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Nature Reviews. Cardiology Apr 2016The 30-year anniversary of the discovery of 'ischaemic preconditioning' is in 2016. This endogenous phenomenon can paradoxically protect the heart from acute myocardial... (Review)
Review
The 30-year anniversary of the discovery of 'ischaemic preconditioning' is in 2016. This endogenous phenomenon can paradoxically protect the heart from acute myocardial infarction by subjecting it to one or more brief cycles of ischaemia and reperfusion. Apart from complete reperfusion, this method is the most powerful intervention known for reducing infarct size. The concept of ischaemic preconditioning has evolved into 'ischaemic conditioning', a term that encompasses a number of related endogenous cardioprotective strategies, applied either directly to the heart (ischaemic preconditioning or postconditioning) or from afar, for example a limb (remote ischaemic preconditioning, perconditioning, or postconditioning). Investigations of signalling pathways underlying ischaemic conditioning have identified a number of therapeutic targets for pharmacological manipulation. Over the past 3 decades, a number of ischaemic and pharmacological cardioprotection strategies, discovered in experimental studies, have been examined in the clinical setting of acute myocardial infarction and CABG surgery. The results from many of the studies have been disappointing, and no effective cardioprotective therapy is currently used in clinical practice. Several large, multicentre, randomized, controlled clinical trials on cardioprotection have highlighted the challenges of translating ischaemic conditioning and pharmacological cardioprotection strategies into patient benefit. However, a number of cardioprotective therapies have shown promising results in reducing infarct size and improving clinical outcomes in patients with ischaemic heart disease.
Topics: Animals; Cardiovascular Agents; Humans; Ischemic Postconditioning; Ischemic Preconditioning; Ischemic Preconditioning, Myocardial; Myocardial Infarction; Myocardial Reperfusion Injury; Treatment Outcome
PubMed: 26843289
DOI: 10.1038/nrcardio.2016.5 -
Minerva Anestesiologica Mar 2020
Topics: Hepatectomy; Humans; Ischemic Preconditioning; Liver; Reperfusion Injury
PubMed: 32013338
DOI: 10.23736/S0375-9393.20.14344-X -
Circulation Research Mar 2021
Topics: Ischemic Preconditioning, Myocardial; TOR Serine-Threonine Kinases
PubMed: 34219792
DOI: 10.1161/circresaha.121.318874 -
Annals of Cardiac Anaesthesia 2019Preconditioning, a milestone concept in the cardiovascular sciences introduced 32 years back by Murry. This concept opened a new era in the field of organ protection. To... (Review)
Review
Preconditioning, a milestone concept in the cardiovascular sciences introduced 32 years back by Murry. This concept opened a new era in the field of organ protection. To start with extensive studies done on ischemic preconditioning for myocardial protection, ischemic preconditioning is an endogenous science of cellular kinetics. Several components in signal transduction cascade have been identified but still some mechanisms not yet revealed. Anesthetic preconditioning also contributed a lot for myocardial protection and concreted the concept of preconditioning. We, with an inquisitive brain meticulously persuing newer methods of cardioprotection. Remote ischemic preconditioning (RIPC) is a brilliant example of it. RIPC can be future of cardioprotection, clinical trials and studies proved the benefits but yet to conclude the superiority of RIPC over myocardial ischemic cardioprotection. This review is an attempt to reveal this extraordinary concept with its basic cellular kinetics, methods, and recent trends.
Topics: Anesthesia, Cardiac Procedures; Cardiac Surgical Procedures; Cardiotonic Agents; Humans; Ischemic Preconditioning, Myocardial
PubMed: 31621678
DOI: 10.4103/aca.ACA_116_18 -
Circulation Journal : Official Journal... May 2020
Topics: Animals; Glycine; Ischemia; Ischemic Preconditioning, Myocardial; Isoquinolines; Mice; Myocardial Reperfusion Injury
PubMed: 32336722
DOI: 10.1253/circj.CJ-20-0233 -
International Journal of Cardiology May 2018
Topics: Humans; Ischemic Preconditioning; Reperfusion Injury
PubMed: 29579594
DOI: 10.1016/j.ijcard.2018.02.019 -
Biomolecules Dec 2022Neurodegeneration can benefit from ischemic preconditioning, a natural adaptive reaction to sublethal noxious stimuli. Although there is growing interest in advancing...
Neurodegeneration can benefit from ischemic preconditioning, a natural adaptive reaction to sublethal noxious stimuli. Although there is growing interest in advancing preconditioning to preserve brain function, preconditioning is not yet considered readily achievable in clinical settings. One of the most challenging issues is that there is no fine line between preconditioning stimuli and lethal stimuli. Here, we show deleterious effect of preconditioning on oligodendrocyte precursor cells (OPCs). We identified Bcl-2/adenovirus E1B 19-kDa interacting protein 3 (BNIP3), a mitochondrial BH3-only protein specifically involved in OPCs loss after preconditioning. Repeated ischemia stabilized BNIP3 and increased the vulnerability of OPCs to subsequent ischemic events. BNIP3 became mitochondrial-bound and was concurrent with the dysfunction of monocarboxylate transporter 1 (MCT1). Inhibition of BNIP3 by RNAi or necrostatin-1 (Nec-1) and knocking out of BNIP3 almost completely prevented OPCs loss and preserved white matter integrity. Together, our results suggest that the unfavorable effect of BNIP3 on OPCs should be noted for safe development of ischemic tolerance. BNIP3 inhibition appears to be a complementary approach to improve the efficacy of preconditioning for ischemic stroke.
