不同剂量乳化异氟醚预处理对大鼠肝脏缺血再灌注损伤的保护作用

摘要 目的：探究不同剂量乳化异氟醚预处理对大鼠肝脏缺血再灌注损伤的保护作用。方法：将48只成年雄性大鼠随机分为六组：假手术组、缺血对照组、脂肪乳组、低剂量乳化异氟醚组、中剂量乳化异氟醚组和高剂量乳化异氟醚组,每组8只。检测血清中酶的含量,观察肝细胞损伤程度,直观的反应乳化异氟醚预处理对肝脏缺血再灌注损伤的影响。结果：不同组别大鼠肝脏再灌注后ALT、AST、LDH和MDA含量,SOD活性和肝细胞坏死比例均具有显著差异,随着再灌注时间的延长,各组大鼠血清ALT、AST和LDH含量均明显增加（均P＜0.05）。再灌注后1 h、2 h和4 h中剂量乳化异氟醚组大鼠血清ALT、AST和LDH含量均显著低于缺血对照组、低剂量乳化异氟醚组和高剂量乳化异氟醚组（均P＜0.05）。中剂量乳化异氟醚组大鼠肝组织匀浆中MDA含量和肝细胞坏死比例均显著低于缺血对照组、低剂量乳化异氟醚组和高剂量乳化异氟醚组,SOD活性显著高于缺血对照组、低剂量乳化异氟醚组和高剂量乳化异氟醚组（均P＜0.05）。结论：中等剂量乳化异氟醚预处理组中血清中酶含量最低,肝组织匀浆中MDA含量最低,SOD活性水平最高,肝细胞损伤程度最轻,对大鼠肝脏缺血再灌注的保护作用最好。     

七氟醚对脑缺血再灌注损伤大鼠认知功能及海马S100β及PGRN表达的影响

摘要 目的：探索用七氟醚预处理后脑缺血再灌注损伤大鼠的认知功能变化情况以及海马细胞内钙结合蛋白（S100β）及颗粒蛋白前体（Progranulin,,PGRN）的表达水平。方法：选取SPF级雄性大鼠36只,按照随机数字表法分为假手术组（A组）、脑缺血再灌注损伤组（B组）、七氟醚预处理组（C组）,每组12只。B组和C组大鼠采用线栓法建立脑缺血再灌注损伤模型,缺血2 h,再灌注24 h,假手术组仅切开不插入线栓。术前七氟醚预处理组大鼠吸入体积分数3 %七氟醚和氧流量为2 L/min的混合气体,持续1 h,假手术组和脑缺血再灌注损伤组单纯吸入2 L /min的氧气。建模完成后采用大鼠神经功能缺损评分（modified neurological severity score,mNSS）评估大鼠的神经功能状况;Morris水迷宫实验检测各组大鼠学习认知功能;Western Blot检测各组大鼠S100β和PGRN的表达情况。结果：（1）B、C组大鼠mNSS评分显著高于A组,C组评分较B组有明显降低（P＜0.05）;（2）与A组相比B、C两组逃逸潜伏期明显延长,C组与B组相比逃逸潜伏期显著缩短（P＜0.05）;（3）B、C组大鼠海马S100β和PGRN的表达较A组有显著上调,其中C组S100β表达较B组显著降低,PGRN表达显著升高（P＜0.05）。结论：本文通过观察七氟醚预处理对CIRI大鼠认知功能及海马S100β和PGRN蛋白表达水平的影响,发现七氟醚预处理对CIRI大鼠认知功能有显著提高,其作用机制与海马S100β和PGRN的表达密切相关,为进一步探索其作用机制提供参考证据。     

