Billah Muntasir, Ridiandries Anisyah, Allahwala Usaid, Mudaliar Harshini, Dona Anthony, Hunyor Stephen, Khachigian Levon M, Bhindi Ravinay
Department of Cardiology, Kolling Institute, Northern Sydney Local Health District, St Leonards, NSW, Australia.
Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia.
Oncotarget. 2019 Jan 4;10(2):216-244. doi: 10.18632/oncotarget.26537.
Acute myocardial infarction (AMI) is one of the leading causes of mortality and morbidity worldwide. There has been an extensive search for cardioprotective therapies to reduce myocardial ischemia-reperfusion (I/R) injury. Remote ischemic preconditioning (RIPC) is a phenomenon that relies on the body's endogenous protective modalities against I/R injury. In RIPC, non-lethal brief I/R of one organ or tissue confers protection against subsequent lethal I/R injury in an organ remote to the briefly ischemic organ or tissue. Initially it was believed to be limited to direct myocardial protection, however it soon became apparent that RIPC applied to other organs such as kidney, liver, intestine, skeletal muscle can reduce myocardial infarct size. Intriguing discoveries have been made in extending the concept of RIPC to other organs than the heart. Over the years, the underlying mechanisms of RIPC have been widely sought and discussed. The involvement of blood-borne factors as mediators of RIPC has been suggested by a number of research groups. The main purpose of this review article is to summarize the possible circulating mediators of RIPC, and recent studies to establish the clinical efficacy of these mediators in cardioprotection from lethal I/R injury.
急性心肌梗死（AMI）是全球范围内导致死亡和发病的主要原因之一。人们一直在广泛寻找能够减少心肌缺血再灌注（I/R）损伤的心脏保护疗法。远程缺血预处理（RIPC）是一种依赖于机体针对I/R损伤的内源性保护机制的现象。在RIPC中，一个器官或组织的非致死性短暂I/R可对远离短暂缺血器官或组织的另一个器官的后续致死性I/R损伤产生保护作用。最初人们认为它仅限于直接的心肌保护，然而很快就发现，应用于肾脏、肝脏、肠道、骨骼肌等其他器官的RIPC可以减小心肌梗死面积。在将RIPC的概念扩展到心脏以外的其他器官方面已经有了一些有趣的发现。多年来，RIPC的潜在机制一直是广泛研究和讨论的对象。一些研究小组提出，血源性因子作为RIPC的介质发挥了作用。这篇综述文章的主要目的是总结RIPC可能的循环介质，以及最近关于确定这些介质在预防致死性I/R损伤的心脏保护中的临床疗效的研究。