Topics: Oligodendroglia; Mitochondria; White Matter; Ischemic Preconditioning
PubMed: 36551300
DOI: 10.3390/biom12121872 -
Neuroprotective effects and mechanisms of ischemic/hypoxic preconditioning on neurological diseases.CNS Neuroscience & Therapeutics Aug 2021As the organ with the highest demand for oxygen, the brain has a poor tolerance to ischemia and hypoxia. Despite severe ischemia/hypoxia induces the occurrence and... (Review)
Review
As the organ with the highest demand for oxygen, the brain has a poor tolerance to ischemia and hypoxia. Despite severe ischemia/hypoxia induces the occurrence and development of various central nervous system (CNS) diseases, sublethal insult may induce strong protection against subsequent fatal injuries by improving tolerance. Searching for potential measures to improve brain ischemic/hypoxic is of great significance for treatment of ischemia/hypoxia related CNS diseases. Ischemic/hypoxic preconditioning (I/HPC) refers to the approach to give the body a short period of mild ischemic/hypoxic stimulus which can significantly improve the body's tolerance to subsequent more severe ischemia/hypoxia event. It has been extensively studied and been considered as an effective therapeutic strategy in CNS diseases. Its protective mechanisms involved multiple processes, such as activation of hypoxia signaling pathways, anti-inflammation, antioxidant stress, and autophagy induction, etc. As a strategy to induce endogenous neuroprotection, I/HPC has attracted extensive attention and become one of the research frontiers and hotspots in the field of neurotherapy. In this review, we discuss the basic and clinical research progress of I/HPC on CNS diseases, and summarize its mechanisms. Furthermore, we highlight the limitations and challenges of their translation from basic research to clinical application.
Topics: Animals; Autophagy; Brain; Humans; Hypoxia-Ischemia, Brain; Ischemic Preconditioning; Nervous System Diseases; Neuroprotection; Treatment Outcome
PubMed: 34237192
DOI: 10.1111/cns.13642 -
F1000Research 2020Acute kidney injury is a common clinical disorder resulting in significantly increased morbidity and mortality. However, despite extensive research, strategies for... (Review)
Review
Acute kidney injury is a common clinical disorder resulting in significantly increased morbidity and mortality. However, despite extensive research, strategies for prevention or treatment are still lacking in routine clinical practice. Already decades ago, several preconditioning strategies (e. g. ischemic/hypoxic preconditioning and calorie restriction) have been published and their extraordinary effectiveness - especially in rodents - has raised the hope for powerful clinical tools to prevent acute kidney injury. However, the underlying mechanisms are still not completely understood and translation to the clinics has not been successful yet. In this review, the most attractive strategies and the current mechanistic concepts are introduced and discussed. Furthermore, we present clinical trials evaluating the feasibility of preconditioning in the clinical setting.
Topics: Acute Kidney Injury; Humans; Hypoxia; Ischemic Preconditioning
PubMed: 32269763
DOI: 10.12688/f1000research.21406.1 -
Travel Medicine and Infectious Disease 2023The high-altitude hypoxia environment will cause poor acclimatization in a portion of the population. Remote ischemic preconditioning(RIPC)has been demonstrated to... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The high-altitude hypoxia environment will cause poor acclimatization in a portion of the population. Remote ischemic preconditioning(RIPC)has been demonstrated to prevent cardiovascular and cerebrovascular diseases under ischemic or hypoxic conditions. However, its role in improving acclimatization and preventing acute mountain sickness (AMS) at high altitude has been undetermined. This study aims to estimate the effect of RIPC on acclimatization of individuals exposed to high altitude.
METHODS
The project was designed as a randomized controlled trial with 82 healthy young males, who received RIPC training once a day for 7 consecutive days. Then they were transported by aircraft to a high altitude (3680 m) and examined for 6 days. Lake Louise Score(LLS) of AMS, physiological index, self-reported sleep pattern, and Pittsburgh Sleep Quality Index(PSQI)score were applied to assess the acclimatization to the high altitude. Five neurobehavioral tests were conducted to assess cognitive function.
RESULTS
The result showed that the RIPC group had a significantly lower AMSscore than the control group (2.43 ± 1.58 vs 3.29 ± 2.03, respectively; adjusted mean difference-0.84, 95% confidence interval-1.61 to -0.06, P = 0.036). and there was no significant difference in AMS incidence between the two groups (25.0% vs 28.57%, P = 0.555). The RIPC group performed better than the control group in spatial memory span score (11[9-12] vs 10[7.5-11], P=0.025) and the passing digit (7[6-7.5] vs 6[5-7], P= 0.001). Spatial memory was significantly higher in the high-altitude RIPC group than in the low-altitude RIPC group (P<0.01). And the RIPC group obtained significantly lower self-reported sleep quality score (P = 0.024) and PSQI score (P = 0.031).
CONCLUSIONS
The RIPC treatment improved spatial memory and sleep quality in subjects exposed to acute hypoxic exposure and this may lead to improved performance at high altitude.
Topics: Male; Humans; Altitude; Spatial Memory; Altitude Sickness; Acute Disease; Hypoxia; Ischemic Preconditioning; Sleep; Acclimatization
PubMed: 37068619
DOI: 10.1016/j.tmaid.2023.102576