Department of Biomedical Engineering, School of Automation (Artificial Intelligence), Hangzhou Dianzi University, Hangzhou, China.
School of Management, Hangzhou Dianzi University, Hangzhou, China.
CNS Neurosci Ther. 2022 Oct;28(10):1492-1508. doi: 10.1111/cns.13925. Epub 2022 Jul 27.
To systematically review studies using remote ischemia postconditioning (RIPostC) for ischemic stroke in experimental models and obtain factors that significantly influence treatment outcomes.
Peer-reviewed studies were identified and selected based on the eligibility criteria, followed by extraction of data on potentially influential factors related to model preparation, postconditioning, and measure time based on outcome measures including infarct size, neurological scales, and cell tests with autophagy, apoptosis, normal-neuron, and damaged-neuron counting. Then, all data were preprocessed, grouped, and meta-analyzed with the indicator of the standardized mean difference.
Fifty-seven studies with 224 experiments (91 for infarct size, 92 for neurological scales, and 41 for cell-level tests) were included. There was little statistical difference between different model preparations, treated body parts, number of treatments, and sides. And treatment effect was generally a positive correlation with the duration of conditioning time to stroke onset with exceptions at some time points. Based on infarct size, the number of cycles per treatment, duration of occlusion, and release per cycle showed significant differences. Combined with the effect sizes by other measures, the occlusion/release duration of 8-10 min per cycle is better than 5 min, and three cycles per treatment were most frequently used with good effects. Effect also varied when measuring at different times, showing statistical differences in infarct size and most neurological scales. RIPostC is confirmed as an effective therapeutic intervention for ischemic stroke, while the RIPostC-mediated autophagy level being activated or inhibited remained conflicting.
Conditioning time, number of cycles per treatment, duration of occlusion, and release per cycle were found to influence the treatment effects of RIPostC significantly. More studies on the relevant influential factors and autophagy mechanisms are warranted.
系统回顾使用远程缺血后处理（RIPostC）治疗实验性缺血性卒中的研究，并获得显著影响治疗效果的因素。
根据纳入标准，筛选出同行评议研究，并提取与模型准备、后处理和基于结局指标（包括梗死面积、神经评分和细胞自噬、凋亡、正常神经元和损伤神经元计数试验）的潜在影响因素相关的数据。然后，对所有数据进行预处理、分组和荟萃分析，指标为标准化均数差。
共纳入 57 项研究、224 个实验（91 个用于测量梗死面积，92 个用于神经评分，41 个用于细胞水平试验）。不同模型准备、处理部位、治疗次数和侧别之间的差异无统计学意义。治疗效果与从卒中发作到开始处理的时间呈正相关，但在某些时间点存在例外。基于梗死面积，治疗次数、闭塞时间、每个循环的闭塞和释放时间存在显著差异。结合其他措施的效应大小，每个循环的闭塞/释放时间 8-10 分钟优于 5 分钟，每个治疗周期 3 次是最常用的，效果较好。不同时间点的测量结果也存在差异，在梗死面积和大多数神经评分方面均存在统计学差异。RIPostC 被证实是缺血性卒中的有效治疗干预措施，而 RIPostC 介导的自噬水平是激活还是抑制仍存在争议。
发现处理时间、每个治疗周期的循环次数、闭塞时间和每个循环的释放时间显著影响 RIPostC 的治疗效果。需要更多关于相关影响因素和自噬机制的研究。
