Multicenter Translational Trial of Remote Ischemic Conditioning in Acute Ischemic Stroke (TRICS BASIC)

Area of Science:

• Neuroscience
• Translational Medicine
• Preclinical Research

Background:

• Basic science suggests remote ischemic conditioning (RIC) offers neuroprotection in acute ischemic stroke.
• Clinical evidence for RIC's efficacy in stroke patients is currently conflicting.
• The TRICS BASIC study aimed to rigorously evaluate RIC in an experimental stroke model.

Purpose of the Study:

• To investigate the efficacy and safety of remote ischemic conditioning (RIC) in a preclinical model of acute ischemic stroke.
• To assess the impact of RIC on functional outcomes and infarct volume in rodents.
• To address variability and enhance translational validity through a multicenter preclinical trial design.

Main Methods:

• A multicenter, multispecies, randomized controlled preclinical trial involving rats and mice subjected to middle cerebral artery occlusion.
• RIC was induced using transient femoral artery clipping after reperfusion.
• Primary endpoint: good functional outcome at 48 hours; Secondary endpoints: infarct volume and safety assessments. Rigorous methodology included blinding, allocation concealment, and intention-to-treat analysis.

Main Results:

• 164 rodents (82 mice, 82 rats) were enrolled across 7 laboratories.
• RIC treatment resulted in a higher proportion of rodents achieving favorable functional outcomes (55% vs. 36%; P=0.009).
• RIC was associated with a significant reduction in infarct volume (SMD=-0.38; P=0.024) and no major safety concerns were identified.

Conclusions:

• Surgically induced RIC demonstrated a modest yet evident neuroprotective effect in experimental ischemic stroke.
• RIC holds potential as an adjunctive treatment strategy for stroke care.
• Multicenter preclinical trials are crucial for improving the translational validity of findings in stroke research.