title: Age-related reduction of cerebral ischemic preconditioning: myth or reality?
abstract: Stroke is one of the leading causes of death in industrialized countries for people older than 65 years of age. The reasons are still unclear. A reduction of endogenous mechanisms against ischemic insults has been proposed to explain this phenomenon. The "cerebral" ischemic preconditioning mechanism is characterized by a brief episode of ischemia that renders the brain more resistant against subsequent longer ischemic events. This ischemic tolerance has been shown in numerous experimental models of cerebral ischemia. This protective mechanism seems to be reduced with aging both in experimental and clinical studies. Alterations of mediators released and/or intracellular pathways may be responsible for age-related ischemic preconditioning reduction. Agents able to mimic the "cerebral" preconditioning effect may represent a new powerful tool for the treatment of acute ischemic stroke in the elderly. In this article, animal and human cerebral ischemic preconditioning, its age-related difference, and its potential therapeutical applications are discussed.
authors.affiliation: Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA ; Department of Advanced Biotechnologies and Bioimaging, IRCCS San Raffaele, Rome, Italy.
authors.forename: David
authors.initials: D
authors.lastname: Della-Morte
authors.forename: Francesco
authors.initials: F
authors.lastname: Cacciatore
authors.forename: Elisa
authors.initials: E
authors.lastname: Salsano
authors.forename: Gilda
authors.initials: G
authors.lastname: Pirozzi
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Del Genio
authors.forename: Iole
authors.initials: I
authors.lastname: D'Antonio
authors.forename: Gaetano
authors.initials: G
authors.lastname: Gargiulo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Palmirotta
authors.forename: Fiorella
authors.initials: F
authors.lastname: Guadagni
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
authors.forename: Pasquale
authors.initials: P
authors.lastname: Abete
mesh_terms: D000367:Age Factors; D000368:Aged; D000818:Animals; D001921:Brain / Q000098:blood supply* / Q000378:metabolism; D002545:Brain Ischemia / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D019194:Ischemic Preconditioning / Q000379:methods*; D018696:Neuroprotective Agents / Q000627:therapeutic use
chemical_list: D018696:Neuroprotective Agents
keywords: elderly; ischemic preconditioning; mortality; stroke; transient cerebral ischemic attack