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Int J Biol Sci 2012; 8(5):707-718. doi:10.7150/ijbs.4231

Research Paper

Combined Preconditioning and Postconditioning Provides Synergistic Protection against Liver Ischemic Reperfusion Injury

Xiaoyu Song1,2✉, Ning Zhang1, Hongde XU 2, Liu Cao 2, Haipeng Zhang1✉

1. Department of Pathphysiology, College of Basic Medical Science, China Medical University, Shen Yang, China
2. Key Laboratory of Medical Cell Biology, China Medical University, Shen Yang, China


Hepatic Ischemia and Reperfusion Injury (IRI) is a major cause of liver damage during liver surgery and transplantation. Ischemic preconditioning and postconditioning are strategies that can reduce IRI. In this study, different combined types of pre- and postconditioning procedures were tested in a murine warm hepatic IRI model to evaluate their protective effects. Proanthocyanidins derived from grape seed was used before ischemia process as pharmacological preconditioning to combine with technical preconditioning and postconditioning. Three pathways related to IRI, including reactive oxygen species (ROS) generation, pro-inflammatory cytokines release and hypoxia responses were examined in hepatic IRI model. Individual and combined pre- and postconditioning protocols significantly reduce liver injury by decreasing the liver ROS and cytokine levels, as well as enhancing the hypoxia tolerance response. Our data also suggested that in addition to individual preconditioning or postconditioning, the combination of these two treatments could reduce liver ischemia/reperfusion injury more effectively by increasing the activity of ROS scavengers and antioxidants. The utilization of grape seed proanthocyanidins (GSP) could improve the oxidation resistance in combined pre- and postconditioning groups. The combined protocol also further increased the liver HIF-1 alpha protein level, but had no effect on pro-inflammatory cytokines release compared to solo treatment.

Keywords: Preconditioning, Postconditioning, Ischemia, Reperfusion Injury, Proanthocyanidins

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See for full terms and conditions.
How to cite this article:
Song X, Zhang N, XU H, Cao L, Zhang H. Combined Preconditioning and Postconditioning Provides Synergistic Protection against Liver Ischemic Reperfusion Injury. Int J Biol Sci 2012; 8(5):707-718. doi:10.7150/ijbs.4231. Available from