Hurdles to clear before clinical translation of ischemic postconditioning against stroke

Transl Stroke Res. 2013 Feb;4(1):63-70. doi: 10.1007/s12975-012-0243-0. Epub 2013 Jan 11.

Abstract

Ischemic postconditioning has been established for its protective effects against stroke in animal models. It is performed after post-stroke reperfusion and refers to a series of induced ischemia or a single brief one. This review article addresses major hurdles in clinical translation of ischemic postconditioning to stroke patients, including potential hazards, the lack of well-defined protective paradigms, and the paucity of deeply-understood protective mechanisms. A hormetic model, often used in toxicology to describe a dose-dependent response to a toxic agent, is suggested to study both beneficial and detrimental effects of ischemic postconditioning. Experimental strategies are discussed, including how to define the hazards of ischemic (homologous) postconditioning and the possibility of employing non-ischemic (heterologous) postconditioning to facilitate clinical translation. This review concludes that a more detailed assessment of ischemic postconditioning and studies of a broad range of heterologous postconditioning models are warranted for future clinical translation.

Keywords: clinical translation; hormesis; ischemic postconditioning; preconditioning; stroke.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Brain / blood supply*
  • Clinical Trials as Topic
  • Disease Models, Animal
  • Hormesis
  • Humans
  • Ischemic Postconditioning*
  • Stroke / therapy*
  • Translational Medical Research*