Journal
CURRENT DRUG TARGETS
Volume 13, Issue 2, Pages 173-187Publisher
BENTHAM SCIENCE PUBL LTD
DOI: 10.2174/138945012799201621
Keywords
Postconditioning; preconditioning; stroke; cerebral ischemia; focal ischemia; neuroprotection
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Funding
- AHA
- NIH grant [1R21NS057750-01A2, 1R01NS 064136-01A1]
- RGC-GRF grant [774408]
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Ischemic postconditioning is a concept originally defined to contrast with that of ischemic preconditioning. While both preconditioning and postconditioning confer a neuroprotective effect on brain ischemia, preconditioning is a sublethal insult performed in advance of brain ischemia, and postconditioning, which conventionally refers to a series of brief occlusions and reperfusions of the blood vessels, is conducted after ischemia/reperfusion. In this article, we first briefly review the history of preconditioning, including the experimentation that initially uncovered its neuroprotective effects and later revealed its underlying mechanisms-of-action. We then discuss how preconditioning research evolved into that of postconditioning - a concept that now represents a broad range of stimuli or triggers, including delayed postconditioning, pharmacological postconditioning, remote postconditioning - and its underlying protective mechanisms involving the Akt, MAPK, PKC and K-ATP channel cell-signaling pathways. Because the concept of postconditioning is so closely associated with that of preconditioning, and both share some common protective mechanisms, we also discuss whether a combination of preconditioning and postconditioning offers greater protection than preconditioning or postconditioning alone.
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