七氟醚预处理对大鼠脑缺血再灌注损伤的改善机制

目的:探究七氟醚预处理对大鼠脑缺血再灌注损伤的影响,以及转化生长因子-β2(TGF-β2)/Smad3信号通路的活化情况。方法:将50只SD大鼠随机分为5组(n=10):假手术组、模型组、七氟醚预处理组、吡非尼酮组和七氟醚预处理+吡非尼酮组。通过右颈内动脉(ICA)缝线结扎方法制备脑缺血再灌注(I/R)损伤模型。建模前1h,七氟醚组大鼠吸入2.0%七氟醚1h,吡非尼酮组大鼠腹膜内注射200 mg/kg的TGF-β2抑制剂吡非尼酮,七氟醚+吡非尼酮组大鼠同时应用两种药物处理。再灌注24 h后,通过Zea-Longa五级评分法评价大鼠神经功能缺损评分,处死大鼠并测量梗死体积。通过苏木精-伊红(HE)染色和Nissl染色评价脑组织损伤程度。TdT介导的dUTP缺口末端标记法(TUNEL)分析细胞凋亡。免疫荧光染色和Western blot检测TGF-β2、Smad3、血管内皮生长因子-A(VEGF-A)和CD34的表达情况。结果:七氟醚预处理明显降低了大鼠的脑梗塞面积和神经功能缺损评分。七氟醚预处理抑制了大鼠大脑皮质和海马CA1区的神经元凋亡。七氟醚预处理上调了TGF-β2、VEGF-A和CD34的表达,以及Smad3的磷酸化水平。TGF-β2抑制剂吡非尼酮处理均可减弱七氟醚的脑保护作用并抑制TGF-β2、VEGF-A和CD34的表达和Smad3的磷酸化。结论:七氟醚预处理通过激活TGF-β2/Smad3信号通路来减轻I/R损伤大鼠的脑损伤。     

七氟醚与体外循环脑损伤保护作用研究进展

心血管外科手术中,体外循环术后的神经系统并发症可延长住院时间、增加死亡率及其他并发症,已成为阻碍心外科手术发展的重要因素。七氟醚作为一种具有神经保护作用的吸入性麻醉药正在逐渐引起人们的重视,本文结合国内外相关的七氟醚与脑缺血再灌注损伤的基础与临床研究,总结目前研究现状以及存在问题,从以下几个方面对七氟醚在体外循环脑损伤中的脑保护作用进行阐述:七氟醚增加脑血流、降低脑氧代谢率;线粒体ATP敏感性钾通道介导七氟醚神经保护的作用;TLR与心血管手术脑保护研究;七氟醚预处理后处理与心血管手术;七氟醚在心血管手术中脑保护作用。基于目前研究,为了确保七氟醚在心血管手术麻醉中更有效、安全地应用,有关七氟醚体外循环脑损伤保护作用的复杂机制及七氟醚最佳使用剂量-保护效应之间的关系仍需要进一步的探索,以期为临床提供理论基础。     

吸氧预处理对大鼠脑缺血再灌注损伤的保护作用

目的探讨吸氧预处理对大鼠脑缺血再灌注损伤的保护作用。方法通过大鼠局灶脑缺血再灌注损伤模型,采用SOD、MDA测定、电镜及神经行为学检查的方法,观察吸氧预处理对大鼠脑缺血再灌注损伤后SOD、MDA、神经行为学评分及脑组织病理变化。结果吸氧预处理组SOD活力高于对照组(P<0.05),MDA含量、神经行为学评分均低于对照组(P<0.05),脑组织超微结构损伤均减轻。结论吸氧预处理对大鼠脑缺血再灌注损伤有保护作用。     

硫化氢对抗脑缺血再灌注损伤的机制研究进展

硫化氢（H2S）是一种新型内源性气体信使分子,在许多生理和病理生理过程中,尤其在神经保护中,扮演重要角色,既是神经调节剂, 也是神经保护剂。近年来的研究发现,H2S对于脑缺血再灌注损伤具有积极的防治作用,它可通过抗氧化应激、抗炎及抗细胞凋亡等多个途径, 对脑缺血再灌注损伤起保护作用,具有良好的临床应用前景。简介脑内H2S生成途径,综述H2S在中枢神经系统中的生物学效应及其对脑 缺血再灌注损伤的保护作用与机制研究进展,以期为脑缺血再灌注损伤的临床防治提供新思路。     

