“…Here, I believe, we have an excellent example of the principle proverbially illustrated by the strikingly disparate interpretations of the true nature of an elephant by a group of blind men, each one based upon the limited palpation of a different appendage thereof. Similarly, the somewhat remarkable salutary effects of ischemic preconditioning have been variously attributed to arachidonic acid metabolism (prostaglandins/leukotrienes), 18,19 acidosis, 20 calcium fluxes, 21 reactive oxygen species ("free radicals"), 4,[22][23][24][25] including the currently fashionable nitric oxide free radical, 26 the synthesis of antioxidant enzymes, 27 heat shock protein expression, 28,29 the PARS pathway, 30 apoptosis, 31 purine (adenosine) signaling, 32 kinins, 33,34 glutamate receptors, endothelial adhesion molecule expression, 5,35,36 and a host of intracellular signalling pathways, including tumor necrosis factor, 37 protein kinase C, 38 G-proteins, ceramide, 39 and innumerable others. Indeed, each of the above cited studies does suggest the association of one or more of the above mechanisms with the clinically relevant beneficial effects of ischemic preconditioning.…”