Protective effect of ischemic preconditioning against hepatic ischemia-reperfusion injury and associated remote organ damage

Table 3 Hepatic ischemia-reperfusion injury-associated remote organ damage

Organ	Underlying mechanisms	Mediators involved	Relative manifestations
Lungs	Systemic inflammatory response. Neutrophil and lymphocytes infiltration. Oxidative stress	TNF-α. ICAM-1. E-selectin. PAF. IL-6. IL-18. Substance P neutrophil-chemoattractant protein. ROS. WISP1	ALI. ARDS
Myocardium	Systemic inflammatory response. Oxidative stress. Hemodynamic instability	Cytokines. ROS. Adhesion molecules	Stress-induced cardiomyopathy postreperfusion syndrome. Arrhythmias
Kidney	Hemodynamic instability. Systemic inflammatory response. Oxidative stress. Renal endothelial and mitochondrial injury	ROS. PINK1. LC3. HIF-1. TNF-α. IL-6. IL-8. ET-1. IL-18. ICAM-1	AKI
Gastrointestinal system	Systemic inflammatory response. Oxidative stress. Postoperative liver failure	LPS. PRRs. TLR4. MAPK signaling pathway. NF-κB. Adhesion molecules	Mesenteric congestion increased intestinal permeability. Venous ischemia. Mucosal barrier disruption. Bacterial translocation
Pancreas	Oxidative stress increased apoptosis	lCAM-1. ROS	Pancreatic dysfunction. Acute pancreatitis
Brain	Increased BBB permeability. Infiltration of immune cells. Neuroinflammation. Neurodegeneration. Apoptosis	ROS. iNOS. TNF-α. IL-1β. IFN-γ. IL-6. Caspase-3. Bcl-2/Bax proteins ratio. NF-κB. Protein kinase 3	Cognitive impairment. Neuron injury

TNF-α: Tumor necrosis factor α; ICAM-1: Intercellular adhesion molecule 1; PAF: Platelet-activating factor; IL-6: Interleukin 6; IL-8: Interleukin 8; ROS: Reactive oxygen species; WISP1: WNT1-inducible signaling pathway protein 1; ALI: Acute lung injury; ARDS: Acute respiratory distress syndrome; PINK1: PTEN-induced kinase 1; LC3: Light chain 3; HIF-1: Hypoxia-inducible factor 1; ET-1: Endothelin-1; IL-18: Interleukin 18; AKI: Acute kidney injury; LPS: Lipopolysaccharide; PRRs: Pattern recognizing receptors; TLR4: Toll-like receptor 4; MAPK: Mitogen-activated protein kinase; NF-κB: Nuclear factor kappa B; BBB: Blood-brain barrier; iNOS: Inducible nitric oxide synthase; IL-1β: Interleukin 1β; IFN-γ: Interferon-γ.