Intestinal Ischemic Preconditioning Modulates Oxidative Stress in Rat’s Spinal Cord Ischemic Reperfusion Injury

Background: Paraplegia is a major devastating and unpredictable complication of spinal cord ischemic reperfusion injury (SC-IRI). Ischemic preconditioning (IPC) is a procedure whereby a brief episode of non-lethal ischemia to an organ produces protection against subsequent detrimental ischemic-reperfusion insult to that organ. It has been shown that IPC may not only induce a local protective effect, but also induces resistant to ischemic-reperfusion damage in remote organs what is termed remote ischemic preconditioning (rIPC). Aim: The aim of the present study was to investigate the potential protective effect of small intestinal ischemic preconditioning on subsequently induced SC-IRI in rats. Methods: Fifty male Sprague-Dawley rats were randomly divided into five groups (n=10 each): control rats (C) which underwent no surgery; Sham rats (S) were subjected to laparotomy without induction of rIPC or clamping of the aorta; remote intestinal ischemic preconditioning group (rIPC) were subjected to 3 cycles of 8-min anterior mesenteric artery occlusion followed by 5-minute reperfusion; SC-IRI rats were subjected to laparotomy with clamping of the aorta just above the bifurcation by non-traumatic vascular clamp for 45 minutes, then the clamp was released for reperfusion for 24 hours; and SC-IRI+rIPC rats underwent 3 cycles of 8-minute anterior mesenteric artery occlusion followed by 5-minute reperfusion each. Twenty four hours later, animals underwent another laparotomy and spinal cord ischemia followed by reperfusion similar to group SC-IRI. Twenty four hours after surgery; neurological assessment was done. Serum tumor necrosis factor alpha (TNF-α), spinal cord homogenate levels of prostaglandin E2 (PGE2),