Delayed Sevoflurane Preconditioning Enhances Endothelial Progenitor Migration In The Ischemia/Reperfusion (I/R) Injured Myocardium

We aim at proving in a rat model of anesthetic preconditioning (APC) and heart I/R injury the involvement of endothelial progenitor cells (EPCs) in the protection conferred by sevoflurane. Wistar rats were treated with 1 MAC of sevoflurane; the I/R lesion was performed immediately afterwards (early preconditioned group, EAPC) or after 24 h post exposure (late preconditioned group, LAPC). Control group was ventilated with room air. Significantly raised levels of VEGF and G‐CSF evaluated with Luminex were recorded at 3 respectively 6 h post exposure. An important increase of CD34+ and CD34+/Flk1+ cells in the peripheral blood, assessed by flow cytometry, was observed at 24 h after sevoflurane administration. The number of c kit+ cells, measured by immunofluorescence one day after the I/R lesion increased considerably (3 ± 0.5) in the LAPC group compared to the control group (0.8± 0.1, p< 0.0001), but not in the EAPC group. Also, the levels of IL‐1alpha and IL‐6, two cytokines involved in resistance to ischemia, were significantly increased at 6 and 24 h post exposure. Cardioprotection conferred by APC was proved by decreased apoptosis and area of fibrosis in rats exposed to sevoflurane versus control. Thus, exposure to sevoflurane increases the levels of plasma cytokines in the early hours, and enhances mobilization and recruitment of EPCs in the damaged area during the late phase. Financed with private founds.