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Remote Ischemic Conditioning: A Potential Treatment for Chronic Cerebral Hypoperfusion
1Department of General Practice Medicine, Dalian Municipal Central Hospital, Dalian, China.
Insights
Remote ischemic conditioning (RIC) shows promise for treating chronic cerebral hypoperfusion (CCH). RIC improves cerebral blood flow and offers neuroprotection, potentially benefiting patients with vascular dementia and Alzheimer's disease.
Area of Science:
- Neuroscience
- Cerebrovascular Medicine
- Pathophysiology
Background:
- Chronic cerebral hypoperfusion (CCH) involves reduced cerebral blood flow (CBF), linked to cerebrovascular diseases and aging.
- CCH causes neuronal damage, amyloid-beta accumulation, blood-brain barrier disruption, and endothelial dysfunction.
- CCH is a significant risk factor for cognitive impairment, including vascular dementia and Alzheimer's disease.
Purpose of the Study:
- To discuss the mechanisms underlying brain hypoperfusion.
- To explore remote ischemic conditioning (RIC) as a potential treatment for CCH.
- To promote the clinical application of RIC for CCH.
Main Methods:
- Review of existing literature on CCH and RIC mechanisms.
- Analysis of pathophysiological pathways in CCH models.
- Evaluation of RIC's therapeutic effects in preclinical and clinical studies.
Main Results:
- RIC increases CBF in CCH models and patients.
- RIC inhibits neuronal apoptosis, reduces amyloid-beta deposition, and protects blood-brain barrier integrity.
- RIC alleviates neuroinflammation and improves cognitive deficits, demonstrating neuroprotective effects.
Conclusions:
- RIC is a safe and effective therapeutic strategy for CCH.
- RIC offers significant neuroprotection by addressing multiple pathological aspects of CCH.
- Further research and clinical translation of RIC for CCH are warranted.
Background:
Chronic cerebral hypoperfusion (CCH) is a clinical syndrome, which is characterized by significantly decreased cerebral blood flow (CBF). CCH is a common consequence of cerebrovascular and cardiovascular diseases and the elderly. CCH results in a series of pathological damages, increasing cell death, autophagy dysfunction, amyloid β (Aβ) peptide accumulation, blood-brain barrier (BBB) disruption, and endothelial damage, which are found in CCH models. In addition, CCH is a prominent risk factor of cognitive impairment, such as vascular dementia, and CCH contributes to the occurrence and development of Alzheimer's disease. Therefore, the treatment of patients with CCH is of great value. It has been confirmed that remote ischemic conditioning (RIC) is a safe, promising treatment for acute and chronic cerebrovascular diseases. RIC significantly increases CBF in both CCH models and patients, inhibits neuronal apoptosis, reduces Aβ deposition, protects BBB integrity and endothelial function, alleviates neuroinflammation, improves cognitive impairment, and exerts neuroprotection.
Summary:
With the development of animal models, the pathophysiological mechanisms of CCH and RIC are increasingly revealed.
Key Messages:
We discuss the mechanisms related to hypoperfusion in the brain and explore the potential treatment of RIC for CCH to promote its transformation and application in humans.
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