PEP-1超氧化物歧化酶对大鼠脑缺血再灌注后Bcl-2的影响

目的：观察细胞穿透肽-铜,锌超氧化物歧化酶（PEP-1-SOD1）预处理对大鼠局灶性脑缺血再灌注损伤的改善作用及其脑保护机制。方法：线栓法建立大鼠局灶性脑缺血6h后再灌注损伤模型,进行神经行为评分,并通过HE染色在光镜下观察神经细胞损伤变化,免疫组化法检测B细胞淋巴瘤基因-2（B—celllymphoma-2,Bcl-2）蛋白的阳性表达。结果：盐水对照组（缺血再灌注组或模型组）神经障碍显著高于假手术组（P〈0．05）,与模型组相比,PEP-1-SOD1预处理组可降低神经障碍评分（P〈0．05）;光镜下,假手术组神经细胞结构正常,PEP-1-SDO1预处理组和缺血再灌注组均有不同程度的缺血再灌注损伤,PEP-1-SOD1预处理组较缺血再灌注组损伤轻;假手术组Bcl-2蛋白表达极弱,缺血再灌注组和PEP-1-SOD1预处理组在脑缺血再灌注后6h在缺血半暗带周围出现Bcl-2蛋白阳性表达,24h达到高峰,48h表达开始减少。与假手术组相比,PEP-1-SOD1预处理组和缺血再灌注组Bcl-2蛋白阳性细胞数显著增多（P〈0．05）;与缺血再灌注组相比,PEP-1-SOD1预处理组Bcl-2蛋白阳性细胞数显著增多（P〈0．05）。结论：PEP-1-SOD1对大鼠局灶性脑缺血再灌注损伤有保护作用,PEP-1-SOD1可通过上调Bcl-2蛋白的表达发挥脑保护作用。     

高压氧预处理对大鼠局灶性脑缺血再灌注损伤的保护作用

目的:研究高压氧预处理对大鼠脑缺血再灌注损伤的保护作用。方法:36只SD大鼠随机分为假手术组、模型组及高压氧预处理组,每组12只。高压氧预处理组大鼠在造模前5天给予高压氧预处理。采用线栓法建立大鼠脑缺血再灌注模型,观察高压氧预处理对脑缺血再灌注损伤大鼠神经功能缺损评分、脑梗死面积的影响,检测大鼠缺血脑组织COX-2 mRNA和蛋白的表达以及IL-1β、TNF-α、MDA的含量。结果:高压氧预处理可明显改善脑缺血再灌注大鼠神经功能缺损评分,减少脑梗死面积,降低COX-2m RNA和蛋白表达量,抑制IL-1β、TNF-α的表达,降低MDA水平。结论:高压氧预处理对大鼠脑缺血再灌注损伤具有明显的保护作用,其机制可能与抑制IL-1β、TNF-α、COX-2的表达以及减弱脂质过氧化反应有关。     

盐酸戊乙奎醚（长托宁）抑制脑缺血／再灌注时谷氨酸的释放及受体机制研究

目的：观察盐酸戊乙奎醚对全脑缺血／再灌注大鼠易损区海马谷氨酸（Glu）及其受体（NMDAR1）的影响,探讨盐酸戊乙奎醚脑保护作用机制。方法：雄性Wistar大鼠60只,随机分为3组（n=20）：假手术组（A组）;缺血再灌注对照组（B组）;盐酸戊乙奎醚干预组,采用Pulsinelli-Brierley四血管阻断法制备全脑缺血模型,实验分两部分进行,各组随机选择10只大鼠于全脑缺血15min再灌注1h、3h、6h,采用脑微透析技术结合高效液相色谱（HPLC）检测大鼠海马细胞外Glu水平的变化,其余10只大鼠于再灌注3h后灌流固定断头取脑,采用免疫组织化学方法,检测海马CA1区NMDAR1蛋白表达。结果：与缺血／再灌注组各对应时点相比较,盐酸戊乙奎醚干预组大鼠海马细胞外Glu含量明显降低,统计结果差异均有显著性（P〈0．05或P〈0．01）;海马CA1区NMDAR1表达明显受抑制,积分光密度、阳性细胞面积、平均灰度值均存在显著性差异（P〈0．05或P〈0．01）。结论：脑缺血／再灌注早期应用盐酸戊乙奎醚不仅减少兴奋性氨基酸释放,还能抑制NMDAR1的高表达而产生脑保护作用。     

木犀草素预处理对缺血/再灌注大鼠肝脏的保护作用

本研究用Sprague-Dawley大鼠建立肝脏缺血/再灌注损伤模型,探讨木犀草素预处理对大鼠肝脏缺血/再灌注损伤的保护作用及其机制,并观察血红素氧合酶-1(heme oxygenase-1,HO-1)活性变化对肝缺血/再灌注损伤的影响.将火鼠随机分为正常组、模犁组、木犀草素组、木犀草素+锌原卟啉(HO-1抑制剂)组及...     

