Cerebral protection by remote ischemic post-conditioning in patients with ischemic stroke: A systematic review and meta-analysis of randomized controlled trials

Lü, Meng; Wang, Yujiao; Yin, Xin; Li, Yuanyuan; Li, Hongyan

doi:10.3389/fneur.2022.905400

“…Conditioning is a widely applied therapeutic technique in which a potentially harmful stimuli is applied below the threshold for tissue damage, leading to the induction of endogenous neuroprotective pathways [ 148 ]. Remote ischemic post-conditioning is a conditioning mechanism widely studied in ischemic stroke and found to be safe and effective in both preclinical and clinical studies [ 149 , 150 ], and has demonstrated promising results in TBI [ 151 , 152 ]. While the mechanistic effects underlying ischemic post-conditioning are still being uncovered, it is known to increase expression of BDNF and promote neurogenesis and neuroplasticity, which may help to prevent neurodegeneration and maladaptive functional alterations following cerebral insults [ 148 ].…”

Section: Discussionmentioning

confidence: 99%

Multi-Mechanistic Approaches to the Treatment of Traumatic Brain Injury: A Review

Lynch

¹

,

Narayan

²

,

Li

³

2023

JCM

View full text Add to dashboard Cite

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Despite extensive research efforts, the majority of trialed monotherapies to date have failed to demonstrate significant benefit. It has been suggested that this is due to the complex pathophysiology of TBI, which may possibly be addressed by a combination of therapeutic interventions. In this article, we have reviewed combinations of different pharmacologic treatments, combinations of non-pharmacologic interventions, and combined pharmacologic and non-pharmacologic interventions for TBI. Both preclinical and clinical studies have been included. While promising results have been found in animal models, clinical trials of combination therapies have not yet shown clear benefit. This may possibly be due to their application without consideration of the evolving pathophysiology of TBI. Improvements of this paradigm may come from novel interventions guided by multimodal neuromonitoring and multimodal imaging techniques, as well as the application of multi-targeted non-pharmacologic and endogenous therapies. There also needs to be a greater representation of female subjects in preclinical and clinical studies.

show abstract

“…Conditioning is a widely applied therapeutic technique in which a potentially harmful stimuli is applied below the threshold for tissue damage, leading to the induction of endogenous neuroprotective pathways [115]. Remote ischemic post-conditioning is a conditioning mechanism widely studied in ischemic stroke and found to be safe and effective in both preclinical and clinical studies [116,117], and has demonstrated promising results in TBI [118,119]. While the mechanistic effects underlying ischemic post-conditioning are still being uncovered, it is known to increase expression of BDNF and promote neurogenesis and neuroplasticity, which may help to prevent neurodegeneration and maladaptive functional alterations following cerebral insults [115].…”

Section: Future Directions In Multimodal Tbi Treatmentmentioning

confidence: 99%

Multi-mechanistic Approaches to the Treatment of Traumatic Brain Injury: A Review

Lynch¹,

Narayan²,

Li³

2023

Preprint

3

0

View full text Add to dashboard Cite

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Despite extensive research efforts, the majority of trialed monotherapies to date have failed to demonstrate significant benefit. It has been suggested that this is due to the complex pathophysiology of TBI, which may possibly be addressed by a combination of therapeutic interventions. In this article, we have reviewed combinations of different pharmacologic treatments, combinations of non-pharmacologic interventions, and combined pharmacologic and non-pharmacologic interventions for TBI. Both preclinical and clinical studies have been included. While promising results have been found in animal models, clinical trials of combination therapies have not yet shown clear benefit. This may possibly be due to their application without consideration of the evolving pathophysiology of TBI. Improvements of this paradigm may come from novel interventions guided by multimodal neuromonitoring and multimodal imaging techniques, as well as the application of multi-targeted non-pharmacologic and endogenous therapies. There also needs to be a greater representation of female subjects in preclinical and clinical studies.

show abstract

“…A recent systematic review concluded that it appeared to be safe, and there may be a suggestion of efficacy, but whether it is really effective remains to be determined. 10 It also highlighted how previous studies had been small and underpowered and that we now need larger definitive trials to confirm whether this treatment, which is been highly effective in animal models, translates into clinical benefit. The protocol for such a trial, SERIC-IVT, in which RIC is given as an adjunct to intravenous thrombolysis is also published in this issue.…”

mentioning

confidence: 99%

Stroke in China

Markus¹,

Leung²

2023

International Journal of Stroke

View full text Add to dashboard Cite

Cerebral protection by remote ischemic post-conditioning in patients with ischemic stroke: A systematic review and meta-analysis of randomized controlled trials

Cited by 9 publications

References 46 publications

Multi-Mechanistic Approaches to the Treatment of Traumatic Brain Injury: A Review

Multi-Mechanistic Approaches to the Treatment of Traumatic Brain Injury: A Review

Multi-mechanistic Approaches to the Treatment of Traumatic Brain Injury: A Review

Stroke in China

Contact Info

Product

Resources

About