Postconditioning: current controversies and clinical implications.
OBJECTIVE
Postconditioning of ischaemic tissue, via mechanical or pharmacological manipulation, offers an exciting avenue towards amelioration of ischaemia-reperfusion injury. Born from the concept of ischaemic preconditioning, postconditioning is advantageous in that prior knowledge of the ischaemic insult is not required, and thus clinical translation may be further reaching. This review explores the current evidence and controversies in both animal and human studies and multiple organ systems.


METHODS
A Medline search was conducted to identify English-language articles with 'postconditioning' as a keyword. Two independent researchers scrutinised the literature search for potentially relevant articles. Reference lists from selected articles were manually searched for further relevant articles.


CONCLUSIONS
Postconditioning has been shown to be successful in reducing ischaemia-reperfusion injury in both animal models and clinical trials. Human studies are presently limited to cardiac studies, but there is scope for research into other organ systems with potential beneficial effects, particularly within the field of vascular surgery where ischaemia-reperfusion occurs by nature of both - the disease and the intervention.
Mockford
K A
KA
Leeds Vascular Institute, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire, LS1 3EX, United Kingdom. katherinemockford@hotmail.com
Girn
H R S
HR
Homer-Vanniasinkam
S
S
D000700:Analgesics / Q000494:pharmacology; D000818:Animals; D002545:Brain Ischemia / Q000517:prevention & control; D002986:Clinical Trials as Topic; D004730:Endothelium, Vascular / Q000502:physiology; D006801:Humans; D033681:Mitochondrial Membrane Transport Proteins; D000083162:Mitochondrial Permeability Transition Pore; D023421:Models, Animal; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D015398:Signal Transduction / Q000187:drug effects; D020760:Spinal Cord Ischemia / Q000517:prevention & control; D013997:Time Factors
D000700:Analgesics; D033681:Mitochondrial Membrane Transport Proteins; D000083162:Mitochondrial Permeability Transition Pore