1. Preclinical evidence of remote ischemic conditioning in ischemic stroke, a metanalysis update
- Author
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Coral Torres-Querol, Manuel Quintana-Luque, Gloria Arque, Francisco Purroy, Institut Català de la Salut, [Torres-Querol C] Clinical Neurosciences Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain. [Quintana-Luque M] Unitat d’Epilèpsia, Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Arque G] Clinical Neurosciences Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain. Experimental Medicine Department, Universitat de Lleida, Lleida, Spain. [Purroy F] Clinical Neurosciences Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain. Medicine Department, Universitat de Lleida, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain. Stroke Unit, Department of Neurology, Universitat de Lleida, Hospital Universitari Arnau de Vilanova, Clinical Neurosciences Group IRBLleida, Lleida, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
Science ,Myocardial Infarction ,Malalties cerebrovasculars - Tractament ,Molecular neuroscience ,Article ,enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::isquemia cerebral [ENFERMEDADES] ,Mice ,hemic and lymphatic diseases ,Animals ,técnicas de investigación::modelos animales [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Ischemic Postconditioning ,Ischemic Preconditioning ,Anesthetics ,Ischemic Stroke ,Multidisciplinary ,Neuro-vascular interactions ,Animals de laboratori ,Disease Management ,Investigative Techniques::Models, Animal [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Brain Ischemia [DISEASES] ,Cellular neuroscience ,Rats ,Disease Models, Animal ,Treatment Outcome ,Models, Animal ,Therapeutics::Ischemic Preconditioning [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Avaluació de resultats (Assistència sanitària) ,Medicine ,Disease Susceptibility ,Neuroscience ,terapéutica::precondicionamiento isquémico [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] - Abstract
Cellular neuroscience; Molecular neuroscience; Neuro-vascular interactions Neurociència cel·lular; Neurociència molecular; Interaccions neurovasculars Neurociencia celular; Neurociencia molecular; Interacciones neurovasculares Remote ischemic conditioning (RIC) is a promising therapeutic approach for ischemic stroke patients. It has been proven that RIC reduces infarct size and improves functional outcomes. RIC can be applied either before ischemia (pre-conditioning; RIPreC), during ischemia (per-conditioning; RIPerC) or after ischemia (post-conditioning; RIPostC). Our aim was to systematically determine the efficacy of RIC in reducing infarct volumes and define the cellular pathways involved in preclinical animal models of ischemic stroke. A systematic search in three databases yielded 50 peer-review articles. Data were analyzed using random effects models and results expressed as percentage of reduction in infarct size (95% CI). A meta-regression was also performed to evaluate the effects of covariates on the pooled effect-size. 95.3% of analyzed experiments were carried out in rodents. Thirty-nine out of the 64 experiments studied RIPostC (61%), sixteen examined RIPreC (25%) and nine tested RIPerC (14%). In all studies, RIC was shown to reduce infarct volume (− 38.36%; CI − 42.09 to − 34.62%) when compared to controls. There was a significant interaction caused by species. Short cycles in mice significantly reduces infarct volume while in rats the opposite occurs. RIPreC was shown to be the most effective strategy in mice. The present meta-analysis suggests that RIC is more efficient in transient ischemia, using a smaller number of RIC cycles, applying larger length of limb occlusion, and employing barbiturates anesthetics. There is a preclinical evidence for RIC, it is safe and effective. However, the exact cellular pathways and underlying mechanisms are still not fully determined, and its definition will be crucial for the understanding of RIC mechanism of action. This study was supported by the Government of Catalonia-Agència de Gestió d'Ajuts Universitaris i de Recerca (FP: 2017 SGR 1628), Instituto de Salud Carlos III and co-funded by European Union (ERDF/ESF, “Investing in your future”) (FP: Project PI17-01725) and the INVICTUS plus Research Network (Carlos III Health Institute). C.T-Q. was supported by a Grant from Contratos predoctorales de formación en investigación en salud (PFIS; FI18/00319).
- Published
- 2021