Remote ischemic conditioning.
Remote ischemic conditioning.
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DOI：
10.1016/j.jacc.2014.10.031
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发表时间：
2015-01-20
影响因子：
24
通讯作者：
Yellon D
中科院分区：
文献类型：
--
作者：
Heusch G;Bøtker HE;Przyklenk K;Redington A;Yellon D
在远程缺血适应(RIC)中，在一个血管床、组织或器官中短暂、可逆的缺血和再灌注可提供全局保护表型，使远程组织和器官抵抗缺血/再灌注损伤。外周刺激可以是化学的、机械的或电的，涉及外周感觉神经的激活。信号传递到心脏或其他器官是通过神经元和体液通讯。保护可以通过血浆来源的透析液转移，甚至可以跨物种转移，涉及一氧化氮、间质衍生因子-1α、MicroRNA144，但也涉及其他尚未确定的因素。心内信号转导涉及：激活特定受体的腺苷、缓激肽、细胞因子和趋化因子；细胞内激酶；以及线粒体功能。RIC通过反复短暂充气/放气来保护经皮冠状动脉介入治疗、冠状动脉旁路移植术和再灌流急性心肌梗死中的内皮功能障碍和心肌损伤。RIC具有安全有效、无创、操作简便、费用低廉等优点。
In remote ischemic conditioning (RIC) brief, reversible episodes of ischemia with reperfusion in one vascular bed, tissue or organ confer a global protective phenotype and render remote tissues and organs resistant to ischemia/reperfusion injury. The peripheral stimulus can be chemical, mechanical or electrical and involves activation of peripheral sensory nerves. The signal transfer to the heart or other organs is through neuronal and humoral communications. Protection can be transferred, even across species, with plasma-derived dialysate and involves nitric oxide, stromal derived factor-1α, microRNA-144, but also other, not yet identified factors. Intracardiac signal transduction involves: adenosine, bradykinin, cytokines, and chemokines, which activate specific receptors; intracellular kinases; and mitochondrial function. RIC by repeated brief inflation/deflation of a blood pressure cuff protects against endothelial dysfunction and myocardial injury in percutaneous coronary interventions, coronary artery bypass grafting and reperfused acute myocardial infarction. RIC is safe and effective, noninvasive, easily feasible and inexpensive.
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