Remote ischemic perconditioning—a simple, low-risk method to decrease ischemic reperfusion injury: Models, protocols and mechanistic background. A review

• Published in: The Journal of surgical research 2012-12, Vol.178 (2), p.797-806
• Main Authors: Szijártó, Attila, MD, PhD, Czigány, Zoltán, MD, Turóczi, Zsolt, MD, Harsányi, László, MD, PhD
• Format: Article
• Language: English
• Subjects: Animals; Calcitonin Gene-Related Peptide - physiology; Humans; Ischemia; Ischemic Preconditioning, Myocardial - methods; Myocardial Reperfusion Injury - prevention & control; Myocardium; Reactive Oxygen Species; Remote ischemic per-conditioning; Reperfusion; Signal Transduction; Surgery
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2012.06.067

Abstract Interruption of blood flow can cause ischemic reperfusion injury, which sometimes has a fatal outcome. Recognition of the phenomenon known as reperfusion injury has led to initial interventional approaches to lessen the degree of damage. A number of efficient pharmacologic agents and surgical techniques (e.g., local ischemic preconditioning and postconditioning) are available. A novel, alternative approach to target organ protection is remote ischemic conditioning triggered by brief repetitive ischemia and reperfusion periods in distant organs. Among the different surgical techniques is so-called remote ischemic perconditioning, a method that applies short periods of ischemic reperfusion to a distant organ delivered during target organ ischemia. Although ischemic reperfusion injury is reduced by this technique, the explanation for this phenomenon is still unclear, and approximately only a dozen reports on the topic have appeared in the literature. In our study, therefore, we investigated the connective mechanisms, signal transduction, and effector mechanisms behind remote perconditioning, with a review on molecular background and favorable effects. In addition, we summarize the various treatment protocols and models to promote future experimental and clinical research.