Journal of Anesthesia

, Volume 27, Issue 2, pp 251–260 | Cite as

Delayed anesthetic preconditioning protects against myocardial infarction via activation of nuclear factor-κB and upregulation of autophagy

  • Shigang Qiao
  • Hong Xie
  • Chen Wang
  • Xuemei Wu
  • Hong Liu
  • Chunfeng Liu
Original Article



Delayed volatile anesthetic preconditioning (APC) can protect against myocardial ischemia/reperfusion (I/R) injury; the delayed phase is called the second window of protection (SWOP), but the underlying mechanism is unclear. Nuclear factor-κB (NF-κB) is involved in the myocardial protection conferred by APC in the acute phase; autophagy has been reported to confer apoptosis inhibition and infarction reduction. We hypothesized that APC initiates delayed cardioprotection against I/R injury via the activation of NF-kB and upregulation of autophagy, thus attenuating the inflammatory response and apoptosis


After a rat I/R model was set up, left ventricular samples were obtained before I/R to assess NF-κB-DNA binding activity and microtubule-associated protein 1 light chain 3 (LC3) and cathepsin B protein expression, and to examine autophagosomes with a transmission electron microscope. Infarct size and the expressions of tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and caspase-3 were measured at the end of 2-h reperfusion.


The infarct size was significantly reduced in the SWOP group (30 ± 3 %) when compared with that in the I/R group (47 ± 7 %, P < 0.05), and this finding was associated with increased NF-κB-DNA binding activity and autophagosomes. In addition, the expressions of LC3-II and cathepsin B were also up-regulated, and the expressions of TNF-α, IL-1β, and caspase-3 were attenuated in the SWOP group when compared with the findings in the I/R group. However, this protection was abolished by the administration of parthenolide (PTN) before sevoflurane inhalation, which resulted in an infarct size that was significantly increased (47 ± 5 %, P < 0.05 PTN + SWOP vs. SWOP group).


Delayed APC protected the rat heart from I/R injury. The underlying mechanisms may include NF-κB activation, upregulation of autophagy, and the attenuation of TNF-α, IL-1β, and caspase-3 expressions.


Ischemia/reperfusion injury Autophagy Preconditioning Apoptosis Nuclear factor-κB 



This work was supported by Grant No. 30872453 (to Dr. Wang) from the National Natural Science Foundation of China, and by Grants No. SYS201130 (to Dr. Wang) and No. SYS201038 (to Dr. Xie) from the Technology Bureau of Suzhou, China. Dr. Wang also received support from the Revitalizing the Key Talent’s Subsidy Project in Science and Education, Jiangsu Province, China).

Conflict of interest

None of the authors has any conflict of interest.


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Copyright information

© Japanese Society of Anesthesiologists 2012

Authors and Affiliations

  • Shigang Qiao
    • 1
  • Hong Xie
    • 1
  • Chen Wang
    • 1
    • 2
  • Xuemei Wu
    • 1
  • Hong Liu
    • 3
  • Chunfeng Liu
    • 2
  1. 1.Department of AnesthesiologyThe Second Affiliated Hospital of Soochow UniversitySuzhouPeople’s Republic of China
  2. 2.Institute of NeuroscienceSoochow UniversitySuzhouPeople’s Republic of China
  3. 3.Department of Anesthesiology and Pain MedicineUniversity of California Davis Health SystemDavisUSA

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