Limb Remote Ischemic Conditioning: Mechanisms, Anesthetics, and the Potential for Expanding Therapeutic Options.
Limb Remote Ischemic Conditioning: Mechanisms, Anesthetics, and the Potential for Expanding Therapeutic Options.
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DOI：
10.3389/fneur.2018.00040
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发表时间：
2018
影响因子：
3.4
通讯作者：
Doré S
中科院分区：
文献类型：
--
作者：
Chen G;Thakkar M;Robinson C;Doré S
新颖和创新的方法对于开发新的治疗方法和改善缺血性卒中患者的临床结局至关重要。远端缺血预处理（RIC）是在终末器官再灌注后，远端器官血流的一系列机械中断，显示通过抑制氧化和炎症显著减少梗死面积。缺血/再灌注（I/R）最终导致中风患者出现不可逆转的脑损伤和临床表现。关于RIC在急性缺血性卒中中的潜力，已有几篇报道和综述;然而，本文重点是全面了解三种类型RIC（远程预处理、预处理和后处理）的差异。由于缺血性事件的不可预测性，预处理在急性缺血性卒中中的应用有限;然而，它确实为临床研究提供了生物标志物的鉴定。远程肢体预处理和后处理在患者护理期间提供了更有希望的治疗，因为它们可以在初始缺血性损伤期间或之后利用。虽然还需要进一步的研究，但必须讨论临床前数据在理解RIC所涉及的方法和机制方面的重要性。这种理解将有助于转化为临床可行的范例，用于医院环境。
Novel and innovative approaches are essential in developing new treatments and improving clinical outcomes in patients with ischemic stroke. Remote ischemic conditioning (RIC) is a series of mechanical interruptions in blood flow of a distal organ, following end organ reperfusion, shown to significantly reduce infarct size through inhibition of oxidation and inflammation. Ischemia/reperfusion (I/R) is what ultimately leads to the irreversible brain damage and clinical picture seen in stroke patients. There have been several reports and reviews about the potential of RIC in acute ischemic stroke; however, the focus here is a comprehensive look at the differences in the three types of RIC (remote pre-, per-, and postconditioning). There are some limited uses of preconditioning in acute ischemic stroke due to the unpredictability of the ischemic event; however, it does provide the identification of biomarkers for clinical studies. Remote limb per- and postconditioning offer a more promising treatment during patient care as they can be harnessed during or after the initial ischemic insult. Though further research is needed, it is imperative to discuss the importance of preclinical data in understanding the methods and mechanisms involved in RIC. This understanding will facilitate translation to a clinically feasible paradigm for use in the hospital setting.
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