Spatio-temporal properties of 5-lipoxygenase expression and activation in the brain after focal cerebral ischemia in rats

The role of 5-lipoxygenase (5-LOX) in brain injury after cerebral ischemia has been reported; however, the spatio-temporal properties of 5-LOX expression and the enzymatic activation are unclear. To determine these properties, we observed post-ischemic 5-LOX changes from 3 h to 14 days after reperfusion in rats with transient focal cerebral ischemia induced by 30 min of middle cerebral artery occlusion. We found that the expression of 5-LOX, both mRNA and protein, was increased in the ischemic core 12-24 h after reperfusion, and in the boundary zone adjacent to the ischemic core 7-14 days after reperfusion. The increased 5-LOX was primarily localized in the neurons in the ischemic core at 24 h, but in the proliferated astrocytes in the boundary zone 14 days after reperfusion. As 5-LOX metabolites, the level of cysteinyl-leukotrienes in the ischemic brain was substantially increased 3 h to 24 h, near control at 3 days, and moderately increased again 7 days after reperfusion; whereas the level of LTB(4) was increased mildly 3 h but substantially 7-14 days after reperfusion. Thus, we conclude that 5-LOX expression and the enzymatic activity are increased after focal cerebral ischemia, and spatio-temporally involved in neuron injury in the acute phase and astrocyte proliferation in the late phase.     

PI3K/Akt 通路在电针预处理诱导脑缺血耐受中的机制研究

目的:通过观察电针预处理对磷脂酰肌醇3激酶/蛋白质丝氨酸苏氨酸激酶(PI3K/Akt)通路的变化以及该通路抑制剂对电针预处理的脑保护的影响,探讨电针预处理诱导脑缺血耐受的可能机制。方法:线栓法单侧阻断大脑中动脉120min,再灌注24h制备大鼠大脑局灶性缺血再灌注(I/R)模型;Western Blot检测Akt磷酸化水平的变化;侧脑室注射PI3K/Akt通路抑制剂LY294002;神经行为学评分(Garcia标准)及TTC染色检测脑梗死体积比评价脑损伤程度。结果:电针预处理使大鼠神经行为学评分增高,脑梗死体积比降低(P<0.05);可上调Akt磷酸化水平,I/R2h达高峰(P<0.05)。侧脑室注射PI3K/Akt抑制剂LY294002,拮抗电针预处理的脑保护作用(P<0.05)。结论:电针预处理增加Ak(tSer473)磷酸化水平,在缺血再灌注早期上调PI3K/Akt通路可能是诱导大鼠脑缺血耐受的产生的主要机制。     

Involvement of CCR-2 chemokine receptor activation in ischemic preconditioning and postconditioning of brain in mice

The present study has been designed to investigate the potential role of CCR-2 chemokine receptor in ischemic preconditioning as well as postconditioning induced reversal of ischemia-reperfusion injury in mouse brain. Bilateral carotid artery occlusion of 17min followed by reperfusion for 24h was employed in present study to produce ischemia and reperfusion induced cerebral injury in mice. Cerebral infarct size was measured using triphenyltetrazolium chloride staining. Memory was evaluated using elevated plus-maze test and Morris water maze test. Rota rod test was employed to assess motor incoordination. Bilateral carotid artery occlusion followed by reperfusion produced cerebral infarction and impaired memory and motor co-ordination. Three preceding episodes of bilateral carotid artery occlusion for 1min and reperfusion of 1min were employed to elicit ischemic preconditioning of brain, while three episodes of bilateral carotid artery occlusion for 10s and reperfusion of 10s immediately after the completion of were employed to elicit ischemic postconditioning of brain. Both prior ischemic preconditioning as well as ischemic postconditioning immediately after global cerebral ischemia prevented markedly ischemia-reperfusion-induced cerebral injury as measured in terms of infarct size, loss of memory and motor coordination. RS 102895, a selective CCR-2 chemokine receptor antagonist, attenuated the neuroprotective effect of both the ischemic preconditioning as well as postconditioning. It is concluded that the neuroprotective effect of both ischemic preconditioning as well as ischemic postconditioning may involve the activation of CCR-2 chemokine receptors.     

