Ischaemic preconditioning - Current knowledge and potential future applications after 30 years of experience

Area of Science:

• Cardiology
• Nephrology
• Hepatology
• Neurology

Background:

• Ischaemic preconditioning (IPC) is a phenomenon where brief ischaemic and reperfusion episodes protect organs from subsequent prolonged ischaemia.
• Initially studied for myocardial protection, IPC is now recognized as a universal protective mechanism across various organs, including the heart, liver, brain, kidney, and intestine.

Purpose of the Study:

• To present recent advancements in understanding the mechanisms of local and remote ischaemic preconditioning.
• To discuss the potential clinical applications and utility of IPC in protecting various organs.

Main Methods:

• This review synthesizes existing research on ischaemic preconditioning.
• It examines potential triggers, intracellular pathways, and effectors involved in IPC's protective activity.
• The review discusses clinical evidence and potential therapeutic strategies.

Main Results:

• IPC demonstrates protective effects on the heart, kidney, liver, and brain against ischaemic injury.
• Potential mechanisms involve complex intracellular signaling, humoral, neural, and genetic factors.
• IPC is a safe, non-invasive, inexpensive, and easily applicable method.

Conclusions:

• Ischaemic preconditioning offers a promising, versatile, and safe strategy for organ protection during various clinical scenarios, including cardiac surgery and transplantation.
• Further research into IPC mechanisms can optimize its clinical utility for preventing ischaemic damage.