Abbasi-Habashi Sima, Jickling Glen C, Winship Ian R
Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada.
Division of Neurology, Faculty of Medicine, University of Alberta, Edmonton, AB, Canada.
Front Neurol. 2021 Dec 9;12:746486. doi: 10.3389/fneur.2021.746486. eCollection 2021.
Remote ischemic conditioning (RIC), which involves a series of short cycles of ischemia in an organ remote to the brain (typically the limbs), has been shown to protect the ischemic penumbra after stroke and reduce ischemia/reperfusion (IR) injury. Although the exact mechanism by which this protective signal is transferred from the remote site to the brain remains unclear, preclinical studies suggest that the mechanisms of RIC involve a combination of circulating humoral factors and neuronal signals. An improved understanding of these mechanisms will facilitate translation to more effective treatment strategies in clinical settings. In this review, we will discuss potential protective mechanisms in the brain and cerebral vasculature associated with RIC. We will discuss a putative role of the immune system and circulating mediators of inflammation in these protective processes, including the expression of pro-and anti-inflammatory genes in peripheral immune cells that may influence the outcome. We will also review the potential role of extracellular vesicles (EVs), biological vectors capable of delivering cell-specific cargo such as proteins and miRNAs to cells, in modulating the protective effects of RIC in the brain and vasculature.
远程缺血预处理（RIC），即对远离大脑的器官（通常是肢体）进行一系列短暂的缺血周期，已被证明可保护中风后的缺血半暗带并减少缺血/再灌注（IR）损伤。尽管这种保护信号从远程部位传递到大脑的确切机制尚不清楚，但临床前研究表明，RIC的机制涉及循环体液因子和神经元信号的组合。对这些机制的深入理解将有助于转化为临床环境中更有效的治疗策略。在本综述中，我们将讨论与RIC相关的大脑和脑血管系统中的潜在保护机制。我们将讨论免疫系统和炎症循环介质在这些保护过程中的假定作用，包括外周免疫细胞中促炎和抗炎基因的表达，这些表达可能会影响结果。我们还将综述细胞外囊泡（EVs）的潜在作用，EVs是能够将细胞特异性货物（如蛋白质和微小RNA）递送至细胞的生物载体，其在调节RIC对大脑和血管系统的保护作用方面的作用。
