Advances in intervention methods and brain protection mechanisms of in situ and remote ischemic postconditioning

Li, Chunyan; Ma, Wei; Liu, Kuangpin; Yang, Jiarui; Wang, Xianbin; Wu, Zhiyong; Zhang, Tong; Wang, Jiawei; Liu, Wei; Liu, Jie; Zhang, Xingkui; Li, Jun; Guo, Jun; Li, Liyan

doi:10.1007/s11011-020-00562-x

Cited by 16 publications

(9 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From the results of cell‐level tests, RIPostC has the ability to reduce normal cell death or apoptosis, and regulate autophagy to reduce I/R injury 7 . Among the studies using autophagy as a measure, the majority showed that RIPostC provided neuroprotection by activating autophagy 34,36,48–50 ; however, Chen et al, 31 illustrated that RIPostC protected the brain from damage by inhibiting autophagy.…”

Section: Discussionmentioning

confidence: 99%

“…26 From the results of cell-level tests, RIPostC has the ability to reduce normal cell death or apoptosis, and regulate autophagy to reduce I/R injury. 7 Among the studies using autophagy as a measure, the majority showed that RIPostC provided neuroprotection by activating autophagy 34,36,[48][49][50] ; however, Chen et al, 31 illustrated that RIPostC protected the brain from damage by inhibiting autophagy. In addition, Wang et al, 51 (The study was also included in the analysis, but the measure of autophagy was performed based on the combination of RIPostC and ISIPostC, so this part of the data did not meet the criteria and was not in statistics.)…”

Section: Ta B L E 3 (Continued)mentioning

confidence: 99%

“…In addition to IPostC, there are also ischemic preconditioning (IPreC, performed prior to ischemia in an organ) and ischemic perconditioning (IPerC, performed during an ischemia event). And IPostC can be further divided into in situ ischemic postconditioning (ISIPostC) and remote ischemic postconditioning (RIPostC) depending on the site of intervention 7 . All kinds of above‐mentioned conditioning methods play their respective parts in studying endogenous survival and protection mechanisms of multi‐organs involving multiple processes, but RIPostC has its own distinct strengths over others in the field of ischemic stroke.…”

Section: Introductionmentioning

confidence: 99%

“…Besides the commonly used infarct size and neurological scales, the measure indicators particularly added some cell-level tests including normal-neuron density, damaged-neuron counting, autophagy, and apoptosis. Nevertheless, since neuron death involves multiple sophisticated and interacted cell signaling pathways, with the associated mechanisms not fully understood, 3,7 the most symbolic biomarkers and detection methods were selected in the study rather than pathway-specific molecules or factors for statistics.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Determination of significant parameters in remote ischemic postconditioning for ischemic stroke in experimental models: A systematic review and meta‐analysis study

