Remote Ischemic Preconditioning

Limani, Përparim; Linecker, Michael; Oberkofler, Christian E.; Barmettler, Gery; Kaech, Andres; Graf, Rolf; Humar, Bostjan; Clavien, Pierre‐Alain

doi:10.1097/sla.0000000000001765

Cited by 25 publications

(8 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, RIP is neuroprotective in young male rodents after experimental stroke, and is also effective after embolic stroke in ovariectomized female mice ( 31 ). In clinical settings, RIP protects the aged liver against I/R injury, and is further associated with improvement in vascular function ( 32 ). Although the mechanism involved is not understood, here, the authors provided direct evidence that indicates that vascular endothelial cells secrete exosomes during cerebral I/R injury that protect neurobehavioral outcomes.…”

Section: Discussionmentioning

confidence: 99%

Endothelial cell-derived exosomes protect SH-SY5Y nerve cells against ischemia/reperfusion injury

Xiao

Chai

et al. 2017

International Journal of Molecular Medicine

View full text Add to dashboard Cite

Cerebral ischemia is a leading cause of death and disability. A previous study indicated that remote ischemic postconditioning (RIP) in the treatment of cerebral ischemia reduces ischemia/reperfusion (I/R) injury. However, the underlying mechanism is not well understood. In the present study, the authors hypothesized that the protective effect of RIP on neurological damage is mediated by exosomes that are released by endothelial cells in femoral arteries. To test this, right middle cerebral artery occlusion/reperfusion with RIP was performed in rats. In addition, an I/R injury cell model was tested that included human umbilical vein endothelial cells (HUVECs) and SH-SY5Y cells. Both the in vivo and in vitro models were examined for injury. Markers of exosomes (CD63, HSP70 and TSG101) were assessed by immunohistochemistry, western blot analysis and flow cytometry. Exosomes were extracted from both animal serum and HUVEC culture medium and identified by electron microscopy. They investigated the role of endothelial cell-derived exosomes in the proliferation, apoptosis, cell cycle, migration and invasion of I/R-injured SH-SY5Y cells. In addition, apoptosis-related molecules caspase-3, Bax and Bcl-2 were detected. RIP was determined to increase the number of exosomes and the expression levels of CD63, HSP70 and TSG101 in plasma, but not in brain hippocampal tissue. The size of exosomes released after I/R in HUVECs was similar to the size of exosomes released in rats subjected to RIP. Endothelial cell-derived exosomes partly suppressed the I/R-induced cell cycle arrest and apoptosis, and inhibited cell proliferation, migration and invasion in SH-SY5Y nerve cells. Endothelial cell-derived exosomes directly protect nerve cells against I/R injury, and are responsible for the protective role of RIP in I/R.

show abstract

Section: Discussionmentioning

confidence: 99%

Endothelial cell-derived exosomes protect SH-SY5Y nerve cells against ischemia/reperfusion injury

Xiao

Chai

et al. 2017

International Journal of Molecular Medicine

View full text Add to dashboard Cite

show abstract

“…Clinical trials have shown that ischemic preconditioning is feasible in people at high risk of stroke and significantly reduces the incidence of stroke. [24,25]…”

Section: Discussionmentioning

confidence: 99%

“…Clinical trials have shown that ischemic preconditioning is feasible in people at high risk of stroke and significantly reduces the incidence of stroke. [24,25] Many previous literatures have discussed the clinical application of VEGF in cerebral ischemia, but the data supporting the protective effect of VEGF-A are almost entirely based on animal models, and there are few clinical studies, mainly focusing on the increased level of human serum VEGF-A after stroke.…”

Section: Discussionmentioning

confidence: 99%

Effect of VEGF on neurological impairment and prognosis of acute cerebral infarction patients: A retrospective case-control study

