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Role of Ischemic Preconditioning on Ischemia-Reperfusion Injury of the Lung^*

* From the Department of Thoracic and Cardiovascular Surgery (Drs. Soncul and Kalaycioglu) and the Department of Physiology (Dr. Öz), Gazi University Medical Faculty, Ankara, Turkey.

Study objectives: Ischemia-reperfusion injury of the lung frequently occurs after cardiopulmonary bypass, after pulmonary thromboembolectomy, and especially during lung transplantation. The protective effects of preconditioning on the heart, liver, bones, and various other organs have been previously evaluated. In this comparative study, we used isolated guinea pig lungs to show the effects of preconditioning on lung ischemia.

Methods: The lungs (n = 10 in each group) were mounted on a modified Langendorff perfusion apparatus and perfused by Krebs-Henseleit solution for 30 min. We applied an ischemic preconditioning (5 min ischemia + 5 min perfusion, two times) in the experimental group. After 3 h of normothermic ischemia, the lungs were reperfused for 30 min. Pulmonary artery pressures and malondialdehyde (MDA) and glutathione (GSH) levels of the tissue and the perfusate were measured before and after the ischemic period and also at the end of reperfusion. Electron microscopic evaluation was done on randomly selected lungs of three animals in each group at the end of the experiment.

Results: Both MDA and GSH levels of tissue and perfusate decreased in the experimental group after reperfusion, although the reduction in GSH levels did not reach statistical significance. The increase in pulmonary artery pressure was lower in the preconditioning group after reperfusion.

Conclusions: Our data showed that ischemic preconditioning of the lung may have a protective effect in ischemic-reperfusion injury.

Key Words: ischemic injury • lung ischemia • preconditioning • reperfusion injury

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