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Post‐ischemic brain damage: effect of ischemic preconditioning and postconditioning and identification of potential candidates for stroke therapy
Author(s) -
Pignataro Giuseppe,
Scorziello Antonella,
Di Renzo Gianfranco,
Annunziato Lucio
Publication year - 2009
Publication title -
the febs journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.981
H-Index - 204
eISSN - 1742-4658
pISSN - 1742-464X
DOI - 10.1111/j.1742-4658.2008.06769.x
Subject(s) - neuroprotection , ischemic preconditioning , medicine , ischemia , ischemic stroke , neuroscience , stroke (engine) , endogeny , mechanism (biology) , anesthesia , cardiology , pharmacology , psychology , mechanical engineering , philosophy , epistemology , engineering
Because clinical trials of pharmacological neuroprotective strategies in stroke have been disappointing, attention has turned to the brain’s own endogenous strategies for neuroprotection. Two endogenous mechanisms have been characterized so far, namely ischemic preconditioning and ischemic postconditioning. The neuroprotective concept of preconditioning is based on the observation that a brief, noninjurious episode of ischemia is able to protect the brain from a subsequent longer ischemic insult. Recently, a hypothesis has been offered that modified reperfusion subsequent to a prolonged ischemic episode may also confer ischemic neuroprotection, a phenomenon termed postconditioning. Many pathways have been proposed as plausible mechanisms to explain the neuroprotection offered by preconditioning and postconditioning. Unfortunately, so far, none of them has clearly identified the mechanism involved in preconditioning and postconditioning. The present article will review the main mechanisms reported to date to explain the neuroprotective effect of both ischemic preconditioning and postconditioning.