Are we ready to apply preconditioning-induced neuroprotection to improve the outcome patients with brain is chemia?

Are we ready to apply preconditioning-induced neuroprotection to improve the outcome patients with brain is chemia?

摘要

Neuroprotection against cerebral ischemia is still a major unfulfilled medical need. Recently, attention has turned to studying the brain,s own endogenous strategies for neuroprotection. Preconditioning, also known as induced toler¬ance to ischemia, is one of these strategies that have been intensively investigated in recent years. Preconditioning describes the phenomenon by which a sub-lethal stimulus confers protection against subsequent detrimental insult-induced injury. Research on preconditioning over the past few decades has brought various promising interventions for reducing ischemic brain injury in patients. Several of these strategies are being tested in randomized clinical trials. Also, the existence of preconditioning phenom¬enon prepares us to the idea that we can prophylactically induce protective effects in patients in whom brain ischemia may oc¬cur during surgery or disease course (for example, patients with subarachnoid hemorrhage are at high risk of brain ischemia within 14 days of the hemorrhage) . In this article, we will review clinically relevant issues relating to preconditioning-induced neuroprotection. Especially, we will discuss the potential of clinical application of preconditioning to improve the outcome pa¬tients with brain ischemia.