Tian¹,

Niu²,

Li³

et al. 2023

Medicine

View full text Add to dashboard Cite

Objective: Due to the complex pathological mechanism of acute cerebral infarction, the role of vascular endothelial growth factor (VEGF) on the disease is not clear. Therefore, a retrospective case-control study was performed to explore the effect of VEGF on neurological impairment and prognosis of acute cerebral infarction patients. Method: A total of 100 patients with acute cerebral infarction admitted to our hospital from April 2021 to April 2022 were selected. Blood samples from all patients would be routinely collected to detect the expression of serum VEGF. Pearson chi-square, Spearman correlation and univariate Logistic regression were used to analyze the clinical data to explore the relationship between VEGF expression and basic information, stroke degree, quality of life, and prognosis of patients. To determine whether VEGF can provide relevant basis for the early prevention and prognostic treatment of acute cerebral infarction. And multivariate logistic regression was used to calculate the odds ratio between each variable and VEGF expression. Results: Pearson chi-square test and Spearman correlation coefficient showed that sex, degree of stroke, limb convulsions, loss of consciousness, hemiplegia, aphasia, mental functioning score, overall quality of life score, and short-term prognosis were significantly correlated with VEGF expression in 100 patients. Univariate logistic regression was used to describe the ORs and 95% confidence interval of subjects at the univariate level, and the degree of stroke (OR = 83.333, P < 0.001), tic of limbs (OR = 26.316, P < 0.001), loss of consciousness (OR = 23.256, P < 0.001), hemiplegia (OR = 62.500, P < 0.001), aphasia (OR = 76.923, P < 0.001), mental functioning score (OR = 7.937, P < 0.001), overall quality of life score (OR = 5.464, P < 0.001), short-term prognosis (OR = 37.037, P < 0.001) was significantly correlated with the high expression of VEGF. Conclusions: The level of serum VEGF was positively correlated with neurological impairment degree and prognosis in patients with acute cerebral infarction, the more severe the degree of stroke and the worse the prognosis.

show abstract

“…In line with this, preconditioning by VEGF-A injections increases cerebral perfusion, reduces stroke-induced neural damage [ 155 ], and increases neurogenesis even for months after the treatment [ 156 ]. Furthermore, the preconditioning event does not need to be present in the organ that is protected, as remote ischemic preconditioning (rIPC) also protects organs from ischemic damage by raising systemic VEGF-A levels [ 157 ]. Laboratory experiments have shown that rIPC reduces brain infarction [ 148 , 158 , 159 , 160 ].…”

Section: Vegf-a In the Prevention And Therapy Of Strokementioning

confidence: 99%

The Janus Face of VEGF in Stroke

Geiseler

Morland

2018

IJMS

135

124

View full text Add to dashboard Cite

The family of vascular endothelial growth factors (VEGFs) are known for their regulation of vascularization. In the brain, VEGFs are important regulators of angiogenesis, neuroprotection and neurogenesis. Dysregulation of VEGFs is involved in a large number of neurodegenerative diseases and acute neurological insults, including stroke. Stroke is the main cause of acquired disabilities, and normally results from an occlusion of a cerebral artery or a hemorrhage, both leading to focal ischemia. Neurons in the ischemic core rapidly undergo necrosis. Cells in the penumbra are exposed to ischemia, but may be rescued if adequate perfusion is restored in time. The neuroprotective and angiogenic effects of VEGFs would theoretically make VEGFs ideal candidates for drug therapy in stroke. However, contradictory to what one might expect, endogenously upregulated levels of VEGF as well as the administration of exogenous VEGF is detrimental in acute stroke. This is probably due to VEGF-mediated blood–brain-barrier breakdown and vascular leakage, leading to edema and increased intracranial pressure as well as neuroinflammation. The key to understanding this Janus face of VEGF function in stroke may lie in the timing; the harmful effect of VEGFs on vessel integrity is transient, as both VEGF preconditioning and increased VEGF after the acute phase has a neuroprotective effect. The present review discusses the multifaceted action of VEGFs in stroke prevention and therapy.

show abstract

Remote Ischemic Preconditioning

Cited by 25 publications

References 36 publications

Endothelial cell-derived exosomes protect SH-SY5Y nerve cells against ischemia/reperfusion injury

Endothelial cell-derived exosomes protect SH-SY5Y nerve cells against ischemia/reperfusion injury

Effect of VEGF on neurological impairment and prognosis of acute cerebral infarction patients: A retrospective case-control study

The Janus Face of VEGF in Stroke

Contact Info

Product

Resources

About