Protection of Ischemic Preconditioning is Dependent upon a Critical Timing Sequence of Protein Kinase C Activation

The protection of ischemic preconditioning (PC) appears to be triggered by activation of receptors which couple to protein kinase C (PKC) during the brief ischemia. Previous experiments, however, suggest that phosphorylation of PKCʹs substrates is not required for the myocytes to enter the preconditioned state. Because of the fundamental importance of this observation, the present study was designed to stringently test when phosphorylation must occur during a PC protocol. We used anin vitrorabbit heart which permitted precise control of the timing of exposure to staurosporine (STA), a reversible blocker of PKCʹs kinase activity. In control hearts a 30-min regional coronary occlusion followed by 2 h of reperfusion resulted in 31.4±1.5% infarction of the region at risk, and STA (100 n ) had little effect. PC with 5 min of global ischemia and 10 min of reperfusion reduced infarction to 11.4% (P<0.01vcontrol). STA starting 5 min before and ending 5 min after the 5-min PC ischemia did not block protection (14.1±1.7% infarction,P<0.01vcontrol). When the PC protocol was changed to 5 min ischemia/20 min reperfusion, STA still could not block protection even though the infusion continued for 15 min after the PC ischemia. However, when a 15-min STA infusion was initiated 5 min before the 30-min ischemic period, PCʹs protection was totally blocked. Moreover this late infusion of STA continued to block protection even when the PC stimulus was amplified by three cycles of 5-min ischemia/10-min reperfusion. These observations indicate that kinase activity is not required to put the rabbit heart into a preconditioned state suggesting that some process upstream of PKCʹs kinase is responsible for the triggering and memory of PC.