Beneficial effect of preconditioning on ischemia-reperfusion injury in the rat bladder in vivo

We investigated the effect of preconditioning on ischemia-reperfusion injury in the rat bladder. Rat abdominal aorta was clamped with a small clip to induce ischemia-reperfusion injury in the bladder. Twelve-week-old male SD rats were divided into three groups; sham-operated control (Cont), 30 min ischemia-60 min reperfusion (IR) and three times of 5 min ischemia and then 30 min ischemia-60 min reperfusion (PC) groups. The bladder functions were estimated by cystometric and functional studies. Contractile response curves to increasing concentrations of carbachol were constructed in the absence and presence of various concentrations of subtype selective muscarinic antagonists, i.e. atropine (non-selective), pirenzepine (M1 selective), methoctramine (M2 selective), and 4-DAMP (M1/M3 selective). We also measured tissue levels of malonaldehyde (MDA) and examined possible histological changes in these rats' bladders. Preconditioning partially prevented the reduction of bladder dysfunction induced by ischemia-reperfusion. Estimation of the pA2 values for atropine, pirenzepine, methoctramine, and 4-DAMP indicates that the carbachol-induced contractile response in bladder dome is mediated through the M3 receptor subtype in all groups. The MDA concentration in the IR group was significantly larger than that of the control group, and preconditioning significantly reduced MDA production in the bladder. In histological studies, the ischemia-reperfusion with or without preconditioning caused infiltration of leukocytes and rupture of microcirculation in the regions of submucosa and smooth muscle without a corresponding sloughing of mucosal cells. Our data indicate that preconditioning has a beneficial effect on ischemia-reperfusion injury in the rat bladder.     

Reduced cerebral ischemia-reperfusion injury in Toll-like receptor 4 deficient mice

Inflammatory reaction plays an important role in cerebral ischemia-reperfusion injury, however, its mechanism is still unclear. Our study aims to explore the function of Toll-like receptor 4 (TLR4) in the process of cerebral ischemia-reperfusion. We made middle cerebral artery ischemia-reperfusion model in mice with line embolism method. Compared with C3H/OuJ mice, scores of cerebral water content, cerebral infarct size and neurologic impairment in C3H/Hej mice were obviously lower after 6 h ischemia and 24 h reperfusion. Light microscopic and electron microscopic results showed that cerebral ischemia-reperfusion injury in C3H/Hej mice was less serious than that in C3H/OuJ mice. TNF-alpha and IL-6 contents in C3H/HeJ mice were obviously lower than that in C3H/OuJ mice with ELISA. The results showed that TLR4 participates in the process of cerebral ischemia-reperfusion injury probably through decrease of inflammatory cytokines. TLR4 may become a new target for prevention of cerebral ischemia-reperfusion injury. Our study suggests that TLR4 is one of the mechanisms of cerebral ischemia-reperfusion injury besides its important role in innate immunity.     

Effect of desflurane-induced preconditioning following ischemia-reperfusion on nitric oxide release in rabbits

Nitric oxide (NO) is the mediator of ischemic preconditioning against myocardial infarction. Desflurane produces anesthetic preconditioning to protect the myocardium against infarction. In the model of myocardial ischemia-reperfusion injury in rabbits, we evaluated desflurane-induced ischemic preconditioning and studied its mechanism of NO synthesis. Thirty-two male adult New Zealand white rabbits were anesthetized with intravenous (IV) 30 mg/kg pentobarbital followed by 5 mg/kg/hr infusion. All rabbits were subjected to 30 minutes (min) long lasting left anterior descending coronary artery (LAD) occlusion and three hours (hr) of subsequent reperfusion. Before LAD occlusion, the rabbits were randomly allocated into four groups for preconditioning treatment (eight for each group). The control group did not receive any preconditioning treatment. The desflurane group received inhaled desflurane 1.0 MAC (minimal end-tidal alveolar concentration) for 30 min that was followed by a 15 min washout period. The L-NAME-desflurane group received L-NAME (NG-nitro-L-arginine methyl ester; non-selective Nitric Oxide Synthetase (NOS) inhibitor) 1 mg/kg IV 15 min before 1.0 MAC inhaled desflurane for 30 min. The L-NAME group received L-NAME 1 mg/kg IV. Infarct volume, ventricular arrhythmia, plasma lactate dehydrogenase (LDH), creatine kinase (CK) activity and myocardial perfusion were recorded simultaneously. We have found that hemodynamic values of the coronary blood flow before, during, and after LAD occlusion were not significantly different among these four groups. For the myocardial ischemia-reperfusion injury animals, the infarction size (mean +/- SEM) in the desflurane group was significantly reduced to 18 +/- 3% in the area at risk as compared with 42 +/- 7% in the control group, 35 +/- 6 in the L-NAME group, and 34 +/- 4% in the L-NAME-desflurane group. The plasma LDH, CK levels, and duration of ventricular arrhythmia were also significantly decreased in the desflurane group during ischemia-reperfusion injury. Our results indicate that desflurane is an anesthetic preconditioning agent, which could protect the myocardium against the ischemia-reperfusion injury. This beneficial effect of desflurane on the ischemic preconditioning is probably through NO release since L-NAME abrogates the desflurane preconditioning effect.     

