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From rapid to delayed and remote postconditioning: the evolving concept of ischemic postconditioning in brain ischemia.

Authors
  • Zhao, Heng
  • Ren, Chuancheng
  • Chen, Xingmiao
  • Shen, Jiangang
Type
Published Article
Journal
Current drug targets
Publication Date
Feb 01, 2012
Volume
13
Issue
2
Pages
173–187
Identifiers
PMID: 22204317
Source
Medline
License
Unknown

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 K(ATP) 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.

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