From Rapid to Delayed and Remote Postconditioning: The Evolving Concept of Ischemic Postconditioning in Brain Ischemia

Author(s): Heng Zhao, Chuancheng Ren, Xingmiao Chen, Jiangang Shen

Journal Name: Current Drug Targets

Volume 13 , Issue 2 , 2012

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Abstract:

Ischemic postconditioning is a concept originally defined to contrast with that of ischemic preconditioning. While both preconditioning and postconditioning confer a neuroprotective effect on brain ischemia, preconditioning is a sublethal insult performed in advance of brain ischemia, and postconditioning, which conventionally refers to a series of brief occlusions and reperfusions of the blood vessels, is conducted after ischemia/reperfusion. In this article, we first briefly review the history of preconditioning, including the experimentation that initially uncovered its neuroprotective effects and later revealed its underlying mechanisms-of-action. We then discuss how preconditioning research evolved into that of postconditioning - a concept that now represents a broad range of stimuli or triggers, including delayed postconditioning, pharmacological postconditioning, remote postconditioning - and its underlying protective mechanisms involving the Akt, MAPK, PKC and KATP channel cell-signaling pathways. Because the concept of postconditioning is so closely associated with that of preconditioning, and both share some common protective mechanisms, we also discuss whether a combination of preconditioning and postconditioning offers greater protection than preconditioning or postconditioning alone.

Keywords: Postconditioning, Preconditioning, stroke, cerebral ischemia, focal ischemia, neuroprotection, heart, synergistic protection, signaling pathways, ROS

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Article Details

VOLUME: 13
ISSUE: 2
Year: 2012
Page: [173 - 187]
Pages: 15
DOI: 10.2174/138945012799201621
Price: $65

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