Pre- and postischemic pulsed acoustic cellular expression conditioning modulates expression of inflammation factors in cremaster ischemia/reperfusion injury model

Authors

  • Joanna M. Cwykiel M.Sc.,

    1. Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH
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  • Aleksandra Klimczak Ph.D., D.Sc.,

    1. Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH
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  • Lukasz Krokowicz M.D., Ph.D.,

    1. Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH
    2. Department of General, Gastroenterological, and Endocrine Surgery, K. Marcinkowski Medical University, Poznan, Poland
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  • Maria Siemionow M.D., Ph.D., D.Sc.

    Corresponding author
    1. Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH
    2. Department of General, Gastroenterological, and Endocrine Surgery, K. Marcinkowski Medical University, Poznan, Poland
    • MD, PhD, DSc, Department of Plastic Surgery, Cleveland Clinic, 9500 Euclid Ave, 44195 Cleveland, OH
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Abstract

Pulsed acoustic cellular expression (PACE) is a treatment that applies focused acoustic shock waves to promote tissue healing. The aim of this study was to assess the effect of PACE treatment on inflammatory responses in a cremaster muscle ischemia/reperfusion injury model. Seventeen cremaster muscle flaps were evaluated in four groups: nonischemic controls (n = 5), 5-hour ischemia controls (n = 4), preischemic (5-hour) PACE conditioning (n = 4), and postischemic (5-hour) PACE conditioning (n = 4). The expression of proinflammatory cytokines (TNFα, IL-6, IL-1α, IL-1β, GM-CSF) and chemokines (CCL3, CCL4, CXCL4) was assessed using TaqMan® real-time PCR. Expression of ELAM-1, VCAM-1, and ICAM-1 was assessed by immunostaining. Preischemic PACE conditioning upregulated expression of IL-6, CCL3, CCL4, and CXCL4, and downregulated expression of TNFα, GM-CSF, and IL-1α. Postischemic PACE conditioning significantly decreased expression of all evaluated genes. Pre- and postischemic PACE conditioning decreased expression of ELAM-1 and ICAM-1. Results of the study indicate that application of PACE conditioning may have a beneficial effect on the recovery of tissues subjected to the ischemia/reperfusion injury. Postischemic PACE conditioning revealed anti-inflammatory effect as confirmed by decreased expression of inflammatory cytokines, chemokines, and cell adhesion molecules (ELAM-1 and ICAM-1) that are responsible for leukocyte recruitment into ischemic tissues. Hence, PACE therapy may be used effectively in clinical practice as a convenient therapeutic strategy to protect tissues against ischemia/reperfusion related injury after microsurgical procedures of free tissue transfers. © 2012 Wiley Periodicals, Inc. Microsurgery, 2013.

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