Perdrizet G A, Shapiro D S, Rewinski M J
Hartford Hospital, CT 06102, USA.
Ann N Y Acad Sci. 1999 Jun 30;874:320-5. doi: 10.1111/j.1749-6632.1999.tb09247.x.
All forms of surgical therapy are stressful and injurious. The majority of surgical procedures are performed electively and provide an opportunity to condition the patient before surgery to maximize outcome. We have successfully protected the spinal cord and kidneys from warm ischemia-reperfusion injury with whole-body heat shock (42.5 degrees C, 15 min, HS) and recovery (37 degrees C, 6-8 h) before acute aortic occlusion. Control rabbits experienced an 88% incidence of paralysis (7/8) after acute spinal cord ischemia, while HS-pretreated animals never became paralyzed (0/9, p < 0.001). Control pig kidneys showed partial function (4/8 survival) after 90-min warm ischemia, while HS-pretreated kidneys always functioned (8/8 survival, p < 0.04). A positive temporal association was made between the HS-associated functional protection and the enhanced expression of inducible HSP70. The induction of the heat-shock response (cellular stress response) to protect tissues from lethal acute ischemia-reperfusion injury could be employed in a wide range of medical and surgical settings.
所有形式的外科治疗都具有应激性且会造成损伤。大多数外科手术都是选择性进行的，这为在手术前对患者进行预处理以最大化手术效果提供了机会。我们通过在急性主动脉阻断前进行全身热休克（42.5摄氏度，15分钟，HS）及恢复（37摄氏度，6 - 8小时），成功保护了脊髓和肾脏免受温暖缺血 - 再灌注损伤。对照兔在急性脊髓缺血后出现瘫痪的发生率为88%（7/8），而经HS预处理的动物从未出现瘫痪（0/9，p < 0.001）。对照猪肾在90分钟温暖缺血后显示部分功能（4/8存活），而经HS预处理的肾脏始终保持功能（8/8存活，p < 0.04）。HS相关的功能保护与诱导型HSP70表达增强之间存在正向时间关联。诱导热休克反应（细胞应激反应）以保护组织免受致命性急性缺血 - 再灌注损伤可应用于广泛的医学和外科场景。
