutes coronary occlusion/reperfusion. Phosphorylation of protein kinase B, extracellular signal-regulated kinase 1/2 (reperfusion injury salvage kinase [RISK] pathway), and signal transducer and activator of transcription 3 (survival activating factor enhancement [SAFE] pathway) in the area at risk was determined by Western blot. Wortmannin/U0126 or AG490 was used for pharmacological RISK or SAFE blockade, respectively. Plasma sampled after RIPC or PLA, respectively, was transferred to isolated bioassay rat hearts subjected to 30/120 minutes global ischemia/reperfusion. RIPC reduced infarct size in pigs to 16±11% versus 43±11% in PLA (% area at risk; mean±SD; P<0.05). RIPC increased the phosphorylation of signal transducer and activator of transcription 3 at early reperfusion, and AG490 abolished the protection, whereas RISK blockade did not. Signal transducer and activator of transcription 5 phosphorylation was decreased at early reperfusion in both RIPC and PLA. In isolated rat hearts, pig plasma taken after RIPC reduced infarct size (25±5% of ventricular mass versus 38±5% in PLA; P<0.05) and activated both RISK and SAFE. RISK or SAFE blockade abrogated this protection.
  
  
  CONCLUSIONS
  Cardioprotection by RIPC in pigs causally involves activation of signal transducer and activator of transcription 3 but not of RISK. Protection can be transferred with plasma from pigs to isolated rat hearts where activation of both RISK and SAFE is causally involved. The myocardial signal transduction of RIPC is the same as that of ischemic postconditioning.
authors.affiliation: From the Institute for Pathophysiology, West German Heart and Vascular Center, University of Essen Medical School, Essen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Skyschally
authors.affiliation: From the Institute for Pathophysiology, West German Heart and Vascular Center, University of Essen Medical School, Essen, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Gent
authors.affiliation: From the Institute for Pathophysiology, West German Heart and Vascular Center, University of Essen Medical School, Essen, Germany.
authors.forename: Georgios
authors.initials: G
authors.lastname: Amanakis
authors.affiliation: From the Institute for Pathophysiology, West German Heart and Vascular Center, University of Essen Medical School, Essen, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Schulte
authors.affiliation: From the Institute for Pathophysiology, West German Heart and Vascular Center, University of Essen Medical School, Essen, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Kleinbongard
authors.affiliation: From the Institute for Pathophysiology, West German Heart and Vascular Center, University of Essen Medical School, Essen, Germany. gerd.heusch@uk-essen.de.
authors.forename: Gerd
authors.initials: G
authors.lastname: Heusch
mesh_terms: D000818:Animals; D001794:Blood Pressure; D001803:Blood Transfusion; D003326:Coronary Circulation; D006439:Hemodynamics; D006614:Hindlimb / Q000098:blood supply*; D019194:Ischemic Preconditioning / Q000379:methods*; D020935:MAP Kinase Signaling System / Q000187:drug effects; D019950:Mitogen-Activated Protein Kinase 1 / Q000502:physiology; D048052:Mitogen-Activated Protein Kinase 3 / Q000037:antagonists & inhibitors / Q000502:physiology; D009203:Myocardial Infarction / Q000097:blood / Q000201:enzymology / Q000473:pathology / Q000628:therapy*; D015428:Myocardial Reperfusion Injury; D009928:Organ Specificity; D010766:Phosphorylation; D047428:Protein Kinase Inhibitors / Q000494:pharmacology; D011494:Protein Kinases / Q000502:physiology*; D011499:Protein Processing, Post-Translational; D051057:Proto-Oncogene Proteins c-akt / Q000037:antagonists & inhibitors / Q000502:physiology; D051381:Rats; D011917:Rats, Inbred Lew / Q000502:physiology*; D050796:STAT3 Transcription Factor / Q000502:physiology; D050799:STAT5 Transcription Factor / Q000502:physiology; D015398:Signal Transduction / Q000187:drug effects / Q000502:physiology*; D013552:Swine; D013556:Swine, Miniature / Q000097:blood / Q000502:physiology*
chemical_list: D047428:Protein Kinase Inhibitors; D050796:STAT3 Transcription Factor; D050799:STAT5 Transcription Factor; D011494:Protein Kinases; D051057:Proto-Oncogene Proteins c-akt; D019950:Mitogen-Activated Protein Kinase 1; D048052:Mitogen-Activated Protein Kinase 3
keywords: myocardial infarction; myocardial ischemia; reperfusion injury; signal transduction