Signaling pathways of cardioprotective ischemic preconditioning.
BACKGROUND
Ischemia/reperfusion (I/R) injury is a major contributory factor to cardiac dysfunction and infarct size that determines patient prognosis after acute myocardial infarction. During the last 20 years, since the appearance of the first publication on ischemic preconditioning (IP), our knowledge of this phenomenon has increased exponentially.


CONCLUSIONS
Basic scientific experiments and preliminary clinical trials in humans suggest that IP confers resistance to subsequent sustained ischemic insults not only in the regional tissue but also in distant organs (remote ischemic preconditioning), which may provide a simple, cost-effective means of reducing the risk of perioperative myocardial ischemia. The mechanism may be humoral, neural, or a combination of both, and involves adenosine, bradykinin, protein kinases and K(ATP) channels, although the precise end-effector remains unclear. This review describes different signaling pathways involved in acute ischemic preconditioning in detail.
Sadat
Umar
U
Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. sadat.umar@gmail.com
D000109:Acetylcholine / Q000378:metabolism; D000241:Adenosine / Q000378:metabolism; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods; D000818:Animals; D001920:Bradykinin / Q000378:metabolism; D003326:Coronary Circulation / Q000502:physiology; D004195:Disease Models, Animal; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D011494:Protein Kinases / Q000378:metabolism; D011859:Radiography; D017382:Reactive Oxygen Species / Q000378:metabolism; D018570:Risk Assessment; D015398:Signal Transduction / Q000502:physiology*
D017382:Reactive Oxygen Species; D011494:Protein Kinases; D000241:Adenosine; D000109:Acetylcholine; D001920:Bradykinin