Remote ischaemic preconditioning modifies serum apolipoprotein D, met-enkephalin, adenosine, and nitric oxide in healthy young adults.

Abstract

Remote ischaemic preconditioning (RIPC) has been employed as a non-invasive protective intervention against myocardial ischaemia-reperfusion injury in animal studies. However, the underlying mechanisms are incompletely defined in humans and its clinical efficacy has been inconclusive. As advanced age, disease, and drugs may confound RIPC mechanisms in patients, our aim is to measure whether RIPC evokes release of adenosine, bradykinin, met-enkephalin, nitric oxide, and apolipoproteins in healthy young adults. Healthy subjects (n=18, 9 males, 23±1.5years old; 9 females, 23±1.8years old) participated after informed consent. RIPC was applied using a blood pressure cuff to the dominant arms for four cycles of 5-minute cuff inflation (ischaemia) and 5-minute cuff deflation (reperfusion). Blood was sampled at baseline and immediately after the final cuff deflation (Post-RIPC). Baseline and Post-RIPC plasma levels of adenosine, bradykinin, met-enkephalin, apolipoprotein A-1 (ApoA-1), apolipoprotein D (ApoD), and nitric oxide (as nitrite) were measured via ELISA and high-performance liquid chromatography. Mean (±SD) baseline levels of adenosine, bradykinin, met-enkephalin, ApoA-1, ApoD, and nitrite in healthy young adults were 13.8±6.5ng/mL, 2.6±1.9μg/mL, 594.1±197.4pg/mL, 3.0±0.7mg/mL, 22.2±4.0μg/mL, and 49.8±13.4nmol/L, respectively. Post-RIPC adenosine and nitrite levels increased (59.5±37.9%, P<.0001; 32.2±19.5%, P<.0001), whereas met-enkephalin and ApoD levels marginally decreased (5.3±14.0%, P=.04; 10.8±20.5%, P=.04). Post-RIPC levels were not influenced by sex, age, blood pressure, waist circumference, or BMI. RIPC produces increased levels of adenosine and nitrites, and decreased met-enkephalin and ApoD in the plasma of young healthy adults.