Biological networks in ischemic tolerance - rethinking the approach to clinical conditioning.
Biological networks in ischemic tolerance - rethinking the approach to clinical conditioning.
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DOI：
10.1007/s12975-012-0244-z
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发表时间：
2013-02
影响因子：
6.9
通讯作者：
Hallenbeck, John M
中科院分区：
文献类型：
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作者：
Anrather, Josef;Hallenbeck, John M
对环境压力源的适应性反应（调节）会引发单细胞和多细胞生物体中进化上保守的程序，从而增强适应性和对压力源引起的损伤的抵抗力。尽管调理的概念已经存在了一段时间，但其向针对神经血管疾病的临床疗法的转化最近才开始。临床采用速度缓慢的部分原因可能是我们对基础机制和生物体对应激源的复杂反应了解不足。在第二次转化预处理会议上，与会者进行了激烈的讨论，讨论是否是时候在脑血管疾病的治疗中更积极地实施临床预处理方案，或者是否最好等到临床前数据有助于最大限度地减少临床经验主义。本综述以两种临床上有前途的调节方式（即远程缺血预调节和预调节或后调节）讨论了生物网络在生物体水平上建立缺血耐受性的复杂参与。
The adaptive response (conditioning) to environmental stressors evokes evolutionarily conserved programs in uni- and multicellular organisms that result in increased fitness and resistance to stressor induced injury. Although the concept of conditioning has been around for a while, its translation into clinical therapies targeting neurovascular diseases has only recently begun. The slow pace of clinical adoption might be partially explained by our poor understanding of underpinning mechanisms and of the complex responses of the organism to the stressor. At the 2nd Translational Preconditioning Meeting participants engaged in an intense discussion addressing whether the time has come to more aggressively implement clinical conditioning protocols in the treatment of cerebrovascular diseases or whether it would be better to wait until preclinical data would help to minimize clinical empiricism. This review addresses the complex involvement of biological networks in establishing ischemic tolerance at the organism level using two clinically promising conditioning modalities, namely remote ischemic preconditioning, and per- or post-conditioning, as examples.