2014
DOI: 10.1227/neu.0000000000000514
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Phase I Clinical Trial for the Feasibility and Safety of Remote Ischemic Conditioning for Aneurysmal Subarachnoid Hemorrhage

Abstract: Background Remote ischemic conditioning (RIC) is a powerful endogenous mechanism whereby a sublethal ischemic stimulus confers a protective benefit against a subsequent severe ischemic insult. RIC has significant potential clinical implications for the prevention of delayed ischemic neurological deficit (DIND) after aneurysmal subarachnoid hemorrhage (aSAH). While RIC has been extensively investigated in animal models, it has not been fully evaluated in humans. Objective To assess the feasibility and safety … Show more

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Cited by 60 publications
(49 citation statements)
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“…Regulates metabolic genes to protect against hypoxia Multiple CNS cells [17,22], peripheral immune cells [23] Type 1 IFNs Regulate neuroimmune function Microglia [11], peripheral macrophages [24,25] Refractive microRNAs Modulate gene expression post-translationally Multiple CNS cells [18,26] Polycomb group proteins Induce lasting alterations of gene-transcription programs…”
Section: Hif-1mentioning
confidence: 99%
See 1 more Smart Citation
“…Regulates metabolic genes to protect against hypoxia Multiple CNS cells [17,22], peripheral immune cells [23] Type 1 IFNs Regulate neuroimmune function Microglia [11], peripheral macrophages [24,25] Refractive microRNAs Modulate gene expression post-translationally Multiple CNS cells [18,26] Polycomb group proteins Induce lasting alterations of gene-transcription programs…”
Section: Hif-1mentioning
confidence: 99%
“…In astrocytes, HIF-1 also induces the expression of P450 2C11, an arachidonic acid epoxygenase, which is protective against ischemia-reperfusion injury in multiple organ systems [22], and contributes to IPC-mediated protection [22]. HIF-1 controls the glycolytic response of immune cells and profoundly alters inflammatory responses under conditions of hypoxia [23]. Microglia will express HIF-1 in response to hypoxic culture conditions [17].…”
Section: Molecular Mediators Of Preconditioningmentioning
confidence: 99%
“…The relative ease of administration, low cost, and potential wide generalizability of RIPC make the concept a particularly attractive clinical strategy for select populations of patients that are at high risk for cerebral ischemic events in the immediate (hours to days) future. This would include patients that are about to undergo major cardiac [32,33] or carotid artery [34] surgery, as well as possibly patients with subarachnoid hemorrhage that are at high risk of developing cerebral vasospasm and accompanying delayed cerebral ischemia [35,36]. The pioneering papers in the RIPC field suggest that neuroprotection is induced rapidly [30,31,37]; however, the duration of protection has not been determined [37,38].…”
Section: Remote Preconditioningmentioning
confidence: 99%
“…Низкая эффективность ДИП в дан-ном исследовании по сравнению с выраженным нейропротек-торным эффектом ЗПС, видимо, объясняется тем, что ДИП вы-полнялось после того как нарушение мозгового кровообращения произошло, а ЗПС предшествовало инсульту. Не удалось обнару-жить позитивного эффекта ДИП и у пациентов с субарахнои-дальным кровоизлиянием [19]. В этой связи следует отметить, что в экспериментальных исследованиях ДИП оказывало выра-женный эффект, ограничивающий инфаркт, при профилактиче-ском применении у животных с ИИ [15] и неэффективно при экспериментальном ГИ [16].…”
Section: контактная информацияunclassified