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Hurdles to Clear Before Clinical Translation of Ischemic Postconditioning Against Stroke

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Abstract

Ischemic postconditioning has been established for its protective effects against stroke in animal models. It is performed after post-stroke reperfusion and refers to a series of induced ischemia or a single brief one. This review article addresses major hurdles in clinical translation of ischemic postconditioning to stroke patients, including potential hazards, the lack of well-defined protective paradigms, and the paucity of deeply understood protective mechanisms. A hormetic model, often used in toxicology to describe a dose-dependent response to a toxic agent, is suggested to study both beneficial and detrimental effects of ischemic postconditioning. Experimental strategies are discussed, including how to define the hazards of ischemic (homologous) postconditioning and the possibility of employing non-ischemic (heterologous) postconditioning to facilitate clinical translation. This review concludes that a more detailed assessment of ischemic postconditioning and studies of a broad range of heterologous postconditioning models are warranted for future clinical translation.

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Acknowledgments

The authors thank Ms. Cindy H. Samos for manuscript assistance. This study was supported by AHA grant in aid and NIH grant 1R01NS 064136-01 (HZ).

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The author declares that he has no conflict of interest.

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  1. Department of Neurosurgery, Stanford University School of Medicine, MSLS Bldg., Room P306, 1201 Welch Rd., Room P306, Stanford, CA, 94305-5327, USA

    Heng Zhao

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Zhao, H. Hurdles to Clear Before Clinical Translation of Ischemic Postconditioning Against Stroke. Transl. Stroke Res. 4, 63–70 (2013). https://doi.org/10.1007/s12975-012-0243-0

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