Liu Jie, Sun Xin, Jin Hang, Yan Xiu-Li, Huang Shuo, Guo Zhen-Ni, Yang Yi
Stroke Center & Clinical Trial and Research Center for Stroke, Department of Neurology, the First Hospital of Jilin University, No. 1 Xinmin Street, Changchun 130021, China; China National Comprehensive Stroke Center, No. 1 Xinmin Street, Changchun 130021, China; Jilin Provincial Key Laboratory of Cerebrovascular Disease, No. 1 Xinmin Street, Changchun 130021, China.
Stroke Center & Clinical Trial and Research Center for Stroke, Department of Neurology, the First Hospital of Jilin University, No. 1 Xinmin Street, Changchun 130021, China; China National Comprehensive Stroke Center, No. 1 Xinmin Street, Changchun 130021, China.
Med Hypotheses. 2021 Jan;146:110409. doi: 10.1016/j.mehy.2020.110409. Epub 2020 Nov 23.
Type 2 diabetes (T2D) is one of the major public diseases which is characterized by peripheral insulin resistance (IR) and progressive pancreatic β-cell failure. While in the past few years, some new factors, such as inflammation, oxidative stress, immune responses and other potential pathways, have been identified to play critical roles in T2D, and thereby provide novel promising targets for the treatment of T2D. Remote ischemic conditioning (RIC) is a non-invasive and convenient operation performed by transient, repeated ischemia in distant place. Nowadays, RIC has been established as a potentially powerful therapeutic tool for many diseases, especially in I/R injuries. Through activating a series of neural, humoral and immune pathways, it can release multiple protective signals, which then regulating inflammation, oxidative stress, immune response and so on. Interestingly, several recent studies have discovered that the beneficial effects of RIC on I/R injuries might be abolished by T2D, wherein the higher basal levels of inflammation and oxidative stress, dysregulation of immune system and some potential pathways secondary to hyperglycemia may play critical roles. In contrast, a higher intensity of conditioning could restore the protective effects. Based on the overlapped mechanisms RIC and T2D performs, we provide a hypothesis that RIC may also play a protective role in T2D via targeting these signaling pathways.
2型糖尿病（T2D）是主要的公共疾病之一，其特征为外周胰岛素抵抗（IR）和进行性胰腺β细胞功能衰竭。在过去几年中，一些新的因素，如炎症、氧化应激、免疫反应和其他潜在途径，已被确定在T2D中起关键作用，从而为T2D的治疗提供了新的有前景的靶点。远程缺血预处理（RIC）是一种通过在远处进行短暂、反复缺血来实施的非侵入性且便捷的操作。如今，RIC已被确立为对许多疾病具有潜在强大治疗作用的工具，尤其是在缺血/再灌注损伤方面。通过激活一系列神经、体液和免疫途径，它可以释放多种保护信号，进而调节炎症、氧化应激、免疫反应等。有趣的是，最近的几项研究发现，T2D可能会消除RIC对缺血/再灌注损伤的有益作用，其中较高的基础炎症水平和氧化应激、免疫系统失调以及高血糖继发的一些潜在途径可能起关键作用。相比之下，更高强度的预处理可以恢复其保护作用。基于RIC和T2D所涉及的重叠机制，我们提出一个假设，即RIC可能也通过靶向这些信号通路在T2D中发挥保护作用。
