Ischemic limb preconditioning downregulates systemic inflammatory activation

We examined local and systemic antiinflammatory consequences of ischemic preconditioning (IPC) in a rat model of limb ischemia‐reperfusion (I‐R) by characterizing the leukocyte‐endothelial interactions in the periosteum and the expression of adhesion molecules playing a role in leukocyte‐mediated inflammatory processes. IPC induction (2 cycles of 10 min of complete limb ischemia and 10 min of reperfusion) was followed by 60 min of ischemia/180 min of reperfusion or sham‐operation. Data were compared with those on animals subjected to I‐R and sham‐operation. Neutrophil leukocyte‐endothelial cell interactions (intravital videomicroscopy), intravascular neutrophil activation (CD11b expression changes by flow cytometry), and soluble and tissue intercellular adhesion molecule‐1 (ICAM‐1; ELISA and immunohistochemistry, respectively) expressions were assessed. I‐R induced enhanced leukocyte rolling and adherence in the periosteal postcapillary venules after 120 and 180 min of reperfusion. This was associated with a significantly enhanced CD11b expression (by ∼80% and 72%, respectively) and moderately increased soluble and periosteal ICAM‐1 expressions. IPC prevented the I‐R–induced increases in leukocyte adherence and CD11b expression without influencing the soluble and tissue ICAM‐1 levels. The results show that limb IPC exerts not only local, but distant antiinflammatory effects through significant modulation of neutrophil recruitment. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27: 897–902, 2009