Repeated non-invasive limb ischemic preconditioning attenuates myocardial ischemia-reperfusion injury in diabetic rats by up-regulating hexokinase II

Background Ischemic heart disease is the leading cause of mortality in patients with diabetes mellitus. Although remote ischemic preconditioning achieved by non-invasively occluding the brachial artery (non-invasive limb ischemic preconditioning, NLIP) lost its cardioprotection in diabetes, our recent study demonstrated that repeated NLIP (rNLIP, applying 3 cycles of 5 minutes occlusion/5 minutes reperfusion in a unilateral hindlimb daily for 3 days) reduced myocardial infarction, but the mechanism is unclear. Hexokinase II (HKII) is a key glycolytic enzyme that regulates cell survival when bonds to out mitochondrial membrane. However, it is unknown whether HKII is involved in the cardioprotection of diabetic myocardial ischemia/reperfusion(I/R) injury conferred by rNLIP and warrants investigation. Methods and Results Type 1 diabetic rat model was established by intravenous injection of streptozotocin (60 mg/kg). Myocardial I/R was induced by ligating the left anterior descending artery for 30 minutes fol...