Header

UZH-Logo

Maintenance Infos

Anaesthetics and cardiac preconditioning. Part I. Signalling and cytoprotective mechanisms


Zaugg, M; Lucchinetti, E; Uecker, M; Pasch, T; Schaub, M C (2003). Anaesthetics and cardiac preconditioning. Part I. Signalling and cytoprotective mechanisms. British Journal of Anaesthesia, 91(4):551-565.

Abstract

Cardiac preconditioning represents the most potent and consistently reproducible method of rescuing heart tissue from undergoing irreversible ischaemic damage. Major milestones regarding the elucidation of this phenomenon have been passed in the last two decades. The signalling and amplification cascades from the preconditioning stimulus, be it ischaemic or pharmacological, to the putative end‐effectors, including the mechanisms involved in cellular protection, are discussed in this review. Volatile anaesthetics and opioids effectively elicit pharmacological preconditioning. Anaesthetic‐induced preconditioning and ischaemic preconditioning share many fundamental steps, including activation of G‐protein‐coupled receptors, multiple protein kinases and ATP‐sensitive potassium channels (KATP channels). Volatile anaesthetics prime the activation of the sarcolemmal and mitochondrial KATP channels, the putative end‐effectors of preconditioning, by stimulation of adenosine receptors and subsequent activation of protein kinase C (PKC) and by increased formation of nitric oxide and free oxygen radicals. In the case of desflurane, stimulation of α‐ and β‐adrenergic receptors may also be of importance. Similarly, opioids activate δ‐ and κ‐opioid receptors, and this also leads to PKC activation. Activated PKC acts as an amplifier of the preconditioning stimulus and stabilizes, by phosphorylation, the open state of the mitochondrial KATP channel (the main end‐effector in anaesthetic preconditioning) and the sarcolemmal KATP channel. The opening of KATP channels ultimately elicits cytoprotection by decreasing cytosolic and mitochondrial Ca2+ overload. Br J Anaesth 2003; 91: 551-65

Abstract

Cardiac preconditioning represents the most potent and consistently reproducible method of rescuing heart tissue from undergoing irreversible ischaemic damage. Major milestones regarding the elucidation of this phenomenon have been passed in the last two decades. The signalling and amplification cascades from the preconditioning stimulus, be it ischaemic or pharmacological, to the putative end‐effectors, including the mechanisms involved in cellular protection, are discussed in this review. Volatile anaesthetics and opioids effectively elicit pharmacological preconditioning. Anaesthetic‐induced preconditioning and ischaemic preconditioning share many fundamental steps, including activation of G‐protein‐coupled receptors, multiple protein kinases and ATP‐sensitive potassium channels (KATP channels). Volatile anaesthetics prime the activation of the sarcolemmal and mitochondrial KATP channels, the putative end‐effectors of preconditioning, by stimulation of adenosine receptors and subsequent activation of protein kinase C (PKC) and by increased formation of nitric oxide and free oxygen radicals. In the case of desflurane, stimulation of α‐ and β‐adrenergic receptors may also be of importance. Similarly, opioids activate δ‐ and κ‐opioid receptors, and this also leads to PKC activation. Activated PKC acts as an amplifier of the preconditioning stimulus and stabilizes, by phosphorylation, the open state of the mitochondrial KATP channel (the main end‐effector in anaesthetic preconditioning) and the sarcolemmal KATP channel. The opening of KATP channels ultimately elicits cytoprotection by decreasing cytosolic and mitochondrial Ca2+ overload. Br J Anaesth 2003; 91: 551-65

Statistics

Citations

Dimensions.ai Metrics
188 citations in Web of Science®
201 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

13 downloads since deposited on 10 Oct 2018
8 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:National licences > 142-005
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Anesthesiology and Pain Medicine
Uncontrolled Keywords:Anesthesiology and Pain Medicine
Language:English
Date:1 October 2003
Deposited On:10 Oct 2018 13:10
Last Modified:31 Jul 2020 02:22
Publisher:Elsevier
ISSN:0007-0912
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1093/bja/aeg205
Related URLs:https://www.swissbib.ch/Search/Results?lookfor=nationallicenceoxford101093bjaaeg205 (Library Catalogue)

Download

Hybrid Open Access

Download PDF  'Anaesthetics and cardiac preconditioning. Part I. Signalling and cytoprotective mechanisms'.
Preview
Content: Published Version
Language: English
Filetype: PDF (Nationallizenz 142-005)
Size: 426kB
View at publisher