Remifentanil preconditioning alleviating brain damage of cerebral ischemia reperfusion rats by regulating the JNK signal pathway and TNF-α/TNFR1 signal pathway

Tumor necrosis factor (TNF) and the TNF receptor (TNFR) superfamily play very important roles for cell death as well as normal immune regulation. Previous studies have strongly suggested that c-Jun N-terminal kinase (JNK) signaling pathway plays a critical role in ischemic brain injury. The purpose of this investigation was to examine the protective effect of remifentanil preconditioning in cerebral ischemia/reperfusion injury (CIR) and its possible molecular mechanism. Results showed that Remifentanil pretreatment significantly decreased the CD4⁺ and increased the CD8⁺ in cerebral tissues. Additionally, CD4⁺/CD8⁺ in CIR + Remifentanil group was markedly lower than that in CIR group. TNF-α and TNFR1 in CIR + Remifentanil group rats was found to be significant lower than that in CIR group rats. The expression levels of Cyt-c, caspase-3, caspase-9 and pJNK proteins in brain of CIR + Remifentanil group rats were found to significantly decreased compared to CIR group rats. In addition, decreased ROS level indirectly inhibit JNK activation and cell death in CIR rat receiving Remifentanil preconditioning. From current experiment results, at least two signal pathways involve into the process of Remifentanil preconditioning inhibiting cerebral damage induced by ischemia reperfusion. The inhibitory effects of Remifentanil preconditioning on the brain damage are achieved probably through blocking the activation of TNF-α/TNFR1, JNK signal transduction pathways, which implies that Remifentanil preconditioning may be a potential and effective way for prevention of the ischemic/reperfusion injury through the suppression extrinsic apoptotic signal pathway induced by TNF-α/TNFR1, JNK signal pathways. Taken together, this study indicated that regulation of the TNF-α/TNFR1 and JNK signal pathways may provide a new therapy for cerebral damage induced by ischemia and reperfusion.     

Ischemic preconditioning exaggerates cardiac damage in PKC-delta null mice

Ischemic preconditioning confers cardiac protection during subsequent ischemia-reperfusion, in which protein kinase C (PKC) is believed to play an essential role, but controversial data exist concerning the PKC-delta isoform. In an accompanying study (26), we described metabolic changes in PKC-delta knockout mice. We now wanted to explore their effect on early preconditioning. Both PKC-delta(-/-) and PKC-delta(+/+) mice underwent three cycles of 5-min left descending artery occlusion/5-min reperfusion, followed by 30-min occlusion and 2-h reperfusion. Unexpectedly, preconditioning exaggerated ischemia-reperfusion injury in PKC-delta(-/-) mice. Whereas ischemic preconditioning increased superoxide anion production in PKC-delta(+/+) hearts, no increase in reactive oxygen species was observed in PKC-delta(-/-) hearts. Proteomic analysis of preconditioned PKC-delta(+/+) hearts revealed profound changes in enzymes related to energy metabolism, e.g., NADH dehydrogenase and ATP synthase, with partial fragmentation of these mitochondrial enzymes and of the E(2) component of the pyruvate dehydrogenase complex. Interestingly, fragmentation of mitochondrial enzymes was not observed in PKC-delta(-/-) hearts. High-resolution NMR analysis of cardiac metabolites demonstrated a similar rise of phosphocreatine in PKC-delta(+/+) and PKC-delta(-/-) hearts, but the preconditioning-induced increase in phosphocholine, alanine, carnitine, and glycine was restricted to PKC-delta(+/+) hearts, whereas lactate concentrations were higher in PKC-delta(-/-) hearts. Taken together, our results suggest that reactive oxygen species generated during ischemic preconditioning might alter mitochondrial metabolism by oxidizing key mitochondrial enzymes and that metabolic adaptation to preconditioning is impaired in PKC-delta(-/-) hearts.