Remote ischemic conditioning: from experimental observation to clinical application: report from the 8th Biennial Hatter Cardiovascular Institute Workshop.
Remote ischemic conditioning: from experimental observation to clinical application: report from the 8th Biennial Hatter Cardiovascular Institute Workshop.
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DOI：
10.1007/s00395-014-0453-6
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发表时间：
2015-01
影响因子：
9.5
通讯作者：
Hausenloy DJ
中科院分区：
文献类型：
--
作者：
Pickard JM;Bøtker HE;Crimi G;Davidson B;Davidson SM;Dutka D;Ferdinandy P;Ganske R;Garcia-Dorado D;Giricz Z;Gourine AV;Heusch G;Kharbanda R;Kleinbongard P;MacAllister R;McIntyre C;Meybohm P;Prunier F;Redington A;Robertson NJ;Suleiman MS;Vanezis A;Walsh S;Yellon DM;Hausenloy DJ
1993 年，Przyklenk 及其同事进行了一项有趣的实验观察，即“一个血管床的短暂缺血也可以保护远处的原始心肌免受随后持续的冠状动脉闭塞”，并且这种效应“……”可能是由在短暂缺血/再灌注期间激活、产生或运输到整个心脏的因子介导的”。这项开创性的研究为发现“远程缺血调节”（RIC）奠定了基础，“远程缺血调节”是一种通过对远离心脏的器官或组织进行短暂缺血和再灌注循环来保护心脏免受急性缺血/再灌注损伤（IRI）的有害影响的现象。 RIC 的概念迅速发展到心脏以外的领域，包括针对急性 IRI 的器官间保护。这一重要发现是，通过简单地对放置在上臂上的血压袖带进行充气和放气来诱导短暂缺血和再灌注周期，可以非侵入性地应用保护性 RIC 刺激，这一发现促进了 RIC 转化为临床环境。尽管过去 20 年进行了深入的研究，但研究人员仍然不清楚其潜在机制。在第八届 Hatter 心血管研究所双年度研讨会上，讨论了 RIC 领域的最新进展，重点是对潜在机制的新见解、非心脏保护的多样性、新的临床应用和大型结果研究。这一研究领域取得的科学进步凸显了 RIC 从有趣的实验观察到造福患者的临床应用的历程。
In 1993, Przyklenk and colleagues made the intriguing experimental observation that ‘brief ischemia in one vascular bed also protects remote, virgin myocardium from subsequent sustained coronary artery occlusion’ and that this effect ‘…. may be mediated by factor(s) activated, produced, or transported throughout the heart during brief ischemia/reperfusion’. This seminal study laid the foundation for the discovery of ‘remote ischemic conditioning’ (RIC), a phenomenon in which the heart is protected from the detrimental effects of acute ischemia/reperfusion injury (IRI), by applying cycles of brief ischemia and reperfusion to an organ or tissue remote from the heart. The concept of RIC quickly evolved to extend beyond the heart, encompassing inter-organ protection against acute IRI. The crucial discovery that the protective RIC stimulus could be applied non-invasively, by simply inflating and deflating a blood pressure cuff placed on the upper arm to induce cycles of brief ischemia and reperfusion, has facilitated the translation of RIC into the clinical setting. Despite intensive investigation over the last 20 years, the underlying mechanisms continue to elude researchers. In the 8th Biennial Hatter Cardiovascular Institute Workshop, recent developments in the field of RIC were discussed with a focus on new insights into the underlying mechanisms, the diversity of non-cardiac protection, new clinical applications, and large outcome studies. The scientific advances made in this field of research highlight the journey that RIC has made from being an intriguing experimental observation to a clinical application with patient benefit.
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