Creating one problem to try and fix another: the saga of ischemic preconditioning

Caplan, Louis R.

doi:10.1002/brb3.170

Cited by 4 publications

(1 citation statement)

References 6 publications

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“…Since preconditioning involves application of non-lethal but noxious stressors, one can question whether it is wise to create one pathological problem to solve another [179]. It is important to analyze whether complete elucidation of the internal repair mechanisms and molecular pathways of PC can guarantee therapeutic benefits in the immediate future [180].…”

Section: Clinical Concerns and Future Prospectsmentioning

confidence: 99%

Cerebral Ischemic Preconditioning: the Road So Far…

Sangwan

Sharma

et al. 2015

Mol Neurobiol

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Cerebral preconditioning constitutes the brain's adaptation to lethal ischemia when first exposed to mild doses of a subtoxic stressor. The phenomenon of preconditioning has been largely studied in the heart, and data from in vivo and in vitro models from past 2-3 decades have provided sufficient evidence that similar machinery exists in the brain as well. Since preconditioning results in a transient protective phenotype labeled as ischemic tolerance, it can open many doors in the medical warfare against stroke, a debilitating cerebrovascular disorder that kills or cripples thousands of people worldwide every year. Preconditioning can be induced by a variety of stimuli from hypoxia to pharmacological anesthetics, and each, in turn, induces tolerance by activating a multitude of proteins, enzymes, receptors, transcription factors, and other biomolecules eventually leading to genomic reprogramming. The intracellular signaling pathways and molecular cascades behind preconditioning are extensively being investigated, and several first-rate papers have come out in the last few years centered on the topic of cerebral ischemic tolerance. However, translating the experimental knowledge into the clinical scaffold still evades practicality and faces several challenges. Of the various preconditioning strategies, remote ischemic preconditioning and pharmacological preconditioning appears to be more clinically relevant for the management of ischemic stroke. In this review, we discuss current developments in the field of cerebral preconditioning and then examine the potential of various preconditioning agents to confer neuroprotection in the brain.

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Section: Clinical Concerns and Future Prospectsmentioning

confidence: 99%