Remote ischaemic preconditioning down-regulates kinin receptor expression in neutrophils of patients undergoing heart surgery.
OBJECTIVES
Remote ischaemic preconditioning (RIPC) may protect distant organs against ischaemia-reperfusion injury. We investigated the impact of RIPC on kinin receptor expression in neutrophils following RIPC in patients undergoing coronary artery bypass grafting (CABG).


METHODS
Patients undergoing elective CABG with cardiopulmonary bypass (CPB) were randomized to RIPC (n = 15) or control (n = 15) groups. The study group underwent RIPC by inflation of a blood pressure cuff on the arm. Expression of kinin receptors, plasma concentrations of IL-6, IL-8, IL-10, TNF-α and neutrophil elastase were determined at baseline (before RIPC/sham), immediately before surgery (after RIPC/sham) and 30 min and 24 h after surgery. Plasma bradykinin levels were assessed before and after RIPC/sham, and at 30 min, 6, 12 and 24 h after surgery. Serum creatine kinase (CK), troponin I, C-reactive protein (CRP) and lactate levels were measured immediately prior to surgery and 30 min, 6, 12, 24 and 48 h after surgery.


RESULTS
Kinin B2 receptor expression did not differ between the groups at baseline (pre-RIPC), but was significantly lower in the RIPC group than in the control group after RIPC/sham (P < 0.05). Expressions of both kinin B1 and B2 receptors were significantly down-regulated in the RIPC group, and this persisted to 24 h after surgery (P < 0.001). Neutrophil elastase levels were significantly increased after surgery. There were no differences in CK, CRP, cytokine, lactate or troponin I levels between the groups.


CONCLUSIONS
RIPC down-regulated the expression of kinin B1 and B2 receptors in neutrophils of patients undergoing CABG.
['Saxena|Pankaj|P|', 'Aggarwal|Shashi|S|', 'Misso|Neil L|NL|', 'Passage|Jurgen|J|', 'Newman|Mark A J|MA|', 'Thompson|Philip J|PJ|', "d'Udekem|Yves|Y|", 'Praporski|Slavica|S|', 'Konstantinov|Igor E|IE|']
D000368:Aged D015415:Biomarkers D001920:Bradykinin D002097:C-Reactive Protein D002315:Cardiopulmonary Bypass D001026:Coronary Artery Bypass D003402:Creatine Kinase D016207:Cytokines D004311:Double-Blind Method D015536:Down-Regulation D005260:Female D006801:Humans D019194:Ischemic Preconditioning D019344:Lactic Acid D019272:Leukocyte Elastase D008297:Male D008875:Middle Aged D009504:Neutrophils D011446:Prospective Studies D043783:Receptor, Bradykinin B1 D043782:Receptor, Bradykinin B2 D012039:Regional Blood Flow D015427:Reperfusion Injury D013997:Time Factors D014111:Tourniquets D016896:Treatment Outcome D019210:Troponin I D034941:Upper Extremity D014904:Western Australia
Ischaemic preconditioning Kinin receptors Bradykinin Cardiac surgery Ischaemia