{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T19:36:18Z","timestamp":1785353778025,"version":"3.55.0"},"reference-count":0,"publisher":"Termedia Sp. z.o.o.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Med Sci"],"published-print":{"date-parts":[[2021,1,28]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Ischemic preconditioning (Ipre) provides protection against renal ischemia-reperfusion (I\/R) injury with its associated remote organ damage. This study examined the enhancing protective effect of Ipre with levosimendan or cilostazol in I\/R-induced kidney and lung injury in a rat model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Rats were divided into: sham-operated, I\/R control, Ipre control, I\/R + cilostazol or levosimendan and Ipre + cilostazol or levosimendan. Drugs were given 30 min before left renal I\/R or 4 cycles of Ipre just before renal ischemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Ipre combined with the implemented drugs enhanced physio\u00adlogical antioxidant defense genes including renal nuclear factor erythroid 2-related factor 2 (Nrf2) and its dependent genes heme oxygenase-1 (HO-1) and NADPH-quinone oxidoreductase-1 (NQO-1) and improved malondialdehyde and superoxide dismutase renal tissue levels. The combined effect improved I\/R consequences for blood urea, creatinine, and creatinine clearance and improved blood oxygenation and metabolic acidosis. Moreover, the combination improved the renal soluble intercellular adhesion molecule (ICAM), tumor necrosis factor \u03b1 (TNF-\u03b1) and interlukin-6 (IL-6) with histopathological improvement of tubular necrosis with a decrease in the apoptotic marker caspase-3 and an increase in the anti-apoptotic Bcl-2 expression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cilostazol or levosimendan potentiates the renoprotective effect  of Ipre against renal I\/R injury, associated with upregulation of antioxidant genes Nrf2, HO-1, and NOQ-1 expression.<\/jats:p><\/jats:sec>","DOI":"10.5114\/aoms\/111373","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T11:31:13Z","timestamp":1635852673000},"page":"1-34","source":"Crossref","is-referenced-by-count":3,"title":["Upregulation of antioxidant nuclear factor erythroid 2-related factor 2 and its dependent genes associated with enhancing renal ischemic preconditioning renoprotection using levosimendan and cilostazol in an ischemia\/reperfusion rat model"],"prefix":"10.5114","volume":"18","author":[{"given":"Mona","family":"Tawfik","sequence":"first","affiliation":[{"name":"Department of Pharmacology, Faculty of Medicine, Suez Canal University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samy","family":"Makary","sequence":"additional","affiliation":[{"name":"Department of Physiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Keshawy","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Nephrology Division, Faculty of Medicine, Suez Canal University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3061","published-online":{"date-parts":[[2021,1,28]]},"container-title":["Archives of Medical Science"],"original-title":[],"link":[{"URL":"https:\/\/www.archivesofmedicalscience.com\/pdf-111373-61265","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.archivesofmedicalscience.com\/pdf-111373-61265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T11:31:19Z","timestamp":1635852679000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.archivesofmedicalscience.com\/Upregulation-of-antioxidant-nuclear-factor-erythroid-2-related-factor-2-and-its-dependent,111373,0,2.html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,28]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022]]}},"alternative-id":["111373"],"URL":"https:\/\/doi.org\/10.5114\/aoms\/111373","relation":{},"ISSN":["1734-1922","1896-9151"],"issn-type":[{"value":"1734-1922","type":"print"},{"value":"1896-9151","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,28]]}}}