title: A practical approach to remote ischemic preconditioning and ischemic preconditioning against myocardial ischemia/reperfusion injury.
abstract: Although urgently needed in clinical practice, a cardioprotective therapeutic approach against myocardial ischemia/ reperfusion injury remains to be established. Remote ischemic preconditioning (rIPC) and ischemic preconditioning (IPC) represent promising tools comprising three entities: the generation of a protective signal, the transfer of the signal to the target organ, and the response to the transferred signal resulting in cardioprotection. However, in light of recent scientific advances, many controversies arise regarding the efficacy of the underlying signaling. We here show methods for the generation of the signaling cascade by rIPC as well as IPC in a mouse model forin vivomyocardial ischemia/ reperfusion injury using highly reproducible approaches. This is accomplished by taking advantage of easily applicable preconditioning strategies compatible with the clinical setting. We describe methods for using laser Doppler perfusion imaging to monitor the cessation and recovery of perfusion in real time. The effects of preconditioning on cardiac function can also be assessed using ultrasound or magnetic resonance imaging approaches. On a cellular level, we confirm how tissue injury can be monitored using histological assessment of infarct size in conjunction with immunohistochemistry to assess both aspects in a single specimen. Finally, we outline, how the rIPC-associated signaling can be transferred to the target cellviaconservation of the signal in the humoral (blood) compartment. This compilation of experimental protocols including a conditioning regimen comparable to the clinical setting should proof useful to both beginners and experts in the field of myocardial infarction, supplying information for the detailed procedures as well as troubleshooting guides.
authors.affiliation: Department of Cardiology and Department of Angiology, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen 45147, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Totzeck
authors.affiliation: Department of Cardiology and Department of Angiology, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen 45147, Germany.
authors.forename: Ulrike B
authors.initials: UB
authors.lastname: Hendgen-Cotta
authors.affiliation: Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22903, USA.
authors.forename: Brent A
authors.initials: BA
authors.lastname: French
authors.affiliation: Department of Cardiology and Department of Angiology, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, Essen 45147, Germany.
authors.forename: Tienush
authors.initials: T
authors.lastname: Rassaf
keywords: laser Doppler perfusion imaging; magnetic resonance imaging; myocardial ischemia/reperfusion; plasma transfer; remote ischemic preconditiong