et al. 2022

View full text Add to dashboard Cite

Objectives:To systematically review studies using remote ischemia postconditioning (RIPostC) for ischemic stroke in experimental models and obtain factors that significantly influence treatment outcomes. Materials and Methods:Peer-reviewed studies were identified and selected based on the eligibility criteria, followed by extraction of data on potentially influential factors related to model preparation, postconditioning, and measure time based on outcome measures including infarct size, neurological scales, and cell tests with autophagy, apoptosis, normal-neuron, and damaged-neuron counting. Then, all data were preprocessed, grouped, and meta-analyzed with the indicator of the standardized mean difference. Results:Fifty-seven studies with 224 experiments (91 for infarct size, 92 for neurological scales, and 41 for cell-level tests) were included. There was little statistical difference between different model preparations, treated body parts, number of treatments, and sides. And treatment effect was generally a positive correlation with the duration of conditioning time to stroke onset with exceptions at some time points.Based on infarct size, the number of cycles per treatment, duration of occlusion, and release per cycle showed significant differences. Combined with the effect sizes by other measures, the occlusion/release duration of 8-10 min per cycle is better than 5 min, and three cycles per treatment were most frequently used with good effects.Effect also varied when measuring at different times, showing statistical differences in infarct size and most neurological scales. RIPostC is confirmed as an effective therapeutic intervention for ischemic stroke, while the RIPostC-mediated autophagy level being activated or inhibited remained conflicting. Conclusions: Conditioning time, number of cycles per treatment, duration of occlusion, and release per cycle were found to influence the treatment effects of RIPostC | 1493 LIU et aL.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Ta B L E 3 (Continued)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Determination of significant parameters in remote ischemic postconditioning for ischemic stroke in experimental models: A systematic review and meta‐analysis study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The neuroprotective effect of RIC is presumably advantageous in presence of salvageable brain tissue, whose survival can last many hours after stroke onset depending on multiple factors. Many preclinical studies indicate that RIC helps the survival of salvageable brain tissue by reducing apoptosis, downregulating inflammatory response, and improving collateral circulation in the ischemic penumbra ( 33 ). Furthermore, two pre-clinical studies on a rat model of experimental ischemic stroke demonstrated that RIC is beneficial up to 6 h after ischemic stroke due to permanent large vessel occlusion ( 18 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

Multi-Center Randomized Phase II Clinical Trial on Remote Ischemic Conditioning in Acute Ischemic Stroke Within 9 Hours of Onset in Patients Ineligible to Recanalization Therapies (TRICS-9): Study Design and Protocol

et al. 2021

View full text Add to dashboard Cite

Aim: To assess the efficacy of remote ischemic conditioning (RIC) in patients with ischemic stroke within 9 h of onset, that are not candidates for recanalization therapies.Sample Size Estimates: A sample size of 80 patients (40 in each arm) should yield 80% power to detect a 20% difference in early neurological improvement at 72 h at p = 0.05, two sided.Methods and Design: TRICS-9 is a phase II, multicenter, controlled, block randomized, open-label, interventional clinical trial. Patients recruited in Italian academic hospitals will be randomized 1:1 to either RIC plus standard medical therapy or standard medical therapy alone. After randomization, RIC will be applied manually by four alternating cycles of inflation/deflation 5 min each, using a blood pressure cuff around the non-paretic arm.Study Outcomes: The primary efficacy outcome is early neurological improvement, defined as the percent change in the National Institute of Health Stroke Scale (NIHSS) at 72 h in each arm. Secondary outcomes include early neurologic improvement at 24 and 48 h, disability at 3 months, rate of symptomatic intracerebral hemorrhage, feasibility (proportion of patients completing RIC), tolerability after RIC and at 72 h, blood levels of HIF-1α, and HSP27 at 24 h and 72 h.Discussion/Conclusion: RIC in combination with recanalization therapies appears to add no clinical benefit to patients, but whether it is beneficial to those that are not candidates for recanalization therapies is still to be demonstrated. TRICS-9 has been developed to elucidate this issue.Clinical Trial Registration:ClinicalTrials.gov, identifier: NCT04400981.

show abstract

The role and mechanisms of microvascular damage in the ischemic myocardium

Zhao,

Ruze,

Zhao

et al. 2023

Cell. Mol. Life Sci.

View full text Add to dashboard Cite

Advances in intervention methods and brain protection mechanisms of in situ and remote ischemic postconditioning

Cited by 16 publications

References 61 publications

Determination of significant parameters in remote ischemic postconditioning for ischemic stroke in experimental models: A systematic review and meta‐analysis study

Determination of significant parameters in remote ischemic postconditioning for ischemic stroke in experimental models: A systematic review and meta‐analysis study

Multi-Center Randomized Phase II Clinical Trial on Remote Ischemic Conditioning in Acute Ischemic Stroke Within 9 Hours of Onset in Patients Ineligible to Recanalization Therapies (TRICS-9): Study Design and Protocol

The role and mechanisms of microvascular damage in the ischemic myocardium

Contact Info

Product

Resources

About