| Ischemic preconditioning means to advance one time or more short-term ischemia, so to enhance the tolerance or adaptability of the organization against the subsequent prolonged ischemia / reperfusion injury. Ischemia-reperfusion injury is common in shock microcirculation dredge, coronary spasm mitigation, cardio-cerebral vascular embolization recanalization , heart or lung surgery and cardiac arrest after CPR, replantation of severed limb, organ transplant restore blood supply et al.it is one of the main reasons of the subsequent organ dysfunction. A large number of researches have shown that ischemic preconditioning can significantly reduce the subsequent ischemia-reperfusion injury.Lung ischemia/reperfusion injury were mostly occurred in cardiopulmonary bypass during open heart surgery, pulmonary artery sleeve resection , lung transplantation and pulmonary lobectomy that needs to block one side of the pulmonary artery.It is unfavorable to the resumption of the pulmonary function, and may cause postoperative complications and influence prognosis. Ischemic preconditioning(IP) is the most effective measure to fight against lung ischemia-reperfusion injury, but its exact mechanism of protection have not been clearly clarified. Research shows that preconditioned lungs prior to prolonged ischemia and reperfusion showing better ischemia tolerance and reperfusion tolerance, less leukocyte infiltration, pulmonary edema, pulmonary hemorrhage and alveolar disruption, when the cell structure, the environmental balance, microcirculatory perfusion, energy metabolism, and genetic re-organization has better continuity and recovery capability.The broad masses of scientific workers have conducted fruitful research from animal experiments to clinical trials on the protective mechanisms of lung ischemic preconditioning against ischemia/ reperfusion injury .They found that adenosine, bradykinin, arachidonic acid metabolites, opioid, catecholamines, free radicals, calcium, nitric oxide and reactive oxygen species et al were related to the initiation of the protective effect ,when G-protein, phospholipase C, protein kinase A and protein tyrosine kinase and mitogen-activated protein kinase et al were related to the mediate of the protective effect.In addition, ATP-sensitive potassium channels, 5 'nucleoside enzyme adenosine, transcription factor, inducible nitric oxide synthase and cyclooxygenase-2, aldose reductase, the enzyme-free radicals category and heat shock proteins et al play a role as end-effector. Although existing researches has revealed a number of protective mechanism, it is still can not fully explain how the ischemic preconditioning induced lung protective effect ,and how to effectively reverse ischemia-reperfusion injury.Pulmonary ischemic preconditioning in the clinical study starts relatively late, but ischemic preconditioning can be performed in a safe and elegant manner as an adjunct to major surgery. Proteomics techniques provide a new tool for the study of IP . To this end, here we used proteomics tool to analysis the molecular mechanism of ischemic preconditioning against human lung ischemia/reperfusion injury in patients.Firstly choosed suitable surgical patients and classified to sham-operated group (Sham group, S group), ischemia-reperfusion group (Ischemia-reperfusion group, I/R group) and ischemic preconditioning group (Ischemic preconditioning group, IP group). I/R group only experienced ischemia and reperfusion, IP group experienced ischemia-preconditioned prior to prolonged ischemia and reperfusion, and S group always maintain ventilation and blood. In the end of the trial,collected specimens. Secondly, comparative two-dimensional gel electrophoresis (2-DE) technology was performed to separate the total protein of lung tissue of these three groups, respectively. The well-resolved, reproducible 2-DE patterns of these three groups lung tissue were established. Then, PDQuest software was used to analyze 2-DE images, and the 20 differential expression proteins between these groups were acquired and 17 of them were identified by peptide mass fingerprint (PMF) based on MALDI-TOF-MS (Matrix-assisted laser desorption/ionization time of flight mass spectrometry).Finally, western-blot analysis technology were used to determine the differential expression levels of partial proteins, and the results were identical with the proteome analysis.Above all, 17 differential expressional proteins between the lung tissue of S group, I/R group and IP group were identified by 2-DE with MALDI-TOF-MS. The differentially expressed proteins could be divided into eight main groups based on their functions: metabolic enzymes ,antioxidants, iron-storaged proteins,calcium-binding proteins, chaperones, cytoskeletal protein ,proteins involved in cell proliferation, and proteins relative to signal transduction. Among them, some of proteins were concerned with Spontaneous anti-ischemia-reperfusion injury ability, some principally reflect the active effect of ischemic preconditioning against ischemia-reperfusion injury , such as HSP27 and Cu/ZnSOD,and some were concerned with the stabilization effect of ischemic preconditioning against ischemia-reperfusion injury. These data are valuable for further study of the mechanism of IP against human lung ischemia-reperfusion injury and provide some new clues for searching new methods for reversing ischemia-reperfusion injury.
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