Effect of Remote Ischemic Preconditioning on Rat Sepsis: Comparison of Two Sepsis Models

초록

Background and Objectives: Remote ischemic preconditioning (RIPC) is a procedure that temporarily compress and relieve distant limbs before fatal ischemia-reperfusion injury of key organs. Because the therapeutic eHect of RIPC is associated with a blunted immune/inflammatory response, RIPC has been expected to improve sepsis. This experiment was designed to confirm whether RIPC can improve the survival rate of septic rats and their clinical blood test based on SOFA criteria. Methods: Two types of sepsis model in SD rats were used: the lipopolysaccharide (LPS)-induced endotoxemia model and the cecal ligation and puncture (CLP) peritonitis model. The survival rate of the control, LPS, RIPC/LPS, CLP, and RIPC/CLP group was observed for 3 days. Clinical blood tests included serum total bilirubin level, BUN and serum creatinine levels, platelet count, serum lactate level. Results: The survival rate of five groups is shown in Fig 1. RIPC did not significantly improve the survival rate of the LPS group (P=0.057). There was no diHerence in survival rates between the CLP group and the RIPC/CLP group (P=0.000). All blood test in LPS endotoxemia did not improved at all with the application of RIPC. RIPC also failed to improve bilirubin level and platelet counts changed due to CLP peritonitis. However, BUN, creatinine and lactate level were significantly higher in CLP group than in RIPC/CLP group. Discussion and Conclusion: RIPC could not improve survival rate and clinical blood tests of rats, in both the endotoxemia (rapid progression of infection) and the peritonitis model (gradual progression of sepsis). This is consistent with the result that, as confirmed in the research team's previous studies, the RBC hemorheologic changes of septic rats did not improve by RIPC. In contrary, previous sepsis studies using mice or sheep reported the positive eHect of RIPC. However, due to inconsistent results, additional studies are needed before human studies.