Tauskela Joseph S, Bourourou Miled, Blondeau Nicolas
Department of Translational Bioscience, Human Health Therapeutics, National Research Council Canada, Ottawa, Ontario, Canada K1A 0R6.
University of Côte d'Azur, Centre National de la Recherche Scientifique, IPMC, UMR7275 Sophia Antipolis, F-06560, France.
Brain Circ. 2017 Apr-Jun;3(2):78-86. doi: 10.4103/bc.bc_8_17. Epub 2017 Jul 18.
Brief periods of ischemia have been shown in many experimental setups to provide tolerance against ischemia in multiple organs including the brain, when administered before (preconditioning) or even after (postconditioning) the normally lethal ischemia. In addition to these so-called ischemic conditionings, many pharmacological and natural agents (e.g., chemicals and nutraceuticals) can also act as potent pre- and post-conditioners. Deriving from the original concept of ischemic preconditioning, these various conditioning paradigms may be promising as clinical-stage therapies for prevention of ischemic-related injury, especially stroke. As no proven experimentally identified strategy has translated into clinical success, the experimental induction of neuroprotection using these various conditioning paradigms has raised several questions, even before considering translation to clinical studies in humans. The first aim of the review is to consider key questions on preclinical studies of pre- or post-conditioning modalities including those induced by chemical or nutraceuticals. Second, we make the argument that several key issues can be addressed by a novel concept, nutraceutical preconditioning. Specifically, α-linolenic acid (alpha-linolenic acid [ALA] an omega-3 polyunsaturated fatty acid), contained in plant-derived edible products, is essential in the daily diet, and a body of work has identified ALA as a pre- and post-conditioner of the brain. Nutritional intervention and functional food development are an emerging direction for preventing stroke damage, offering the potential to improving clinical outcomes through activation of the endogenous protective mechanisms known collectively as conditioning.
在许多实验设置中已表明，短暂的缺血期，若在正常致死性缺血之前（预处理）甚至之后（后处理）给予，可使包括大脑在内的多个器官产生对缺血的耐受性。除了这些所谓的缺血预处理外，许多药理和天然制剂（如化学物质和营养保健品）也可作为有效的预处理和后处理剂。源自缺血预处理的最初概念，这些不同的预处理模式有望成为预防缺血相关损伤尤其是中风的临床阶段疗法。由于尚无经实验验证的策略转化为临床成功案例，在考虑转化为人体临床研究之前，使用这些不同预处理模式进行神经保护的实验诱导就已引发了几个问题。本综述的首要目的是思考关于预处理或后处理模式（包括由化学物质或营养保健品诱导的模式）临床前研究的关键问题。其次，我们认为一个新的概念——营养保健品预处理可以解决几个关键问题。具体而言，植物源可食用产品中含有的α-亚麻酸（一种ω-3多不饱和脂肪酸）在日常饮食中必不可少，并且大量研究已将α-亚麻酸确定为大脑的预处理和后处理剂。营养干预和功能性食品开发是预防中风损伤的一个新兴方向，通过激活统称为预处理的内源性保护机制，有可能改善临床结果。
