Chronic Remote Ischemic Conditioning May Mimic Regular Exercise:Perspective from Clinical Studies

Abstract

Chronic remote ischemic conditioning (RIC), particularly long-term repeated RIC, has been applied in clinical trials with the expectation that it could play its protective roles for protracted periods. In sports medicine, chronic RIC has also been demonstrated to improve exercise performance, akin to improvements seen with regular exercise training. Therefore, chronic RIC may mimic regular exercise, and they may have similar underlying mechanisms. In this study, we explored the common underlying mechanisms of chronic RIC and physical exercise in protecting multiple organs and benefiting various populations, the advantages of chronic RIC, and the challenges for its popularization. Intriguingly, several underlying mechanisms of RIC and exercise have been shown to overlap. These include the production of many autacoids, enhanced ability for antioxidant activity, modulating immune and inflammatory responses. Therefore, it appears that chronic RIC, just like regular exercise, has beneficial effects in unhealthy, sub-healthy and healthy individuals. Compared with regular exercise, chronic RIC has several advantages, which may provide novel insights into the area of exercise and health. Chronic RIC may enrich the modes of exercise, and benefit individuals with severe diseases. Also, the disabled, and sub-healthy individuals are likely to benefit from chronic RIC either as an alternative to exercise or an adjunct to pharmacological or non-pharmacological therapy.

Ischemic Conditioning Ameliorated Hypertension and Vascular Remodeling of Spontaneously Hypertensive Rat via Inflammatory Regulation

“…Limb remote ischemic conditioning (LRIC) is a physiological treatment that protects against acute ischemic events and traumatic injury [ 13 , 14 ]. Chronic remote ischemic conditioning simulates regular exercise and exerts its protective effect via humoral and immunological regulation [ 14 , 15 ]. Some clinical cases reported that LRIC could decrease blood pressure [ 16 ].…”

Remote Ischemic Conditioning Improves Attention Network Function and Blood Oxygen Levels in Unacclimatized Adults Exposed to High Altitude

“…Remote ischemic conditioning (RIC) is a systemic strategy in which several cycles of ischemia followed by reperfusion in the limbs confer protection on distant vital organs [13,14]. RIC has been demonstrated to benefit patients with cardiocerebrovascular disease, exerting strong neuroprotective effects [15,16].…”

Effects of chronic remote ischemic conditioning on atrial fibrillation burden in patients with permanent pacemakers

“…Thus, neural factors may play an important role in CRIC, too. CRIC could regulate immune/ in ammation system 14 and improve cardiac remodeling 31 , which also plays an important role in the progression of AF. However, the exact mechanism in reduction of AF burden by CRIC need to be further exploited in the future.…”

“…Long-term repeated RIC, now called chronic RIC (CRIC) 14 , may increase the 'dose' of RIC and subsequently lead to enhanced protection 15 . It was showed that RIC before CABG surgery and/or valve surgery could reduce the incidence of postoperative AF by 54% (11% RIC vs 24% control; p = 0.031) 16 .…”