Division of Neurology, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
Stroke. 2011 Oct;42(10):2960-2. doi: 10.1161/STROKEAHA.111.622340. Epub 2011 Aug 11.
Remote ischemic preconditioning is a phenomenon by which a short period of sublethal ischemia to an organ protects against subsequent ischemia in another organ. We have recently demonstrated that remote ischemic conditioning by transient hind limb ischemia delivered during ischemia and before reperfusion can provide potent cardioprotection, a phenomenon we termed per-conditioning. This study evaluated whether remote ischemic per-conditioning may provide neuroprotection in a clinically relevant rat model of acute ischemic stroke.
Remote ischemic conditioning by transient limb ischemia was used in a rat transient middle cerebral artery occlusion model of acute stroke. A total of 39 P60 rats were randomly allocated to receive preconditioning, per-conditioning, or sham conditioning. Cerebral ischemia was maintained for 120 minutes followed by reperfusion. The resulting infarct size at 24 hours was quantified using computerized image analysis of 2-3-5-triphenyl tetrazolium chloride-stained brain sections.
Compared with control, both pre- and per-conditioning significantly reduced brain infarct size with the more clinically relevant per-conditioning stimulus being superior to preconditioning.
Remote per-conditioning by transient limb ischemia is a facile, clinically relevant stimulus that provides potent neuroprotection in a model of regional brain ischemia-reperfusion injury. Further studies are required to better understand the mechanisms and biology of this response before translation to randomized controlled trials of remote per-conditioning for acute ischemic stroke.
远程缺血预处理是一种现象，即器官的短暂亚致死性缺血可保护另一个器官免受随后的缺血。我们最近证明，在缺血期间和再灌注之前短暂的下肢缺血可提供有效的心脏保护，我们将这种现象称为预处理。本研究评估了远程缺血预处理是否可以在急性缺血性卒中的临床相关大鼠模型中提供神经保护。
采用大鼠短暂性大脑中动脉闭塞模型中的短暂肢体缺血来进行远程缺血预处理。总共 39 只 P60 大鼠随机分为预处理组、预处理组和假处理组。脑缺血持续 120 分钟，然后再灌注。用 2,3,5-三苯基氯化四氮唑染色的脑切片的计算机图像分析来定量计算 24 小时后的梗死面积。
与对照组相比，预处理和预处理都显著减少了脑梗死面积，而更具临床相关性的预处理刺激比预处理更有效。
短暂肢体缺血的远程预处理是一种简便、临床相关的刺激，可以在区域性脑缺血再灌注损伤模型中提供有效的神经保护。在将远程预处理应用于急性缺血性卒中的随机对照试验之前，还需要进一步研究以更好地了解这种反应的机制和生物学。
